Brightonrn1

Having a extensive background in the icu, has afforded me increased confidence in the field. When you have a background in staff nursing whether micu or a medical surgical floor, you develop critical thinking skills. That is something that comes from experience. That said, you should always following your heart. Do what you love and its never considered work.

Go straight for your BSN. I too am a ADN and now at 47 with four kids, I am stuggling with going back. No time for me. only working and taking care of the kids. Go now for it! you will never regret it!

Looking for some advice: I will make this brief. I have been a nurse for 24 years. Twenty of those in the micu. I have been a certified hospice nurse for going on five years. Love my place of employment, love my manager, Drs, etc. Here is the deal, recently i have been case managing assisted living patients five actually. The patients are Dementia patients. Which is fine, but I am bored out of my mind. I so enjoyed being in the field more and going around to people's home. Currently I have four patients in home care. The rest are assisted living and skilled care. I have experience but again I only has a associates degree. Started back online school for a BSN but working and taking care of four kids left me in tears and I quit after three classses. Any advice out there?

I took the exam two years ago and found it to be harder than the questions in the study guide. Just like boards, its all about test taking and choosing the best answer. There will always be two that will leave you guessing. Its a great certification and preparing for it made me a better hospice nurse. Good luck to you!

Thanks for all the support. Things were better today. Pt is very comfortable. Eating less than two weeks ago but VS stable and caregiver seems tolerate at this point. I truly felt that roxanol would have been better but I could bet my life on it that the caregiver would not have given it. Very old world and old school. Afraid of the M word. Again, thanks all!:heartbeat

I can tell you that would will not like it either. are we not professionals? Can you even imagine giving one of these devices to an executive or an attorney? No, lets give it to the nurses? Our work is so mentally draining that it does often require us to stop and relieve ourselves and also get a cup of coffee and stop and smell the roses! Our agency will be starting computer charting in the next six months. I wondering how our monitoring will change. There are bigger issues out there than knowing the exact location of nurses who are doing such profound work.

We ordered a 12 mcg Fentanyl patch for our bedbound end stage Parkinsons disease and Dementia pt who was taking 3gms of Tylenol daily for generalized pain. she was moaning in pain prior to this change with also increase bp and heart rate. Has anyone out there seen someone not come around after over a week with the Fentanyl patch? By this I mean, she has a decrease appetite, not as responsive, and generally not the same. Although no further moaning when turned. Caregiver is really upset at me, the nurse, for suggesting this change for the pt. What have other hospice nurses seen with low dose Fentanyl patches?

Please everyone, it was just a question. I certainly did not want to offend anymore. Really! Yes, I am a former micu nurse who always took excellent care of the pts who had to be surrogated from vents. I spent countless hours with families helping them and just being a ear. I too have had family and friends use hospice and am no stranger to death. Believe I was fine on my own. My co worker is the only one of its kind in our hospice. I will use the suggestions given to be by all. Yes I will talk to her one and one. Maybe I was quite to judge. I should view this arrangement as more of a blessing then a burden. I will update when all is worked out. Thanks again

:angryfire:bugeyes:As a Hospice nurse, I have been always educating myself on good case management, symptom relief and of course social, spritual, and psychosocial issues. I have found what I love to do. I am currently with a LPN and we share our pts. I see them once and she sees them once in a week. The issue is She is questioning all my orders. Even though I have discussed everything with the NP and The MD. I am not feeling that she is asking because she is curosity as to why but more or less because she does not agree. This arrangement is ruining my days at a job I love. I am feeling stepped on and disrespected. Quick example, we have a pt who is declining. she saw the pt today. Its been hours since that visit and she is yet to call with an update for me. I even called the pt and she had been there for over 3 hours. That was five hours ago. I cannot work like this. I really want out of this arrangement but I feel like I am dumping on the other nurses if I dont continue to try. It seems no one really wants to work with her. Even the nurse that did who moved spent the last year complainting about her and saying she was leaving so let it go. I cant. I cant work with her second guessing all me decisions. I am a very experience RN with 20 years in micu. Although, not hospice I still can learn and always will. I know what I am doing. Any words of wisdom out there!!!! Not many to talk to about this, I feel like a lost sole......

I have learned from experience recently, that we can only make recommendations for pain relief. Sometimes, we have to step back and continue to let people have control over their death. That being said, we can continue to listen. Giving them an open ear is one of the best medicines. I hope this helps.

Going to take the exam soon. Can anyone who has recently taken this exam and passed recommend books to study from? any and all help very much appreciated Thanks in advance

I have joined this evening and was just about to post this same question. I have been in hospice for over a year working as a case manager. Recently an Lpn was assigned to case manage with me. she is very knowledgeable but we do not think the same. It is becoming a issue because she will see a pt once and then I will and somehow we are not on the same page. We are two different people and I fear that this is not working out so well. She is the only Lpn at our agency. Although she is very experienced in hospice over 5 years, We seem to be tripping over each other. Can anyone offer any ideas to make this partnership work???