dreamriderRN

Hello, I have recently interviewed for a full time hospice case manager position. It would be a 40hr week with a case load of 12-15pts but is paid per visit at $47:50 plus mileage. Can anyone give me some input as to whether this is the norm, good, bad? So I have an idea whether to go forward if it offered to me. I would appreciate any input.

I am an RN who is new to hospice/home health nursing. I am working for a small agency and have some questions to ask of those on here who work in the field to gauge whether I am overreacting to some things I have encountered. Number one: The agency have a doctor contracted but the DON cannot get hold of her for orders/sign documents etc. Consequently pts have to wait extended periods of time for medications or (which i think is more the case) the DON is ordering meds without an order. Number two: One of my pts on hospice has Emphysema and AFib and was complaining to a particular aide that he was constipated. He has colace prescribed with instructions to take x1 day but the aide told him to take two and she would go and get some suppositories and put in for him. Additionally, for some reason she is measuring his legs/feet whenever she goes, the pt thinks she is the nurse and yelled at me the other day for trying to measure his calf because she had already done it. I have discussed my concerns with the DON but she just shakes her head and does nothing about it. I am concerned about my licence particularly with no active physician on board, does anyone think im overreacting or is this commonplace in Hospice/homehealth??

I am an RN who is new to hospice/home health nursing. I am working for a small agency and have some questions to ask of those on here who work in the field to gauge whether I am overreacting to some things I have encountered. Number one: The agency have a doctor contracted but the DON cannot get hold of her for orders/sign documents etc. Consequently pts have to wait extended periods of time for medications or (which i think is more the case) the DON is ordering meds without an order. Number two: One of my pts on hospice has Emphysema and AFib and was complaining to a particular aide that he was constipated. He has colace prescribed with instructions to take x1 day but the aide told him to take two and she would go and get some suppositories and put in for him. Additionally, for some reason she is measuring his legs/feet whenever she goes, the pt thinks she is the nurse and yelled at me the other day for trying to measure his calf because she had already done it. I have discussed my concerns with the DON but she just shakes her head and does nothing about it. I am concerned about my licence particularly with no active physician on board, does anyone think im overreacting or is this commonplace in Hospice/homehealth??

Can anyone tell me how long port access can be maintained in a pt who is getting Zofran prn (usually q4/6) before being changed out and how often it should be heparinised. Thank you