Keta

Anyone using EPIC for hospice charting? We recently transitioned and it has been quite the learning curve! Having experience in home health for years, I am very familiar with visit sets and how to do them. Our supervisory, who is basically a new nurse, insists that we schedule everything on a week basis (medicare week is Sunday through Saturday) to avoid missed visits. I don't do it and never have missed visits for RN or CNA. So even if your certification period ends on Wednesday, she still wants RN to enter 1x week for 1 week. She has no actual rationale for this. I won't schedule outside of my certification period. She just can grasp the 1D4 so she wants to make up rules as she goes along. Does anyone else have this issue?

As vampiregirl said, this will depend on several factors. I work in community hospice as a case manager and we are paid hourly and have a GREAT & active union. Where I work, Case Managers and Admission Nurses often put in extra hours due to patient scheduling wishes and fear of not meeting "visit expectations" (number of patients seen daily). Personally, I do not worry about this as I can account for all of my work hours. If you want to maintain a set schedule, I would definitely look at working in a hospice house setting that has set shifts. I love being in the community - seeing my patient's in their homes. Each company has different set ups - we have evening and night shift nurses so Case Managers/Admit Nurses do not take call. I have worked for other agencies where CMs do have to take call and it was awful. When working salaried, RNs were taken advantage of (imagine that!) so I love being hourly. I believe in being paid for my education, experience, and time and will not give it away. Hospice work is so fulfilling.

I would be interested to know what other hospice nurses are doing at home visits. Are you taking your bag and computer into the home, or just the bare minimum? Does your agency provide visit packs and admission packs (I hear Kaiser does)? Are you wearing full PPE? Please be as specific as you can!

Dexamethasone

How slow do u push dex?

I thought your answer was very informative. Pardon my ignorance, but what is an EMR?