sclpn

Since my original post we have hired an lpn and she has been a godsend. She helps with on call with an rn backup for deaths, she can work as the cna in the field and fill in as the aide or assist the nurse in the inpatient unit

PPS ECOG FAST

I agree with everything nutella said except be careful using fentanyl patches as they don't absorb well if there isn't enough subcutaneous fat...our MD will not use them on any patient that weighs 100 lbs or less and shows signs of muscle wasting.

Same here....Hospices are under great pressure to turn a profit, whether they are for profit or not. In my area the hospice competition is very fierce and I see "patient seeking" so much. I also see doctors sending referrals when patient/family keeps pressuring him for "help" in the home. The doctor knows the patient won't qualify for home health so he sends them to hospice and if hospice turns them down for services the doc office plays 20 questions on why the patient wasn't appropriate for hospice. It's sad but it's everywhere.

I feel your pain. I too, am leaving my hospice job of 6+ years. I've done case managing/on call, hospice house and clinical director/with 24/7 call during this time. Being a hospice nurse is my identity. I don't know how to change that and wonder if I will be happy in any other field of nursing. I have no answers for you, only more questions...I do hope to return to hospice nursing one day.

The company I work for has a 12 bed IPU. We have had a difficult time keeping beds filled, particularly with GIP patients, at times de-staffing due to no patients. Our choice was to close or contract with other hospices that does not have an IPU. We contract with them for respite and GIP. This has been difficult but it has kept the doors open and staff working

Most of the time if the haldol didn't work it's because the patient needed a bigger dose

I would imagine the op is asking regarding finding hospice nurses to work for that agency....and if that's the case, I don't know either. We have utilized ads in the local paper, online, job fairs etc and still find it difficult to secure applications for employment of hospice experienced nurses

Hello I'm a inpatient manager and I've done homecare and inpatient nursing. I did not rewrite anything that was already some place else...I didn't rewrite the prn meds given in my narrative because they were already on the MAR etc. I didn't rewrite my assessment in the narrative either. You are correct in thinking that the nurse should "paint" a picture of the pt however, documentating in multiple places will get you in hot water when DHEC/Licensing shows up. I encourage the nurses to document along this line also but find previous hospice nurses can't let go of this heavy documentation. How to fix it is another question... I have revised our nursing forms to take away things that are in multiple areas or on another form. Not sure about your facility but here the Medical Director is sometimes the driving force behind heavy documentation and/or documentating in multiple places.

Our medical director will not sign for pts comfort kit (crisis meds) anymore. Said she must have a "pt relationship"to write for c2 meds. She will do it in the occasional emergency but then she must make a face to face visit to establish that relationship. Can make for a difficult admit on an actively dying pt

Hi Would your hospice hire a new grad RN? We are a small nonprofit hospice with a hospice house facility. I'm considering hiring a new grad RN for the hospice house...thoughts??

My company hasn't allowed us to use debility in over a year. We were also told AFTT would have to stop being used over the next few months.

Hi Everyone I work for a not-for-profit hospice,and as most do, we struggle with funds/money. I was wondering what type of fundraisers your hospice does? We currently have an annual butterfly release and a bike ride that is very popular. Both, usually raise some much needed money that we use to care for our charity pts. What do you guys do to help raise funds at your hospice?? Thanks in advance!

Hi Im wanting to start some type of employee appreciation/reward program at my Hospice. Hospice can be very rewarding when dealing with our pts and families but I would like to find creative and inexpensive ways to show the employees that management cares also. Does anyone have any type of program in place, if so, how do you select which emplyee receives the award/recognitation or do employees nominate each other, how often do you present it, any info/ideas would be greatly appreciated! Thanks

Located in SC. no pay raises in 3 years not even a cost of living raise. Medical insurance has tripled over 3 years. I expect that it will increase again in March. (open enrollment). accrue PTO at 12 hours a month depending if you work 12 hr shifts or 8 hour shifts. Most 8 hr folks get 40 hrs per week while 12 hr people get 36 hrs per week. So that amount affects how much you actually accrue each pay period. Mileage is at the IRS rate and only changes if the IRS changes the rate they pay. Over 3 yrs low was 50 cents/mile. High is 55 cents/mile. I work for non profit. I dont know the answer to the money problems that all hospices seem to face but it doesnt make it easy to continue working without pay increases, especially since the cost of living keeps climbing..