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RNWithAHeart

RNWithAHeart

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  1. RNWithAHeart

    Core Measures Auditor

    Hello, I am looking for any Core Measures Auditors out there or anyone that is familiar with this type of data collection. I am an RN ASN who has been performing WAH Core Measure Auditing for the past four years. Due to many different variables, the auditors with our company have had their current workload reduced. I am at about half of my normal workload. I am wondering: 1) Do you know of any companies that hire WAH Core Measures Auditors? 2) Maybe this is a good time to go back for more training. What would the natural progression from this job be? Doing this WAH for the last 4 ears, I have really been "on my own" so to speak, so I am not sure where to go next. Telehone Triage? Coding? BSN? MSN Infomatics? There is so much information to sort through, just trying to get another professional's advice. I am also in a non compact state so that seems to have an influence for availability for telephonic positions. Any help or guidance would be greatly appreciated. Thank you!
  2. RNWithAHeart

    Question of changing fields

    Hi there, I am an RN with experience in telemetry, med surg, oncology, renal, and most recently hospice. Thinking of taking a position in L&D for a change......being at the other end of life-death. In all honestly, I have always had a strong interest in L&D and NICU, just other opportunities got in the way. To others who did not start out in L&D, and may have had similar backgrounds as mine, how difficult of a transition would this be? How long of an orientation should I expect? How long will it be until I feel somewhat comfortable? Any tips/hints/advice from anyone here would be greatly appreciated! Thanks!
  3. RNWithAHeart

    Sticky situation.....please help!

    Hi there, Patient does not qualify based on evaluation, however, I am told that she has advanced ESRD....with labs to back it up that should qualify her. But, I am not seeing that picture just by the visit without any documentation. Non compliant in many areas.......missed frequencies....non compliant with many of the COPs (one example....medical director not being present for IDG.......maybe over the phone and then somehow he is there to "sign" the paperwork without stepping foot in the building. Patients are well cared for and the benefit portion of the COPs is followed well........most of these issues are with in the office with documentation, care plans, idg updates, etc. I should be supervising these things, but spend the majority of my time out in the field seeing patients, doing admits. I am DCS, but have a patient caseload.....am on call 24/7....if not directly, always back up, but have been doing call about 20 days out of 30. Also working 60+ hours a week. I just cant keep up.
  4. RNWithAHeart

    Sticky situation.....please help!

    I am going to cut to the chase here. Working for a private hospice agency.....1 year old. Very good people/intentions, but very poor upper management skills. Think business plan was not well thought out......have been extremely short staffed.....because..."this is a start up"....blah, blah. Now the company is out of compliance with regs in so many areas. Upper management is aware but not making corrections. Last straw, I was asked to do an admission with NO records. Just told the lady qualifies.....go out and admit her. I literally did not have 1 sheet of paper on this woman. Oh, did I mention I am the DCS? I know I need to get out of this company and fast......do I report this company? It is SO sad because we give excellent patient care.
  5. RNWithAHeart

    Question

    Hi, I am a RN Case Mgr who has a pt and wife in their early 50's, both with mild MR. His hospice diagnosis is pancreatic ca. He is independent at this time. He wants a "meeting" with his RN, MSW and the Chaplain and his family to "talk about cancer." We are planning to meet with him later this week. His wife does not want to discuss cancer. As I said, the pt has mild MR and I have tried asking him what specific things he would like to discuss about cancer, he just says everytime "to talk about cancer." The MSW, Chaplain and I are not quite sure how to proceed with this meeting, we are all fairly new to Hospice (within the last 6 months) and we woulod appreciate any insight/suggestions/input you could give us. Thanks:redbeathe
  6. RNWithAHeart

