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Mazzi's Latest Activity

  1. Mazzi

    Faxed signatures of physician orders

    Unsigned is the hand written copy of the order that the RN writes per telephone order and then sends this to the Dr. for signature per fax. Then he signs the faxed copy, faxes it back to our office and then the secretary will throw the hand written orginal away and file the faxed signed copy. I'm from the old school where the ink origianal is SACARED. HA!!
  2. If you (LNC) were reviewing a chart and found only faxed signed orders and no originals, would this be questionable? The organization I work for has started this practice. I really have a hard time throwing away the unsigned original written order. Our new Security Officer says this is accepted practice since the invention of technology, Computers, fax machines and PDA. Any input? Thank you in advance.
  3. Mazzi

    Faxing orders for DR. signature

    Does any one know a ruling on the legality of faxing the Doctor's orders to him and have him sign and return via fax with the signature. AND then THOWING AWAY the original. I'm refering to a telephone order. This is what my company is telling us to do. It seems to go against everything I was taught in nursing school. It was stressed that any piece of paper refering to the patient is considered a legal part of the patient's chart. Does any one else do this?? I do know that pharmacies will do this with perscriptions. But I still thought they had to recieve the original within 24-48 hours. Does this sound right??
  4. 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.
  5. Mazzi


    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.....
  6. Mazzi

    Proposed CoPs and admission process

    Last admission I did took 5 hrs. I am a 13 year hospice nurse. The day we admitted the same day as the referral is over. By the time you get Dr OK/order, set up with MSW a meeting with the pt/family, get living will, POA, Medical rep IN WRITTING, check with insurance, talk with pt/family, get approval, impliment POC, and then finally do you true nursing care like making pt comfortable, set up in the home setting or in the ECF. In between all this you do a little charting but know you set down at your desk to finish all the paperwork. YEP about 5 hrs.
  7. Mazzi

    Copies of original Orders

    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!!!!!!!!!
  8. Mazzi

    Some questions about Hospice Case Mananagement

    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.
  9. Mazzi

    Tags??What are they?

    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.
  10. Mazzi

    Help How to keep pts IN Bed

    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....
  11. Mazzi

    National average for pt caseload

    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!!!!
  12. Mazzi

    Hospice and Dialysis

    Thanks... the yes's have it. Thanks again.
  13. Mazzi

    Hospice and Dialysis

    Can a pt receiving dialysis be on the Hospice Medicare Benefit? I know that the primary diagnosis would reflect yes or no. Example: If the pt had breast cancer but also on dialysis, could you put her on HMB for the breast cancer and still have her receive dialysis treatment?
  14. Mazzi

    Final days:AGITATION

    Look for the obvious. Full bladder, stool inpaction.....
  15. Mazzi

    Breathlessness and lung cancer help

    No buzz....I have not found pt complaining of any s/e. It is not at all like systemic morphine. I works in the lungs only. I suppose a little amount actually goes into the blood stream but not enough to worry about. All I know is that most of the pts get relief.
  16. Mazzi

    PDA's and nursing software

    This is a new area for me. I would like to know what is out there and which are the best for a field nurse. Best PDA for this use? Best Drug/Medication software? Taber's? Thank you in advance.