a21chdchic

a21chdchic

Hospice, Med Surg, Long Term

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All Content by a21chdchic

  1. Hospice Pharmacia- wounds

    a21chdchic replied to nurselearner's topic in Hospice, Palliative

    We use HP for our medications, but not for wounds. I did not realize they also offered this service. Thanks for the info. HP is great, they have their formulary book that you can look things up in,...

  2. What to do??????????secretions.....

    a21chdchic replied to AtlantaRN's topic in Hospice, Palliative

    We only use suctioning for bleeding problems. We don't use scopalamine patches either. We use levsin and atropine drops. The patches are expensive, levsin is effective, and suctioning is not...

  3. Hospice On Call Compensation Structure

    a21chdchic replied to Katillac's topic in Hospice, Palliative

    I'm salaried, week night call is $10/hour, w/e call is $12/hr. Get $25 for an afterhours admission and mileage, that's it. Katillac - I'll bet your Hospice is 'not for profit'?

  4. Is this practicing without a license??

    a21chdchic replied to rnkalee's topic in Hospice, Palliative

    Everyone is right, do need the order. Just do what needs to be done, then get the order. A good med. director will back you up, as long as you can give a good rationale to back you up.

  5. How is your medical director?

    a21chdchic replied to ShayRN's topic in Hospice, Palliative

    I love my med director too. She is wonderful. Very knowledgeable, wonderful teacher, and allows a great deal of autonomy. I tell her what I want or write out the order and she just signs it 9/10...

  6. REAL Pain or ADDICTION?

    a21chdchic replied to captain morgan's topic in Hospice, Palliative

    You need to fully assess pain, what kind of pain is he having? Somatic, Visceral, or Neuropatic - or a combination of 2 or 3? Lortab and Fiorcet both have acetaminophen, and you can OD on too much....

  7. Anyone else Salaried here?

    a21chdchic replied to AtlantaRN's topic in Hospice, Palliative

    No comp time, just salary, mileage, and straight call pay. Extra $25 if you do an afterhours admission. And that's not even an hourly wage. Admissions usually are at least 4 hours work, so $25. is a...

  8. methadone therapy for cancer pain?

    a21chdchic replied to ceelynncee's topic in Hospice, Palliative

    6-26-2007 I work with Methadone on a daily basis and find it to be very effective and useful as a long acting med. It may only be titrated up once Q 5-7 days due to the long half life. This must be...

  9. How many pts do you care for?

    a21chdchic replied to FrankieJane's topic in Hospice, Palliative

    6-26-2007 We aim for 10, but usually have 12-13. This is plenty. To have more than that and be pushed, I'm guessing you work for a 'for profit' organization. The difference is working for a 'not for...

  10. First Hospice Experience....enough to bring a man to tears

    a21chdchic replied to Atl_John's topic in Hospice, Palliative

    6-26-2007 Don't fret too much, Hospice isn't for everyone. There is a niche in nursing just for you. You may have to search a little to find it though. Good luck in all endeavors.

  11. How often are you on-call; scheduled weekend visits?

    a21chdchic replied to Caffeinated's topic in Hospice, Palliative

    6-26-2007 On call on w/e is 24 hours at $12/hour. We do scheduled visits, referrals, admission, and take calls that sometimes require unscheduled visits. Our census is usually around 70, we have 7 RN...

  12. Does patient need to know the diagnosis?

    a21chdchic replied to Ms.RN's topic in Hospice, Palliative

    6-26-2007 Number One - Is patient capable of understanding the diagnosis and prognosis? Number Two - Does patient want to know? How honest does the patient want you to be? This is what I would...

  13. Oncall pay

    a21chdchic replied to hospicemom's topic in Hospice, Palliative

    6-26-2007 I work for a 'not for profit', and our call sucks! If it's a weeknight, we get $10/hour from 1700 - 0800. From Friday night to Monday morning, I get 12/hour. Friday night to Sat morning, or...

  14. Anyone else Salaried here?

    a21chdchic replied to AtlantaRN's topic in Hospice, Palliative

    6-26-2007 Salaried positions suck! I have put in 60-72 hours a week every week for the last2 1/2 months. I'm getting tired and burned out! I love my work, but when you increase the number of hours...

  15. Projectile Vomiting just prior to death

    a21chdchic replied to EmptytheBoat's topic in Hospice, Palliative

    6-26-2007 My first instinct would have been to question a bowel obstruction also. We usually order 'comfort packs' that include compazine suppositories, although phenergan isjust as good, For those...

  16. Problem facility giving poor care

    a21chdchic replied to wonderbee's topic in Hospice, Palliative

    6-26-2007 I am so sorry for what you are experiencing. I am in a very similar situation. I frequently write 3 medication errors a day in the same facility and frequently the same patient. I write the...

  17. primary diagnosis and co-morbidity

    a21chdchic replied to Hospice Nurse LPN's topic in Hospice, Palliative

    6-26-2007 The Hospice RN Case Mgr. is responsible for the whole patient and seeing to all areas of the patient. I, as a Case Manager, assess the whole patient and would expect anyone who seen any of...

  18. Evaluation question

    a21chdchic replied to Rnmomajmj's topic in Hospice, Palliative

    I have to agree with the last writer. 21 pounds is alot of weight to be losing in 5 months. This is a significant decline even if it is not 10% of her body weight. I also agree with her that you...

  19. Should Patient be Revoked???

    a21chdchic replied to AtlantaRN's topic in Hospice, Palliative

    6-26-2007 It sounds like your Hospice is "for Profit'? That would be why your marketer is getting ugly. As far as revoking goes, we let patient's/families know upon admission that if they choose to...

  20. Hospice nurse advice

    a21chdchic replied to cherokeesummer's topic in Hospice, Palliative

    6-26-2007 Hospice patients do need to be turned every 2 hours to prevent skin breakdown. After getting the breakdown, it may or may not heal. So prevention is always the best policy as repositioning...

  21. Hospice nurse advice

    a21chdchic replied to cherokeesummer's topic in Hospice, Palliative

    6-26-2007 You really need to start with a very thorough assessment of the patient, carefully evaluating pain, medications, how long he has been on each medication, etc. It sounds like he is on a lot...

  22. wound odor

    a21chdchic replied to nurselearner's topic in Hospice, Palliative

    6-26-2007 There is something that we do in our practice - after dressing the wound, you can sprinkle baking soda on the dressing (only the dressing). This helps a great deal.

  23. So, do you have another job as well?

    a21chdchic replied to callygirl's topic in Legal

    i think most LNC's keep their full time jobs until they can support themselves with the consulting. i will be taking the VMI course this oct., and i'm worndering if i should move to a metropolitan...

  24. What is........?

    a21chdchic posted a topic in Legal

    Siri, what is AALNC and ABA? What do these letters stand for?

  25. Oct VMI course in Vegas?

    a21chdchic replied to seattledeb's topic in Legal

    hey fellow vegas trippers, I know waynesvillern is going in october, and i am too. i'm from az. where r the rest of u