    Meds during dialysis

    Hi, I am a hospice nurse and have a 50 year old end stage renal patient. My question is, she has alot of pain (from other co-morbidities) and has prescribed pain meds for Q4 hrs. She is usually at dialysis for her runs for around 6 hours, and she is not permitted to take a pain pill while she is there, she cannot have 1 sip of water. In fact, according to the patient, she had to fight with the dialysis nurses in order to be able to take her scheduled insulin. I have prior tele experience and when our patients went up to dialysis, we would send up their breakfast and they would eat while they were having their run. This patient says she has seen the nurses literally pull a piece of hard candy out of another pt's mouth. Is this standard practice during dialysis, and if so, could you tell me the rationale so that I can explain it to my patient? Thanks for your help!:redbeathe
  7. RNWithAHeart

    I need some help

    Hi there, I am sorry that no one responded to your post. You are not "only an LPN" you are a nurse no matter what initials follow your name! I agree that I do not understand why people need to hurt each other, some people are just malicious. I think that most hospice nurses that I have come across are very gentle, kind people, but I guess there are a few bad apples in every group. I don't know what advice I can give you, other than to try to stay strong and keep up the prayers. You are in my prayers and I am sending you big ((hugs)). :heartbeat
  8. RNWithAHeart

    Interview with Hospice tomorrow

    Hi, I took the position of RN Case Mgr. Can't talk alot right now, getting ready for work, but I have been there for a month. I think the company has their head on straight. My branch is growing like crazy and had a census of 27 in Dec....we are now at 78. So, with that comes growing pains. But, I am happy so far. But I can tell you.....I have lots more paperwork than I ever expected! Good luck with your interview, let me know how it goes!
  9. RNWithAHeart

    Straight weekend call

    This is Hospice (in home) call.
  10. RNWithAHeart

    Straight weekend call

    Hi, Anyone have experience in working straight weekend call only....Fri at 5p until Mon at 8a? I am not sure if it is salary or per diem. They are offering this position at our office and was just wondering if other companies do this and what kind of pay should be expected for that type of shift? I am sure that there would be scheduled visits on Sat.:loveya:
  11. RNWithAHeart

    Standing orders/protocols

    Hi, Here I am again, begging for answers! New to Hospice for only a month. Is it standard for Hospices to have standing orders/protocols? I was told we have none and I think that is strange. If you have standing orders, could you tell me what type of things you have them for? Thanks again:redbeathe
  12. RNWithAHeart

    implantable defibrillators/pacers

    I have just entered into Hospice, came from a telemetry background. I have seen many occasions in tele where a pt is being discharged to Hospice and the ICD is turned off before they are discharged from the hospital.
  13. RNWithAHeart

    Help

    Hi everyone, As a new Hospice nurse I am looking for a book to carry with me in the field as a resource for symptom management, etc. I looked through the "recommended reading..." sticky, but was unable to get a good idea of a book for the field. Can anyone tell me of a good resource book for a new Hospice RN? Thanks again, you are the best.:heartbeat
  14. RNWithAHeart

    LPN with no hospice experience?

    Hi, I just started with hospice a few weeks ago. I am an RN who had 1 year of telemetry experience prior to this. You can get a job with no hospice experience. Hospice was my dream job.....I had a very specific plan.....I was very sure of my goals and I had researched hospice and its philosophies and I feel I was chosen/hired for my beliefs. I wanted a year of hospital nursing first, and honestly I started in Hospice 1 year to the week after I started in the hospital. There is also an RN in our company who I graduated with that was a LPN prior to being hired and was hired right out of school. Best of luck to you with school (focus on that now, you need all the energy you have to get through) and then follow your dreams.:heartbeat
  15. RNWithAHeart

    LTC Question

    Thanks everyone for the responses. These pts were non verbal as in 1 has end stage MS and has not spoken a word in 10 years. 1 is Alzheimer's, 1 is post CVA, and 2 are dementia patients. As far as training, I have had 5 days of training with 3 different RN's. We saw pts in the home setting, AL facility and LTC. These pts that I saw on Friday will not necessarily be on my caseload, they are having me go out on my own now to get "routine visits" down. I am evpected to be given a caseload in about a week I guess.
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