LMTRN

It sounds like her PPS would be below a 40, my hospice would be able to make that work. I would just keep working on the husband r/t quality of life. Some hospices have special volunteers, 'survivors', people who have had family members in the program. It sometimes helps to hear it from someone who has "been there, done that". Good luck.

I'll help. Please PM me.

However, your case load is light, compared to what is expected in my organization. I'm in Florida, and I was hired as a new grad, with basically the same type of patients, about 48K. I maxed out at one time with 23.

What kind of pain is she complaining about? mets to bone? My organization uses a ketamine gel that works great for that. And as above, document your education, especially to family. Good luck, don't let the energy vampires get you down.

Ultimately, you're playing in their sandbox. When I was doing facilities, I would ask staff what THEIR schedule was, and see the patients with them when they were getting personal care done. If you help them a time or two, you may see a change. Good luck!

Your clinical manager needs to speak to the DON about what role you are expected to play.

@ babybee, I agree, it's really not set up for IPU. I have worked on home and facility teams, though, and it is good for them. The trick is trusting the n/e and n/a buttons!

I am a hospice nurse that works in a local hospital, doing admissions and followups on current patients that come in. The hospital system I work with has a "Quality of life" team. They have patients all through the hospital, but they sit in on the "grand rounds" in the ICU. The qlife team works closely with the hospice team, often referring patients to us. The qlife team says there are "buzz words" for patients, and doctors routinely write for consults for them if the patient is: on a vent, over a certain age, multiple hospitalizations for the same issues. Not all qlife patients make it to hospice, but it's a good stepping stone.

That New Yorker article was terrific!

We will all have to die at sometime and when it is someone I love I am saddened by it, but as a nurse I see death as a transition, just like birth, it is something we all must experience. Just as maternity nurses work to make the happy occasion of birth as good an experience as possible we as palliative/hospice nurses make the sad occasion of death as good an experience as possible. :twocents:I've used this sentiment with families, and most get it. Some births are violent, some are easy, but ultimately, it's a life going to another plane. Energy is not destroyed, just changed.

My hospice does NOT cover Megace. If people are hungry, they'll eat, even if it's just a bite or two. Educating the family is the most important thing at this point.

I've been in homes in neighborhoods that I wouldn't want to visit at night, but I've never had an individual patient or family member that I was afraid of. People are usually pretty glad to see us.

I work for a non-profit, and I would guess one third of the people we admit are not truly appropriate.

Same here, they hired me straight out of school.

Same for my hospice, except on weekends, when the office is closed. Then, it starts from my driveway, the thinking being my home is the office.

I would stress the fact the you are also open to new things, because the hospice you apply to might need you initially in a different setting, i.e. home health. Another thing, if you're close to any of your current patients' families, ask them, if you type up a recommendation letter, would they sign it. Keep it simple, 'caring touch, my (so) was fond of this nurse'. Good luck, let me know how it goes. LMTRN:twocents:

I would take any of the jobs that are posted above! I'm currently working at my hospice's inpatient facility, but have worked on facility and home teams in the not to distant past. I've had as many as 28 patients, and there is no way you can do justice to that number of people. Under 20, 18 is my magic number, is ideal. I'm in a suburban area of Florida, so no one is too far.

If the spouse has talked her out of a DNR, she probably doesn't have an Advanced Directives either. Does he spend time in the room with her? Let him listen to her lungs! I'm sorry for her and you.

I work for a small hospice. We recently had an incident, 2 nurses sign narcotics in from the pharmacy, but only one signiture is required to sign them out to give to patients. Our medication room is locked, and the medication cabinet is locked, but all nurses on the floor have access to all medications. Does anyone else have as archaic a system as this? And if so, how is it handled?