Mazzi

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....

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 ver...

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 informa...

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 ...

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 wit...

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 goi...

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 i...

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 ...

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. ...

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 ...

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. The...

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 no...

I am a Hospice nurse and see horrible things happening to my patients that believe radiation is going to help with the pain. I have yet to see this....Why do Doctors even suggest this. It seems like it gives them false hope. As I only see those that ...

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-wor...

Patient is asking about marijuana use for his cancer/brain mets pain. His asked me for dronabinol/Marinol and how many he can smoke in a day? How would you persue this if it was you pt?

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 can...

Picked up a hospice pt 5 days ago that stopped TPN that day. Guess what?? He ate po (few bites) of potatoes and green beans yesterday and had two eggs and toast for breakfast today and is feeling better. Dx: ES liver disease (from TPN....hmmmmmm).

It is very hard to change the mind set that Nursing School teaches you about how to take care of the patient. While in school, all thought is about keeping the patient alive. But with hospice it is allowing the patient to die comfortablely. That is w...

Our hospice uses Hospice Pharmacia based out of Philidelphia. They over night meds. Our Comfort Kit has phenergan (tab and supp), Tylenal ( supp), ABHR (supp), Roxinal liquid, Haldol liquid, hyoscyamine tabs, and ativan Tabs. NO injectiable. We go fo...

I am finding oncology departments offering chemo and radiation as a form of palliative care for pain, n/v, ect. This is very high cost. With what the govenment alots for Hospice Medicare Benefit to be paid to the hospice organiation, are you finding ...

Great question!!!! The non-profit hospices end up taking the uninsured, non medicare, non medicaid pt. You would not believe how many people fit into that catagory. Persons that are hard working, have assets should not have to deplete all of their h...

As a hospice nurse going into the LTC facility, I try very hard not to "take over" the care from the staff. My duty is to be the second pair of hands, if needed, give my expert advise or recommendation to the staff, support them and help them any way...