debblynn13

Hospice nurse here. My perspective is ....life is too short to live in fear. I wear all the protective gear. Most of the time I ride in low traffic areas. Big on defensive riding...and I keep my insurance up to date...LOL. We just had a kid get ran over in the parking lot. Several people died or were sent to the hospital during our big RABRAI bicycle ride across Iowa. I won't stop enjoying thunderstorms for fear of lightening or tornado's and I won't stop riding my bike as long as I am able.

I am a 53 almost...year old nurse and I am the go to person if someone has computer issues. How did I get this "job"? I was aware of people and if they had problems I would offer suggestions, short cuts, even flow sheets. OP you can become the nurse that can be the helper and advance technology in your area or become the nurse that brings down the others and causes discord on the floor. Your choice. Debblynn

We have peer interviews at our facility. You have your HR interview and then the manager of your floor interview first. They send only the people they would hire to the peer interview. Unless they have several people to interview your chances of getting the job is very good if you make it to the peer interview level. I would get to the peer interview at 1145 or earlier try to be the first one in and then go with your family to the pinning ceremony. Even if you can't be involved at least you could enjoy watching your friends get pinned. Then you and your family could have your own private pinning and probable new job celebration afterwords. Trust me a job will feel much better than the pinning will.

We have been having the same problem and have been discussing how it could be changed to be more user friendly. We are one of McKessons test sights and give suggestions on changes we think would help. I would love to hear your assessment of the problems and suggestions on how to fix it. Debblynn

We have used a Duragesic patch and brought in one patch at a time and had the family put the old one in a baggie for us to pick up at the next visit. It is a difficult situation. Debblynn

I don't know, hot glue can be pretty dangerous. Make your own flour and water paste, much safer and you can eat it if you get hungry.

I am 52 yrs old and just started riding last year. Never thought I would ever ride, always thought it was too dangerous. I work in Hospice, maybe that is why I feel we need to live life as much as possible. I will admit I am very careful of where and when I ride and always wear my gear.

We supply linens with our hospital beds but we don't supply depends or disposable chux or baby wipes. I usually do have a few in the car for emergencies but it is expected the families will buy the personal items. Debblynn

Nice street clothes, no jeans and Lab coat. I admit I don't do the lab coat most of the time. I don't like advertising to the neighbors that I'm the nurse. Also I get too hot wearing a coat over my normal clothing. I have also had dementia patients that respond better to no coat.....and I had one that responded better to a coat. I do wear the lab coat into hospitals and into nursing homes at least until they know who I am.

Thou shalt not say to the resident...You don't like me and I don't like you.

Here is a list of activities an LPN can do. Iowa Board of Nursing Here is a generic cna job description.. CNA Job Description A Certified Nursing Assistant fulfills the need of patient care in hospitals or clinics where nurses may be assigned to 12 or more patients. A CNA can assist patients with ADLs so nurses can focus on what they must do with patients. A CNA observes patients conditions and reports back to the nurse. Work duties may include, but are not limited to, taking vital signs, moving patients, assisting with some medical procedures, feeding patients, and monitoring food and liquid input and output. A CNA is the eyes and ears of the nurse, and should always have a strong knowledge of emergency procedures and be able to stay calm in stressful situations. with additional education cna's can become med aides and give some medications in nursing homes. As a Nurse I must say I couldn't do my job without good cna's. They spend more time with each patient than I can and sometimes they are the first to notice changes. Debblynn

I am a full time case manager with an average load of 10 - 12 pts. We are a small nonprofit hospice connected with a hospital. We also have an inpatient unit. Currently we have 3 full time case managers and a full time admission nurse. Our supervisor also does admissions during the week as needed. I am expected to do on call one night a week from 4:30 pm to 8 am the next day. I also do weekend call every 4th weekend from 4:30 Friday night until 8 am on Monday. I do get the rest of Monday off after my on call weekend. We do admissions when on call both in the evenings and on weekends. Luckily we don't do very many on call but it is part of our job description. I've been doing this for almost 3 years and I am starting to wear out. I love my job and the people I work with so I'm hoping I'll get a second wind. I would love to have a dedicated on call person for even half the time. Debblynn

I agree with tewdles. It takes a special nurse to be able to take care of kids at end of life. I haven't had to take care of any children in my hospice career, yet. I feel that you need to know yourself really well. Will you be able to emotionally handle repeated deaths of children? Will the satisfaction of helping families learn how to make the child to be more comfortable and die as well as possible be enough to keep you going? Can you detach from the situation and still be emotionally available? It is a tough tightrope that some can do well, some can do, and others find they can't do at all. Do you have a good support system? Do you have a good healthy plan to rejuvenate yourself? On the hospice organization..do they have a good support system for you? do they have debriefings? I love what I do. I love helping families learn to take care of their loved ones. Could I handle a peds case? Probably but hope I don't have to find out too soon. debblynn

I've had my end stage copd patients that put the cannula in their mouth when they are feeling more short of breath. They swear it works better. Otherwise in the nares....curved down.

