new2hospiceRN

I started in Home Health and was suckered in to it when there wasn't any other RN willing to help out. Ends up, I love it. I like it better than Home Health. I actually feel like I am making a difference in an end of life experience for the patient and the family. I like all the dynamics involved. I enjoy the autonomy. I am only there to help and I haven't come across anything other than greatfulness. That is not the case in Home Health. There are lots of wonderful things I come away with as well. Life and our time here is precious. Always let those you love know you love them. Dying isn' fun to watch, but we all will have to do it. Why not make it pain free and have our loved ones around us. The support is essential. Use the MSW, Chaplain, and Volunteers, otherwise it can be difficult.

He is Diabetic and a Stroke pt. He isn't rapidly declining. Continent of u/b. His appetite is decreasing , but not any significant weight loss. We also have Home Health, I think that is what he needs at this point.

Thanks!! I think my gut was telling me that. I have found that sometimes Corporate is only thinking about the #'s.

Thanks again. I just started using an LVN this week. What a lifesaver good help is. I think every 2 weeks is perfect. I will still be able to check in and stay aware of changes in the pts condition. I have been the only one seeing the pts, so I am nervous about being out of the loop. This way I will still be in the field and able to manage the pts care. A nice mix. It will take me time to trust my LVN's judgement, but so far she has been good at calling me with report.

Thanks for the advise. I would love to have the pts records with the referral. I appreciate the help. Doing the eval and then getting the records seems so much more logical when it is at all questionable. You gals are great!!!!

I am salaried as a Director of Hospice, I am work 40 hours a week and I am on call 24/7. I spend most of my time in office and seeing pts. I leave early alot to compensate for the at home work of calls and med refills and general pt conserns. I am the only RN and I have a PRN LVN I share with our Home Health Services and I am glad to have her. Sure hope she lasts. I have one HHA I share as well. Currently we have 7 pts. I have no support staff of my own. I do all the filing, orders, DME, audits, etc... This is truely a one woman show. I do have a Chaplain. I am without a MSW. I have no computer. Coroprate has not been receptive to my pleas for help. They want to do more with less. I am not sure how long I will last here with out the TEAM that is required to provide even the minimum Hospice Care.

I have a pt with a PSA of 6.9. He is not able to tolerate surgery or biopsy. The family doesn't want to seek tx. With no pathology should he be on Hospice? His family says he has prostate ca, but how can they know this without a biopsy. I ran it by my supervisor and they want the pt admitted. I plan to speak with the Urologist. How bad does the PSA need to get to be terminal or is it not reliable in giving an estimated life expectancy. Is it possible for the PSA to be used alone to qualify a person with Prostate ca for Hospice?

Does anyone know the reg on how often an RN has to supervise an LVN and HHA in Texas according to Medicare Hospice Benifit guidelines?

I took on a Hospice Director position recently, and hope someone out there can help. Have you ever admitted someone and not had enough information to know if they qualify or it is a stretch? Without labs or history and physical or other documentation to support a terminal Dx --How do I know the pt meets criteria? I can assess and ask questions, but sometime they can't give me the info I need. I could wait on the PCP to get me the needed info, but that takes time. Are there any ways to not admit until PCP provides needed documents? I hate when it comes back that they didn't need to be admitted.

I just took a Director of Hospice position 3 weeks ago. I am the only one. I am overwhelmed with the 9 patients I have. I was at 4. My boss has an add to hire an nurse and an aid. My MSW just resigned and the aids are unreliable. My team is me and the chaplain, no volunteers. I am trying to keep up with all the filing and med refills and overall problems with the charts. I have No computer and don't forsee one anytime soon. To do it all and give good patient care and family support is impossible. I have begged for help from corporate, but they think I am doing a great job---the census is going up. I am on call 24-7. HELPPPPPPPPPPPPPP!