twinkle_ears

The company I work for utilizes this form of charting. The system is very user friendly, mostly checking boxes. I went from paper charting to computers and at first I thought the same that it would take away from the intimacy. I have found however that the pts nor the families seem to mind. Our laptops are notebooks so the screen flips down on itself and doesn't look much different than the clipboard I used to carry. It is nice too to have the complete chart in front of you. Makes recerts and case managing much easier. It does have some negatives though mostly technology problems. Batteries going dead, program running slow. And when a family is rushing me out the door (not very often) I just finish up in the car before moving on. It does take more time, so we don't see as many pts in a day.

what a pain. i completely feel for you. whenever i get a hard script i make a photo copy and place in the pt chart and write on it original to pharmacy. its the law that the pharmacy have the original. you can find a list of all cii and ciii at dea.gov and follow the links on the left for scheduling of meds. this isn't just pain meds but it is a list. also there is a link to the dea guidelines/laws for when a pharmacy is allowed and not allowed to dispense. this might help your office staff understand that the original must go to the pharmacy. we also just had an issue were a pharmacy wouldn't fill a cii even with a hard script because "it was too soon" so we now have to write "terminally ill hospice pt" on all hard scripts even though the script pad has our company logo on them. a final note i would be concerned about switching my pts from cii to ciii because of the obvious; pain. i just invision my case load all having uncontrolled pain at the same time because i switched meds. which means a bad day for all involved.

Hey! I completed the PN program at PHCC 5 years ago. can tell you that my start date was changed 3 times in about a month time. However 5 years ago my original start date was like 3 years later. There was huge waiting lists. Anyhow; I started in August and didn't have orientation until like July. They gave you no time to prepare for what was happening. When I asked they just told you to attend orientation. And I didn't really know my schedule until the first day of class; we all showed up and the teachers handed out the semester schedule. It was crazy but worth it. Good Luck.

I work for a hospice that has a very structured IDG and we have cheat sheets. We start with dx, comorbidities, any changes since last IDG, any spiritual or psychosocial issues, and end with why they are still meeting hospice criteria.

I have always been taught that the FAST scale goes from 1 to 7 and you can not go forward without having the previous on the scale therefore, someone that is A&O x3 cannot be a 7C because they are able to speak more than 6 intelligle words throughout a day or conversation. Even if this pt can't walk. If they were incontinent of both B&B they would then only be a 6E. Therefore you cannot use dementia as primary dx. This has caused many a long recertification because our hospice docs will fight tooth and nail to make sure they do not speak more than 6 intelligle words. The person must have severe dementia to use this as a hospice diagnosis and just because they cannot walk does not make them a 7C if they can hold a conversation with you. Hope this helps.

i believe that the university of south florida has a combined program. the way i understood it once you begin your bn you can apply and start your msn. hope this helps.

This is my first reply but after being up all night reading this thread it made me remember a couple of funny stories that happened to me so I had to share. During my clinicals while still in school I was assigned a pt that was going for a BKA due to a wound that had become necrotic. I was very excited as I got to go into surgery with her to watch. All went well and she returned to the floor. The next day I was assigned observation in same day surgery and was talking with the nurse manager she asked what I had gotten to do during my clinical rotation very confident I explained the previous day I had seen a BKA due to a nephrotic ulcer. The anesthesiologist was sitting next to us and had obviously been listening looked up with this very puzzled look on her face and said do you mean necrotic? I was mordified. Needless to say I never forgot necrotic again. After getting my first job in LTC I had a pt that was actively dying I had no idea what to do so I went to the CN and explained that the pt in room so and so was molting. She looked at me and said "like a bird?" I had a strange look on my face and said no like when their skin becomes discolored purple. I couldn't believe this women was a CN and didn't know what molting was. She politely informed me to call the MD and let him know the pt is "mottling". Never forgot that word either. And finally this didn't actually happen to me. A nurse I worked with at this same LTC facility comes out of a pt room laughing out loud. She comes to the nurses station and says that she was disimpacting "Mary" a very pleasantly confused dementia pt whos husband had passed away many years ago. The nurse states that every time she went to remove stool that Mary would yell "Oh George", her late husbands name. Finally the nurse had to explain that she was not George. Mary turned her head slightly to look at the nurse and stated "I know George would never do me this way." I am no longer at this facility but every time I have a bad day I think of this story and it makes me laugh.