Mazzi

Federal guidelines state to place narcotics in cat litter or coffee grounds to dispose narcotics.

We have a disscusion at work regarding the Hospice nurse picking up the patients medications (some narcotics). Some feel this goes against Federal Regulation, some State regulations, some that its OK. Does any one know were we can find the information on Transporting Medications? Thanks in advance.

The hospice I work for have been working on updating the way we do things for the past few months. Things are really going to change. Some are good and some will be very difficult to comply with. One of our local facilities is not at all happy with our changes. But they need to prepared due to the COP's will next be made to fit the facilities so when all is said and done, the plan of care should match. EVERYONE that works for hospice needs to start now getting used to the changes. Hope this can open some eyes to changes to come.....

When you find a way to shorten IDG let me know. We average 40-50 pts and takes 2-3 hours and that is keeping to just the basics. Medicare is really starting to look to see that EVERYYHING is passed through IDG. So as things go along it is only going to get worse. Back to the old saying "If it is not charted it's not done".

My day sounds like yours. I work three days a week and have had up to eight pt. I felt like I was drowning. Right now I have six and only two at the time are actively dying, so I am OK yet still have to do some work (ex. IDT notes) at home. It is even worse when you have a lot of faxes out to DR for orders and they all come back in about 5:00pm ( that means staying overtime). Home office doesn't like this but "Oh Well". Yet today I was able to spend extra time with four different Pt/families just giving emotional support. That to me is what nursing is all about. I keep telling myself I would not be able to do this is I had a hall full of pt's wanting their meds. I love my job. That passion keeps me going. And learning to ask for help has helped. Good luck in all you do.

Here in Indiana we are being preped for the Medicare changes coming up for Hospices. Have any of you been through the Nuts and Bolts? One of the things it talks about is going back to the SOAP charting. The Government is wanting clear charting as to what they are spending our money on. It is a good thing but is going to change the way we all do things. I am interested in knowing others thoughts on these changes.

All my orders are written in triplicate. Original to DR, Yellow to chart/MAR, pink for me to remind me to place on IDG note. Works great!!!!!!!!!

I would recommend being a field nurse first in order to grasp the whole realm of issues dealt with by patient and family. There is also the area of payment that you would need to understand. Example if pt was Medicare, Medicaid, Private Insurance. Then you need to understand DME's, the different types of any supply. There would also be the underdstanding of all the different interdisiplinary support staff, Chaplin, MSW, HHA, and voluteer. If your background is Home Health, this would make it a little easier to understand the pt/family needs. Hope this helps.

I am a Hospice nurse and have pt in LTC. I hear about TAGS, but do not know what these are or where to find how to get information of them. Are they from state or federal. Please help?? This is what I do know- the DON fears them.

When State Board of Health sets such strict guidlines on safty issues, how do LTC facilities keep the resident safe? I work for a hospice and have pts in a LTC facility, I have three pts for various reasons get out of bed. OK, fall out of bed. They are in a hi/lo bed, 1/2 side rails, mat on the floor beside the bed. In some cases, the bed is up against the wall. (Which I am told is considered a restraint by STATE). And still the pt rolls out of bed, or falls. The LTC DON is asking hospice to DO SOMETHING!!!! What more can be done??? Help please. I have PT/OT evaluation set up but not scheduled. Of course, medicating with Ativan (example) is also not an option. I need ideas....

The LTC I work in as a hospice nurse expects our IDG to do most of the work. Of course, we are in the building maybe a total of 6hr a week. That leaves a lot of hours that the LTC staff must care for the pt. If any thing goes down, we may or may not be notified. Then when I make my next visit, they are all over me to fix it. Ex: pt rolled out of a Hi/Lo bed with 1/2 side rails, and mat on the exposed side of the bed. Two days after the roll out, the DON calls and says "What are YOU going to do about it." Did I mention that State is in the building almost monthly. I have had home pt and now totally LTC pt and am ready to as my coordinator to state giving me back home pts. It's is much easier!!!!

What are the guidelines for taking an 02 saturation? Is it no longer considered a nursing measure? The hospice I work for is now saying it must be a doctor's order in order to take it. They do not consider it a nursing measure. What is the concensus of the readers on this issue? Also if it needs to be an order, then it must be specific as: PRN for air hunger or dyspnea. If the family asks for it would you take it without an order? Then, would you chart it? Is it really that big of a deal? Please let me know how you feel on this issue. Thanks.

This may not fit this forum but here goes. A pt with ALS, still able to use slide board to get into w/c, is having (how do I put this delicately) finishing what his wife can start. Is there some medication that would help with ejectulation? It is very disturbing for him. With ALS he has lost control (little by little) every function. But this especially seems to be hard for him to deal with. He is also new to Morphine to assist with his breathing. Could this also be causing a dysfuntion with sexual performance? I thought may this site would most likely be able to help since it is a neuro disease.

I work for a company that recently requested all the employees to sign a concent for Consumer and Investigative Consumer Reports. If you sign this consent you are consenting for them to obtain information about me from corporation, employers, co-workers, references, credit reporting agencies, educational institutions,licensing bodies,courts,law enforcement agencies,governmental agencies or departments, and military sevices to provide information about my background, including but not limited to driving records, court records,credit report,academic records, professional license record, and employment related information. WOULD YOU SIGN THIS???? Incorporated in this concent is also the authorization for them to conduct an investigative consumer report obtained through interviews and may contain information about my character, general reputation, personal characteristics, and/or mode of living. Would you sign this concent???? I have a funny feeling about signing way so much of myself/my finances/my personal info.

I have a patient asking about Vitamin B17. She states the only place she knows about that she can buy it is in the UK. I do not know much about this vitamin and its use for cancer. Please, does any one know of some one that has used this and what cancers does it work best against? I have found very little on this in the US. Most places I find to purchase Vit B17 is on other countries. It is safe? Does it work? Any info you have would be appriciated. Thanks in advance.