saribeth

saribeth

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All Content by saribeth

  1. Deep Suctioning: Should We Do It At End of Life?

    saribeth replied to tencat's topic in Hospice, Palliative

    never, never, never....these poor pts have been through enough already by the time they come to us. :grn: Good that you listened to your

  2. c diff

    saribeth posted a topic in Infectious Disease

    Hi all...I have a hospice pt with c diff...I know about using universal precautions and using his own thermometer, is there anything else we should be doing...he has multiple skin tears that are...

  3. Non-Hospice appropriate patients admitted or kept on Hospice

    saribeth replied to Mamanurse62's topic in Hospice, Palliative

    I know that the nurses that work for profit hospices are doing a wonderful job and doing it because they love what they do. In my little corner of the world our VNA is really losing so many referrals...

  4. continuous care

    saribeth posted a topic in Hospice, Palliative

    Very curious about medicare's criteria for "continuous care." I was under the impression that it had to be a "skilled nursing" activity every 15 minutes. Could anyone clarify or explain what exactly...

  5. frequency on RN visits

    saribeth replied to americanTrain's topic in Hospice, Palliative

    What about when a pt is actively dying???? Don't you visit daily???? At our VNA the visits are totally up to the nurse. For documenting frequency in the POC we put 1-5x weekly x13 + 3-4 for sx...

  6. Taking care of ourselves

    saribeth replied to dalmos's topic in Hospice, Palliative

    I have "support meetings" every other month with the team. I play some calm music and we discuss difficult cases. Recently I have been doing some fun things...trivia questions, ice breaker type...

  7. Low Census

    saribeth posted a topic in Hospice, Palliative

    Hi kids...just wondering if your hospice census is on the low side...our home care is low also...

  8. Disposing of medications at time of death

    saribeth replied to RubyRN,CHPN's topic in Hospice, Palliative

    well get a load of what we do...our manager heard about this at a reginal meeting...plastic zip lock bags with kitty litter...dump the liquids, pills etc and patches (opened and folded in half) and...

  9. What Diagnosis would you say this patient is?

    saribeth replied to CANRN's topic in Hospice, Palliative

    What about Failure to Thrive or Total Body System Failure???? I know Medicare doesn't love those but heck, it is what it

  10. O2 safety

    saribeth replied to nrcnurse's topic in Hospice, Palliative

    I had investigated this a few years ago and the amount of petroleum in vaseline is very low compared to what it was years ago...so lather her up and make sure you have a fire extinguisher close...

  11. Bone Pain

    saribeth replied to RNSUEIA's topic in Hospice, Palliative

    We have had really good results with Dexamethasone 4mg bid..it increases appetite and gives them a feeling of "well being" (oxymoron I know)! What about a fentanyl patch starting with 75-100 mcg and...

  12. standing orders

    saribeth replied to hospiceheart's topic in Hospice, Palliative

    Upon admission we have the pts doc sign the SO...they are already signed by our med director. For our comfort pack SO, even though they have signed off on the morphine etc, we do get a new order if...

  13. ALS info

    saribeth posted a topic in Hospice, Palliative

    Hi kids...From what I can gather death can come rather abruptly with ALS and at times does not follow the "typical" s/sx of dying...Is that accurate? Any insight would be most appreciative...thanks...

  14. Discipline Frequencies

    saribeth replied to shrinky's topic in Hospice, Palliative

    This is how we write the orders: SN: 1-5x week and 3-4prn for sx management x13weeks MSW: 1-4xmo and 3-4 prn for distress Chaplain: same HHA: 2h 5x week x13 wks Volunteer: 1-5xmo and 3 prn hope that...

  15. Do you attend funerals?

    saribeth replied to Rnmomajmj's topic in Hospice, Palliative

    I do go to the funeral home if I am close to the pt and family (which usually happens) and I almost always write a note...I do it for me and I know the families appreciate it...professional boundries...

  16. Hospice Team Leader

    saribeth posted a topic in Hospice, Palliative

    Hi kids...our hospice is developing a team leader position...can anyone tell me what they do specifically? thanks and enjoy the final days of

  17. Paper or computer documentation???

    saribeth replied to andre's topic in Hospice, Palliative

    We use lap tops...the program is Clinical Novius but it truly is geared toward home care...they told us from the very beginning that it would not save time and boy were they right!!!!!!! I have a...

  18. Pain tool for nonverbal, dementia, alzheimers, and terminal patients

    saribeth replied to jyhn's topic in Hospice, Palliative

    We use the FLACC SCALE...We make copies for the families to have in the home so they can also do an assessment...just go on the web and type FLACC SCALE and pull up the Nat'l Hospice and Palliative...

  19. Assessing patient to prounce death

    saribeth replied to Ms.RN's topic in Hospice, Palliative

    We have a check list...absence of Pulse, Respirations, B/P, pupils fixed and dilated...even when the pt is cold with the waxy color I still go through the VS and really really listen for that...

  20. "The Jesus Factor"

    saribeth replied to FireStarterRN's topic in General Nursing

    hmmm I am a hospice nurse and I have a very deep faith, however...I only talk about the good Lord above IF a pt brings up the subject and I tread carefully. If I know they are Roman Catholic I would...

  21. Need tips when charting after the death of a patient

    saribeth replied to skittlebear's topic in Hospice, Palliative

    At our agency we have a check list...absence of P,R,B/P pupils fixed and dilated-all narcotics disposed of and witnessed by______(initialed) we notify the funeral home, MD, DME company, & HHA...

  22. Patient doesn't tell she is getting cataract surgery

    saribeth replied to AtlantaRN's topic in Hospice, Palliative

    I agree...medicare should cover the cost but make sure they know she is a hospice pt and that she has a

  23. Fentora

    saribeth posted a topic in Hospice, Palliative

    Hi all, has anyone used Fentora for BTP with their pts? It's the transmucosal buccal fentanyl...does it work and is it expensive?

  24. Huntington's Chorea

    saribeth posted a topic in Hospice, Palliative

    Hi all...I have a pt with Huntington's and he has developed these episodes of "coughing" that last for 3 hours plus and go into the wee hours...he does cough up small green mucous plugs (no fever) but...

  25. Help! What meds are not covered under hospice?

    saribeth replied to RN4hospice's topic in Hospice, Palliative

    We do cover all meds that are directly related to the hospice dx...even ambien (which does not work for our older pts and it is costly) Our comfort packs are $28 and THE BEST THING but we don't order...