doodlemom

doodlemom

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All Content by doodlemom

  1. RN Case Mngr Hospice

    doodlemom replied to RNDYN2CU's topic in Hospice, Palliative

    I don't remember if mu stands for anything - just that there are 3 categories of mu receptors. NMDA = N-methyl d-aspartate I'm sure if you google it, you will find a lot more info than I can give

  2. Weekend Work Shift

    doodlemom replied to jharper's topic in Hospice, Palliative

    This is pretty common pay for full time weekend on call. You are basically being being paid a full time salary but you are on call for many more than 40 hours. Depending on how much back up help you...

  3. Again, would someone please give me some input on hospice?

    doodlemom replied to kstec's topic in Hospice, Palliative

    It's all depending on what they are hiring you for. Are they hiring for continuous care or to work with their home care program? For continuous care, you'll be with patient's that are having symptoms...

  4. Specialty Mattress covered by medicare Hospice Benefit?

    doodlemom replied to AtlantaRN's topic in Hospice, Palliative

    That depends what you mean by "covered." Medicare pays your hospice a per diem rate - you have to pay for equipment out of what they pay - which means that your hospice should pay for whatever...

  5. methadone therapy for cancer pain?

    doodlemom replied to ceelynncee's topic in Hospice, Palliative

    I have had a patient with up to 70 mg q 8 hrs for pain control and it worked quite well. It took quite some time to titrate up to this

  6. Weeping legs and wounds

    doodlemom replied to rnkalee's topic in Hospice, Palliative

    Many times when people have liver mets, they may already have renal insufficiency by the time the edema has gotten this bad (Hepatorenal syndrome.) I would think that they have already tried the...

  7. extubating for terminal patient

    doodlemom replied to verock's topic in Hospice, Palliative

    We frequently get involved when a family is considering extubation. We usually have the patient on a morphine drip for comfort. Patient's sometimes die within a few minutes and many live for several...

  8. Something I've never seen!

    doodlemom posted a topic in Hospice, Palliative

    I have a new patient that has leiomyosarcoma in her shoulder and it has metastasized as dime shaped fungating tumors all over her back. I covered her whole back with antibiotic ointment and ABD pads....

  9. Ever Admit without all the needed info?

    doodlemom replied to new2hospiceRN's topic in Hospice, Palliative

    We frequently admit without a written H and P or progress notes, as long as we have a physician's order and they appear eligible. Most of our records are received after the fact. If the patient is...

  10. RN supervisory visit Frequency?

    doodlemom replied to new2hospiceRN's topic in Hospice, Palliative

    Every 14 days is a Medicare requirement nationwide for RN's to make a supervisory visit with CNA's. I don't think there is a requirement for LVN's, but it is required that pt's be seen by the RN at...

  11. Prostate Ca Questions

    doodlemom replied to new2hospiceRN's topic in Hospice, Palliative

    Increased PSA does not mean that the guy has prostate cancer. You need proof before admitting

  12. REAL Pain or ADDICTION?

    doodlemom replied to captain morgan's topic in Hospice, Palliative

    How much methadone was he started on? 2 days on the methadone is really not enough time to do anything with methadone. You really need several days to titrate the med. We usually start low and...

  13. Evaluation question

    doodlemom replied to Rnmomajmj's topic in Hospice, Palliative

    A 21 pound weight loss is very significant and is a telltale sign that something is going on. She definitely doesn't meet criteria for end stage dementia but I would admit her for general...

  14. primary diagnosis and co-morbidity

    doodlemom replied to Hospice Nurse LPN's topic in Hospice, Palliative

    I totally agree with Aimeee. Yes, you are supposed to be documenting on decline in status but documenting on other problems does not mean that your hospice is responsible for paying for them. For...

  15. Urine smell reduction?

    doodlemom replied to cherokeesummer's topic in Hospice, Palliative

    Concentrated urine does smell strong but are you sure he does not have a UTI? I would ask the nurse to check his urine. A foley catheter might contain the smell - just a

  16. Assisted Living question...

    doodlemom replied to AtlantaRN's topic in Hospice, Palliative

    None of our AL facilities have nurses that work at night - only aides. We will pre-fill syringes for them with Roxanol and ativan. Some have higher licensing requirements and will administer meds that...

  17. Hospice...not what I thought it was going to be

    doodlemom replied to Louisepug's topic in Hospice, Palliative

    I agree with aimee. Case management is much more than paper shuffling. You have a great opportunity here to get to know these patient's and their families while they are stable. As they decline, you...

  18. bladder cancer and spasms

    doodlemom replied to curiousauntie's topic in Hospice, Palliative

    also - I've seen them ordered qid instead of

  19. bladder cancer and spasms

    doodlemom replied to curiousauntie's topic in Hospice, Palliative

    Are the B and O suppositories helping at

  20. Should Patient be Revoked???

    doodlemom replied to AtlantaRN's topic in Hospice, Palliative

    The pt would only have to pay a co-pay if they don't meet criteria. The other hospice might be using some creative documentation to get the patient in to their IPF - or they may decide it's worth it...

  21. My 54 Yr old Pt wiht ES Liver Mass: What can I expect?

    doodlemom replied to RNDYN2CU's topic in Hospice, Palliative

    No I was speaking of each dose. We usually go for about 15% of the daily dose for BTP. When I wrote this before, it was very early in the morning and I wasn't quite

  22. methadone therapy for cancer pain?

    doodlemom replied to ceelynncee's topic in Hospice, Palliative

    We never use methadone prn because of it's long half life. We use it only as a long acting drug and use another drug for

  23. My 54 Yr old Pt wiht ES Liver Mass: What can I expect?

    doodlemom replied to RNDYN2CU's topic in Hospice, Palliative

    The roxanol dose of 5 mg is not near enough with a long acting dose of 240 mg/day. His BT dose should probably be somewhere in the range of 60 - 80 mg or more. I agree with the methadone suggestion -...

  24. Need tips when charting after the death of a patient

    doodlemom replied to skittlebear's topic in Hospice, Palliative

    Are LVNs allowed to pronounce in your

  25. hospice organizations

    doodlemom replied to hcan's topic in Hospice, Palliative

    Our state organization meetings are fun to go to. We have some educational opportunities, but it also gives us the opportunity to ask questions of other hospices and share information so that we can...