doodlemom

doodlemom

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All Content by doodlemom

  1. A little help, please, JCAHO stuff

    doodlemom replied to river1951's topic in Hospice, Palliative

    They're a pain in the ***, aren't

  2. A little help, please, JCAHO stuff

    doodlemom replied to river1951's topic in Hospice, Palliative

    Is there a requirement to take O2 sats in the first place? If you don't know what someone's O2 sats are, then you would not have to worry about calling the doctor. We don't even own an O2 sat monitor,...

  3. Can you help me with some career advice?

    doodlemom replied to CMSNYC's topic in Hospice, Palliative

    I agree with Sarah. I can't remember the last time I gave someone a bath and it's been at least a couple of months since I changed someones briefs - and that was because someone was soiled when I was...

  4. missed visits?

    doodlemom replied to yayanurse's topic in Hospice, Palliative

    I agree with Aimeee - you are supposed to visit based on your plan of care. We generally use a range of 1-3 visits (plus prn) q wk so that means that we need to make at least 1 visit a week. Medicare...

  5. How to decide visit frequency?

    doodlemom replied to twigmaster99's topic in Hospice, Palliative

    I've never seen any flow chart or algorhythms regarding visits. It is so hard to predict. I usually make a plan for the week on Monday and try to stick to it - but so many things change. Someone that...

  6. wound care in eol patients

    doodlemom replied to hcan's topic in Hospice, Palliative

    I think it really depends on what kind of wound it is. I had a patient that had a chronic infected wound that he had been treating himself - for years! He lived on our service for about 5 months. We...

  7. wound care in eol patients

    doodlemom replied to hcan's topic in Hospice, Palliative

    I think that you can use your own judgement on this and should not rely on algorithms (which are narrowly construed, as you said.) If you have a patient that is bed bound and no longer eating, it...

  8. roxanol in neb treatments

    doodlemom replied to lesrn2005's topic in Hospice, Palliative

    Very good

  9. Help! What meds are not covered under hospice?

    doodlemom replied to RN4hospice's topic in Hospice, Palliative

  10. use of Cadd pumps in pain management

    doodlemom replied to jwelhwel's topic in Hospice, Palliative

    A CADD pump is a very small pump that is made to be portable for people in non hospital settings. For ambulatory patients on the go, they can carry them in back packs or waistpacks. I think that many...

  11. When do you need an order to increase dosage of med?

    doodlemom replied to Libralady's topic in Hospice, Palliative

    I agree - don't be hard on yourself. You did everything to keep the patient comfortable (and he was comfortable.) As Emptytheboat said, most docs want to hear about how much someone had over the last...

  12. Help! What meds are not covered under hospice?

    doodlemom replied to RN4hospice's topic in Hospice, Palliative

    We cover antibiotics in certain circumstances but not all. Our Medical Director makes the determination. If a patient has a foley and gets a UTI, it is something that we would cover. Not all UTI's...

  13. Preparing to be hospice nurse

    doodlemom replied to tjarn's topic in Hospice, Palliative

    I would look for a job at a long time established hospice. Be prepared for a salary cut - hospice nursing is not known to pay a lot compared to other areas of nursing. Ask lots of questions on the...

  14. roxanol in neb treatments

    doodlemom replied to lesrn2005's topic in Hospice, Palliative

    We've always used sterile morphine that is meant for injection - still never any good

  15. Anyone's 1st job in hospice?

    doodlemom replied to RN007's topic in Hospice, Palliative

    We have hired new grads and some have worked out fine. If this is for an inpaitnet unit, you would have a lot more support. If it's for case management/home care, you will be required to be very...

  16. Uncontrolled Seizures

    doodlemom replied to SCgirl1962's topic in Hospice, Palliative

    I've not used versed but I have used valium or ativan

  17. SNF asking hospice to change meds

    doodlemom replied to silverwillow's topic in Hospice, Palliative

    If your agency has a contract with the facility you should be able to write orders in their chart. That is part of a standard contract between a nursing facility and a hospice. Generally facilities...

  18. SNF asking hospice to change meds

    doodlemom replied to silverwillow's topic in Hospice, Palliative

    That's interesting. On any orders, we make sure to call the MD and obtain any orders and then write them in the chart. If they have had to call the doctor for orders, then I feel like I am falling...

  19. Attending memorial services, funerals, condolence calls etc

    doodlemom replied to nurselearner's topic in Hospice, Palliative

    We frequently hear from people who do not do hospice that we are special to do the work that we do. We all have our specialties and ours is this - and yes, I have met many extraordinary people in this...

  20. Help! What meds are not covered under hospice?

    doodlemom replied to RN4hospice's topic in Hospice, Palliative

    Kittlylover, Are the comfort paks not written for any particular patient? You are able to just take one - even if the referral has just been called in? If so, that is a much easier system. Who writes...

  21. Help! What meds are not covered under hospice?

    doodlemom replied to RN4hospice's topic in Hospice, Palliative

    Our hospice does not use Hospice Pharmacia but our emergency kits are brought out on admission if we know about the admission ahead of time (like the day before or if we're doing an afternoon...

  22. Attending memorial services, funerals, condolence calls etc

    doodlemom replied to nurselearner's topic in Hospice, Palliative

    Oh, I do attend some - generally the patients and families that I've gotten to know very well. I do not attend anywhere near what I did in the first few years. I don't think it burned me out - I just...

  23. Attending memorial services, funerals, condolence calls etc

    doodlemom replied to nurselearner's topic in Hospice, Palliative

    Agree with all of the above. If I have not pronounced, I'll call the family to check on them the next day. Usually I will call and check on them again after several

  24. Help! What meds are not covered under hospice?

    doodlemom replied to RN4hospice's topic in Hospice, Palliative

    I would argue that the digoxin is r/t to the hospice diagnosis and should be paid for. Just a side note, we recently were turned down payment for a diagnosis of CHF because it is a symptom, not the...

  25. Help! What meds are not covered under hospice?

    doodlemom replied to RN4hospice's topic in Hospice, Palliative

    Actually I believe that medicare regs require the hospice to pay for meds that are r/t to the hospice diagnosis. Some private insurances continue to pay for medications but most of the time the ones...