We have several patients in assisted living facilities as hospice patients. Most of the time these people become a high fall risk and the families and facilities do not want the patient to be moved. Some of the common advanced prevention efforts, baby monitors and personal alarms do not work well at these facilities due to staffing and area covered. I was just looking for some suggestions that you may have encountered when dealing with this situation.

I agree with everyone else. Also are you required to get sats? Those numbers will make everyone upset but they are normal for a dying person. We have taken the mask off people if it really irritates them and just medicated with the roxanol and ativan to keep them comfortable. Oh and use a fan to keep the air circulating and cool cloth on the forehead. Sometimes you have to play with things to find out what works the best for THAT patient. One other thought....we have admitted people to hospice and left them in the hospital as hospice inpatient esp if they are terminal. Is there a hospice that could come in and do that? If your floor doesn't want to have a hospice involved in care maybe they could have a hospice come do an inservice on end of life medications. A hospice nurse mindset is different than a floor nurse....goals are different. Good luck, Debblynn

We have been instructed that the medications are the patients meds and the family is to destroy them. We instruct the family to make a solution out of the pills and then mix it with kitty litter and throw in mess in the garbage. We still have them flush the fentanyl patches.

12 to 14 visits a day in a 4 county area? WOW, is all I have to say. Unless you have a bunch of visits all together in a nursing home I don't see how this is realistic. How can you give good care? I would definitely be looking for a different job with a better caseload. My boss feels 4 to 5 visits a day are acceptable considering rural drive times. If we have a bunch in a nursing home it could be a bit higher just because we don't have to drive between visits. Remind me to thank my boss for being realistic. Debblynn.... btw...look for a different job before you crash and burn.

We have been told that hospice is to supplement but not replace services given by the nursing home. So if the patient/client was getting a shower/bed bath 2 times a week prior to hospice then she still should be getting those baths as well as the ones your aide is giving. At least that is what my boss states medicare requires. I guess there could be exceptions I don't understand. debblynn

Hi Fran, I graduated from DMACC and worked my first nursing job at Methodist. I would suggest you try to get a job in a hospital. It would help immensely in your nursing classes. I just checked online and Methodist has quite a few clinical partner jobs. Mercy is a bit harder to see online. If you are taking your classes at Mercy you probably would have first chance at jobs there over people on the outside. My other suggestion is to take any none nursing classes you need before you start nursing classes. You probably have most of them done since have a degree already. If you have any questions about DMACC or the DM hospitals just message me. Debblynn

We use McKession and I think it is the most convuluted program I have ever seen. I feel I am better than average in computer literacy and spend quite a bit of my time helping others figure out how to use McKession. There is a lot of redundency and I swear they hide things that I have to do during admissions. *snicker* I do know that you can change and add things to McKession {not sure how much tho} so I guess with a good computer team you might be able to make it better. Good luck. Deb

Sounds like a very good possiblity. You can always ask the doctor about getting a referral. Make sure they give you a choice of hospice providers. You can always have hospice come out and assess your father. get the information and then decide later. It is MUCH better if we get a a person into hospice early so we can build a relationship and help control symptoms early on. Deb

We have the same exact script at our hospital. SOMEONE is making money on this one...LOL. Anyway I'm in home hospice and one of my patients prefers me over some of the other nurse because I don't say that "script". He is so sick of it after being in the hospital and hearing it thousand times a day. I have my own script. I always ask if they have any other questions or concerns, if there is anything else i can do for them and encourage them to call us at any time. But those are MY words not the same ones everyone is saying verbatum.:barf01: Deb

I looked at your past posts and see you are taking your LPN boards. You will find that most of the hospitals won't hire LPNs. I know Broadlawns sometimes does and the clinics do. There are a lot of nursing homes in Des Moines that are always looking for LPN's. DMACC based in Ankeny has an excellent LPN to RN bridge program. They have a parttime night program too. Just incase you are interested. Deb

Most of the nursing jobs in Des Moines are covered by the three major hospital systems in the area. Iowa Health Systems ( made of two hospitals Iowa Methodist and Lutheran hospitals), Mercy Hospital, and Broadlawns hospital. Most of the clinics and outpatient surgeries are branches of those hospitals. Broadlawns is the county hospital and pays the least of the three. The other two are pretty comparable. They all have websites with jobs and applications posted there. I was interviewed both by Methodist and Mercy after applying online. One warning tho, sometimes they aren't very quick and Methodist is slower than Mercy. Web sites. http://www.ihs.org/body.cfm?id=512 (Iowa health systems) http://www.broadlawns.org/employment.cfm (Broadlawns) http://www.mercydesmoines.org/careers/index.cfm (Mercy) Ames, Iowa is about 30 miles north and has a hospital there that has wages comparable to Des Moines. http://www.mgmc.org/body.cfm?id=362 I worked for Iowa Health systems on the oncology floor and I now work for MGMC in ames doing home hospice. What are you interested in? If I can help just ask. Deb