nutella

nutella MSN, RN

Member

All Content by nutella

  1. Mortality rates for cardiac surgery

    nutella replied to SororAKS's topic in General Nursing

    as mentioned, "hospital compare" has a variety of data. But you also need to analyze. Not every hospital takes all patients. There are places who will perform heart surgery on patients who are pretty...

  2. Before Hospice

    nutella replied to Guest941822's topic in Hospice, Palliative

    Hi OP - I commend you for your wish to go back to school to become a nurse. I think it is good to have a vision or strong motif because nursing school is demanding and requires a lot of dedication,...

  3. Rally for National Nurse-Patient Ratios

    nutella replied to nrsadvocate's topic in Activism, Healthcare

    I have seen the same trend. Instead of the nurse having time to be diligent, spend more 1:1 time with patient and so on they end up with providing direct care that otherwise a CNA would perform (if...

  4. Nursing: The Highly Skilled Customer Service Representative

    nutella replied to gleanns's topic in General Nursing

    This is what happens when reimbursement is directed by patient satisfaction surveys and scores - HCAHPS. And of course administrators focus on maximizing profit because Medicare will reduce payments...

  5. Before Hospice

    nutella replied to Guest941822's topic in Hospice, Palliative

    1) How long you worked as a nurse prior to your hospice job? More than 15 years ... 2) In what specialties you worked (or that you wished you'd have worked) prior to working in hospice? Critical...

  6. Transitioning from HH to hospice

    nutella replied to rdugirl's topic in Hospice, Palliative

    I never thought about "holistic certification" so I can not offer much information regarding that. Home hospice and palliative care was very interesting and I liked it. Since you are already in home...

  7. I am finally employed as a palliative care nurse!!

    nutella replied to midazoslam's topic in Hospice, Palliative

    Brush up on the advanced directives in your state - I have conversations about care goals non stop. In addition, get a solid knowledge of symptom management especially but not limited to pain,...

  8. I don't thnk these patients are appropriate

    nutella replied to Raviepoo's topic in Hospice, Palliative

    Yes - play by the rules. If your agency gives you a hard time and expects you to admit pat who are not appropriate look for a different agency that plays by the rules. Also, make sure that if a pat...

  9. In need of some advice

    nutella replied to swankyminnow's topic in General Nursing

    No, one year is fine. Also, they can not give you enough hours, what they do is keep you "sort of" in case their census picks up but there is no guarantee. In fact - it is smart to get out because...

  10. "Career Suicide"

    nutella replied to dannygirl315's topic in General Nursing

    You never know where you are going to be in a couple of years.... In my opinion it is best to do what works for you best. There will be something else come along in a couple of years if you do not...

  11. hospice nurse patient ratio

    nutella replied to ann50bellrose's topic in General Nursing

    Are you working in home hospice or hospice house? In any way - case load in home hospice where I worked was between 18-22. When i Left some had as many as 28 (some of them palliative though and less...

  12. Do a disproportionate amount of nurses suffer from anxiety?

    nutella replied to R!XTER's topic in Health, Stress Management

    I think that the typical work environment just exacerbates anxiety more. Also, if somebody is prone to getting stressed working in a busy nursing job will definitely make it worse. And once a person...

  13. Acute Hemodialysis Nursing

    nutella replied to KyraMaeLynne's topic in Dialysis, Renal, Urology

    The hospitals I worked in acutes had techs only work in the acute HD rooms, not on the floors 1:1 or critical care. Having said that - acutes is different from chronic and requires eye for detail and...

  14. Schedule with inpatient/acute dialysis?

    nutella replied to lazerlime23's topic in Dialysis, Renal, Urology

    I loved acute dialysis but the schedule.... In most hospitals nurses started around 6:30 or perhaps 7 am and he first patients come around 8 am if there is an acute dialysis room, if it is in room...

  15. How do you deal with untherapeutic situations on the unit?

    nutella replied to RNdynamic's topic in Patient, Colleague Relations

    Thanks for asking - I work in an environment that is very therapeutic for nurses. Me and my coworker stop between patients to do some meditation, yoga or also jazzercise to enhance the therapeutic...

  16. I don't thnk these patients are appropriate

    nutella replied to Raviepoo's topic in Hospice, Palliative

    Very good discussion .... OP - I did evals and hospice liaison work. Because I believe that the CMS guidelines need to be followed I will not recommend admission to hospice for AZ patients and that...

  17. Difficulty Accessing A Port

    nutella replied to REDDICKD's topic in General Nursing

    I encountered a patient at home with a VAD that had been implanted around 8 years ago and was still functioning fine! It did give a little problems here and there with flushing but it had served the...

  18. I don't thnk these patients are appropriate

    nutella replied to Raviepoo's topic in Hospice, Palliative

    That is bad practice all around but there are hospice company that specialize in those clients because they usually live a bit longer, do not require crisis visits and generate steady income. There is...

  19. Transfers to GIP

    nutella replied to nursecathi's topic in Hospice, Palliative

    I totally agree with you! An acute hospital is not the best place to die - though patients and sometimes relatives are convinced it is! The acute hospital is not only noisy, the staff is very busy...

  20. Supervisor Loves to Micromanage

    nutella replied to pcaldea's topic in General Nursing

    At this point I guess it is too late for any attempts to rescue your job. I am sorry to say that but you do have to show up on time and work the hours you are paid for or ask for PTO/make...

  21. I don't thnk these patients are appropriate

    nutella replied to Raviepoo's topic in Hospice, Palliative

    There are specific criteria for Alzheimer Dementia, see this link for further information: http://geriatrics.uthscsa.edu/tools/Hospice_elegibility_card__Ross_and_Sanchez_Reilly_2008.pdf The FAST...

  22. Transfers to GIP

    nutella replied to nursecathi's topic in Hospice, Palliative

    LOL - yes - I know what GIP means. But your problem does not seem to be related to GIP level of care to me as GIP conditions per

  23. Bullying or Not? Rant!

    nutella replied to skittlebear's topic in General Nursing

    It is normal human nature that we want to be liked and make friends. If that happens - ok - if not , also ok. You cannot please every person but you can try to do your job as good as you can and get...

  24. Difficulty Accessing A Port

    nutella replied to REDDICKD's topic in General Nursing

    Sometimes it can "feel off" when you are used to a specific kind of port. Also, depending on the needle and length it can "feel" differently. If you get a good blood return and flushes without...

  25. Bullying or Not? Rant!

    nutella replied to skittlebear's topic in General Nursing

    It sounds that the workplace is supporting her behavior because "she gets the job done". I am not saying that this is right - but it is how a lot of places still operate. And a lot folks from "old...