PeacePisceRN

I have to agree with the last post...as a night on-call nurse...please have the equipment available for the patient if there is even the possibility of a need for oxygen. In my opinion, there is a possibility with every hospice patient. O2 is something that will be necessary (if only for the comfort of the family) for any change in breathing. Thanks to all the nurses who make it better for us at night! :bowingpur

our probe is finally over. :w00t: thankfully, my job survived...so far. but, we have lost many nurses and many others are so unhappy. the office is a most unpleasant place to be. everyone's nerves have been so on edge for the past several months. i don't know for how long i will still have this position, nor do i know how long i want to have it! :innerconf but, anabel, my thoughts are with you because the several months that this has been going on i have just been holding my breath waiting for the other shoe to fall. i can only hope that the census will now start to rebuild, but i hope this has taught the powers that be a lesson to better follow medicare rules and regulations! i certainly don't want to see this happen again!! best of luck!

Thank you for all your useful information. I think part of the problem is that any nurse on staff does admissions, and we are not all well versed in Medicare rules and guidelines. I do around 2-3 admissions per week, and I still don't understand all the regulations. I do my best, use my appropriateness worksheets, and if I have any questions, call the medical director to verify appropriateness. As for OB nursing...NOT FOR ME!! For some reason, I just don't think I could handle that. I was an ER nurse for many years prior to working with Hospice. It was a very hard decision for me to leave the ER because I absolutely loved it. :1luvu: But, now I love hospice and don't want to leave it. But, things will happen as they should. I don't carry a caseload. I work 16-hour on-call shifts at night. Even with a dramatic decrease in our census, the demand at night has not lessened. I just worry about the potential for change with the constant change among the primary day nurses and administrative staff. Thanks again!

i thought dead bodies would be bad for me too. but i have now been working in hospice for two years, and really, they don't! at a death, i treat that patient (yes even gone still our patients) as i would want my family treated at their time of death. i clean them up, change their clothes if necessary, and always try to place their bodies in positions which make them look comfortable and at peace. it is the last thing you can do for that patient and the families really appreciate it. i have found that hospice is the most rewarding job i have ever had, in healthcare and out of it. good luck!

I am in a metro area, and there are many other hospices in my area. The census has been hovering around 150 for about a month or so. There have already been significant layoffs in nursing staff (both RN and LPN nurses) as well as administrative staff. BUT, higher ups just keep moving higher up...in "restructuring" things. Seems staff nurses are disposable while managers and higher are just getting higher and higher.

At my agency, we only use FTT for a patient who can be weighed currently and has documented weights for 6 & 12 months prior. Otherwise, we would use the DX of Debility.

I work for what was formerly a large hospice (250-300 patients). Within the last 4-6 months, we have dropped over 100 of our patients due to a medicare probe...i.e. investigation of non-cancer diagnosis patients. We were told the LOS for most of our non-cancers was too high and so the powers that be have been discharging patients left and right due to being no longer hospice appropriate. Claims are being denied. This has resulted in major staffing cuts, etc. Has anyone else out there experienced this? Please give any details you know. I'm rather concerned for my job at this point. Didn't think I would ever be worried about my job in nursing!

My hospice does take on pediatric patients. And, by far, they are the hardest for me personally to cope with. I have never cried so much as when leaving the home of a dying child who was very close in age to my own daughter. I attended a weekend conference on pediatric palliative care at a university hospital in my area. However, I did not find it very educational in terms of treatment at end of life for pediatric patients. It was mainly focused on the emotional issues of the families, which is indeed quite challenging. Good luck!

The hospice I work for has 4 night on call nurses. Two work each night and alternate making visits. We (I am one of the night on call nurses) are on call for 15.5 hours weekdays (4:30p-8:00a) or Friday nights 4:30p-7:00a, Saturday 7p-7a, and Sunday 7p-8a. We are paid regular time +$2.50 as a night shift diff for 11.5 hours. We work 7 nights of a 14-day pay period. Essentially we are paid for 80 hours (per 2-week pay period) but available to see patients for about 110 hours. We are considered salary employees. We can be called out to make a visit as late as 7:30a and may be on that visit for hours with no additional compensation. Our census is around 150 and we cover 7 counties in two states. Sometimes I may drive well over 200 miles per night. We are compensated for door-to-door mileage as well. This would all be wonderful, EXCEPT, of late, we have been also starting our nights out with scheduled visits which may keep us out for 6-8 hours. Then, we are still on call for nearly 8-10 more hours! Sometimes, that is quite exhausting. At times this pay seems unreasonable with all the scheduled visits we are also making. Any thoughts?