doodlemom

doodlemom

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All Content by doodlemom

  1. What is the ideal caseload?

    doodlemom replied to Hospice4me's topic in Hospice, Palliative

    Wow! This is horrible! We are required to attend all of our deaths (and this is how it should be.) If we have 2 at one time then we send another nurse out. This is unacceptable and I have never heard...

  2. What is the ideal caseload?

    doodlemom replied to Hospice4me's topic in Hospice, Palliative

    I think 10-12 is ideal. I've never had an LVN to work with, but I would imagine 18-20. Since the LVN cannot do the weekly assessments, don't you have to do all of the weekly assessments

  3. Interview tomorrow......

    doodlemom replied to NewCreation's topic in Hospice, Palliative

    Our admissions nurses do 2 admits in an 8 hour day. Sometimes they may even do a referral visit, as well. The paperwork depends on how detailed your assessment is required to be. We use computer...

  4. What does your Hospice do for you?

    doodlemom replied to Hospice4me's topic in Hospice, Palliative

    We do not use our full time case managers for on call at all. We have a separate staff for that. If we are short staffed for on call we are offered time and 1/2 for anyone willing to do on-call. Most...

  5. Any ideas for unrelieved N/V

    doodlemom replied to spoiled28's topic in Hospice, Palliative

    Yes, it is legal in all states. I don't think it will do much for an obstructed pt,

  6. Homeopathic Hospice?

    doodlemom replied to BeExcellent's topic in Hospice, Palliative

    DO's pretty much practice allopathic medicine - or "conventional" medicine. They also receive training in physical manipulation which makes them different - but they do everything an MD does -...

  7. Homeopathic Hospice?

    doodlemom replied to BeExcellent's topic in Hospice, Palliative

    While there is a natural approach to childbirth, it is painful for a very limited time. Even many women who opt for natural childbirth will ask for pain meds at some point during their experience....

  8. Homeopathic Hospice?

    doodlemom replied to BeExcellent's topic in Hospice, Palliative

    You could argue that morphine is a "natural" medicine - derived from the opium poppy. It's a hard sell and she probably won't go for it. If the pt goes into respiratory distress, has the dtr stated...

  9. Homeopathic Hospice?

    doodlemom replied to BeExcellent's topic in Hospice, Palliative

    Indigo girl has a good idea. A homeopathic physician might be able to give them realistic guidance. Are they actually taking homeopathic remedies or are they taking herbal remedies? Homeopaths deal...

  10. Homeopathic Hospice?

    doodlemom replied to BeExcellent's topic in Hospice, Palliative

    I have had pt's like this before and what I do is just keep at it by recommending sx mgmt meds and usually when the symptoms become so bad, they will give in and agree that comfort is more important...

  11. ? regarding pain management....

    doodlemom replied to luvmy2angels's topic in Hospice, Palliative

    Yes, it is very common to see pt's on both a long acting pain medicine (which the fentanyl patch is) and a short acting pain medicine(which the Roxanol is) The patch is giving him a steady continuous...

  12. End of Life Decision Making

    doodlemom replied to taighwilliam's topic in Hospice, Palliative

    Our hospice has a palliative care practice affiliated with it and the pt's that come on to their service have not necessarily stopped aggressive treatment. The practice is consulted when there are...

  13. Any recommendations for new hospice RN?

    doodlemom replied to Nickle's topic in Hospice, Palliative

    It's called Symptom Management Algorithms - A Handbook For Palliative

  14. Sub Q Butterfly

    doodlemom replied to Irishgirl's topic in Hospice, Palliative

    We use sq needles that kind of look like tiny huber needles and they have a sticky pad around it to keep it attached to the pt. These needles go straight in. I like those better beause they don't seem...

  15. End of Life Decision Making

    doodlemom replied to taighwilliam's topic in Hospice, Palliative

    I did not understand your question - could you

  16. pain relief in pancreatic cancer

    doodlemom replied to Limegreen's topic in Hospice, Palliative

    Methadone, methadone, methadone! Well, the conversation lately seems to always go back to methadone (mainly because I bring it up)...and I have to say that methadone is the best thing out there that I...

  17. I feel like just giving up...

    doodlemom replied to mc3's topic in Hospice, Palliative

    MC, you have my support. I agree wholeheartedly with Leslie. You will see these kinds of pt's everywhere - particularly in nursing homes. Also, there are hospices out there that are very poorly run....

  18. Hospice Houses

    doodlemom replied to Curious1alwys's topic in Hospice, Palliative

    Some hospices have "residential beds" that are privately paid for by the pt/family - or charity care. Many or possibly most hospice inpatient facilities have only acute beds which are to be used for...

  19. Any recommendations for new hospice RN?

    doodlemom replied to Nickle's topic in Hospice, Palliative

    Wow, it sounds like you are very well prepared! I think that your interest and obvious excitement for the work will get you through - and will get you far, quickly. Good luck in your new job. I hope...

  20. The dreaded 911 calls

    doodlemom replied to silverwillow's topic in Hospice, Palliative

    Is he still eating? If he isn't you're probably better off just leaving him in the hospital until he dies (it doesn't sound like you have an inpatient facility.) If he is in the shape you are saying,...

  21. The dreaded 911 calls

    doodlemom replied to silverwillow's topic in Hospice, Palliative

    It really depends on what they are doing for him at the hospital. What's his diagnosis? Is he having some kind of symptoms that they are treating at the hospital - or do they just have him there...

  22. Defibrillators...

    doodlemom replied to CANRN's topic in Hospice, Palliative

    We have several magnets around our office that we got from the cardiologist's office that we just place on top of the pt (if the pt has not been able to go in to have it

  23. Pay rate

    doodlemom replied to verock's topic in General Nursing

    If she's been an LVN for a long time and has experience in the hospital, she may have been making more as an experienced LVN then what the new RN grads are making at your hospital. Was her previous...

  24. Pain Management Protocol

    doodlemom replied to webblarsk's topic in Hospice, Palliative

    If you feel comfortable, I would push your administrators to spend the $ educating your Medical Director. I work for a non profit, so the switch to methadone was a necessity for us to decrease our...

  25. Any ideas for unrelieved N/V

    doodlemom replied to spoiled28's topic in Hospice, Palliative

    Is she vomiting because she is obstructed? Is she eating? We've used sandostatin to decrease gastric secretions in pt's that are obstructed and are not eating with good relief. I've only seen it used...