doodlemom

doodlemom

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All Content by doodlemom

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

    doodlemom replied to RN4hospice's topic in Hospice, Palliative

    Many times our medical director will ask that a cheaper med be ordered in place of a more expensive one. Our pharmacy has a formulary which we try to go by but exceptions are made. As Leslie said, if...

  2. Uncontrolled Seizures

    doodlemom replied to SCgirl1962's topic in Hospice, Palliative

    I agree with Leslie and Charmcity. You do not have to place a pt in ICU for a versed or valium drip. What does your medical director

  3. use of Cadd pumps in pain management

    doodlemom replied to jwelhwel's topic in Hospice, Palliative

    If he doesn't have a pca button, who is giving the q 20 minute 2 mg dose? Is that programmed in? If he is still wincing, then he probably needs an

  4. Mentally Ill Patients and Hospice

    doodlemom replied to SCgirl1962's topic in Hospice, Palliative

    Does he meet criteria for

  5. Salary for hospice nursing?

    doodlemom replied to timewood's topic in Hospice, Palliative

    It really depends on where you are living. 27/hr is a pretty good rate in my area. Are all of your patients in facilities? If so, how many facilities and how far do you have to drive? If you have...

  6. use of Cadd pumps in pain management

    doodlemom replied to jwelhwel's topic in Hospice, Palliative

    I am curious how your hospice is finding this cheaper than sl or oral meds. We find the solution alone is much more expensive than the oral alternative and if you have to rent the pumps - even more...

  7. roxanol in neb treatments

    doodlemom replied to lesrn2005's topic in Hospice, Palliative

    I have never had good results with morphine nebs - it doesn't seem to work as well as sl for any of my

  8. Ethical Death Issue

    doodlemom replied to dinkysam's topic in Medical-Surgical

    I've done hospice work for many years and I can tell you that this is not either unethical or illegal. It is something that we do all of the time and encourage our families to do so, as well - and...

  9. Hospice nurse...needs help with admission rate/salary

    doodlemom replied to nursey_nurse's topic in Hospice, Palliative

    Yes. Our fulltime admissions nurses are expected to be able to do 2 admissions in an 8 hour day. Some hospices expect

  10. Hospice nurse...needs help with admission rate/salary

    doodlemom replied to nursey_nurse's topic in Hospice, Palliative

    $120.00 is a good rate. Even if it takes you 4 hours, you're still making 30 an hour. In my experience, a full admission can take anywhere from 2-4 hours. Our agency pays the government reimbursement...

  11. Help with Sarcoma Wound - Warning, graphic description!

    doodlemom replied to Wildbriar's topic in Hospice, Palliative

    Wow! I've not heard of this product before. I am going to file that away in my brain for the next time I come into this situation.

  12. SubQ route for PCA?

    doodlemom replied to jonear2's topic in Hospice, Palliative

    If a patient is in the home setting, it is nearly impossible to maintain a peripheral IV. In the hospital when a peripheral line goes bad, you can call the IV team and have a new one placed right...

  13. Help with Sarcoma Wound - Warning, graphic description!

    doodlemom replied to Wildbriar's topic in Hospice, Palliative

    I wouldn't try this. Wound Vac's are only used for healable wounds and are not usually used in hospice patients. It would not keep the sarcoma from growing into her artery and it would be causing...

  14. SNF asking hospice to change meds

    doodlemom replied to silverwillow's topic in Hospice, Palliative

    I think Obra 22 has to do with chemical restraints but I'm not

  15. SNF asking hospice to change meds

    doodlemom replied to silverwillow's topic in Hospice, Palliative

    Have you tried to talk with someone in the administration at the SNF? There has to be a way around this. We have hospice patients that we give a heck of a lot more ativan than that and have never been...

  16. vital signs

    doodlemom replied to hcan's topic in Hospice, Palliative

    I've only had one family member ask me if I was going to check vitals (when I had

  17. nebulized ms

    doodlemom posted a topic in Hospice, Palliative

    one of the nurses that I work with was try to get a doctor to write for nebulized ms and he wasn't buying it. She wanted my input and I told her that I, myself had never had great results from this....

  18. Huntington's Chorea

    doodlemom replied to saribeth's topic in Hospice, Palliative

    If they're green, could he possibly have a respiratory infection that has not yet gotten bad enough to run a fever? What about a long acting narcotic before bed? I've had a couple of Huntingtons...

  19. vital signs

    doodlemom replied to hcan's topic in Hospice, Palliative

    I'm pretty sure that there are no medicare or JCAHO requirements that VS be taken on each nursing visit - if they are, we are way out of compiance! The requirement at your agency must be handed down...

  20. vital signs

    doodlemom replied to hcan's topic in Hospice, Palliative

    This is interesting to learn everyones different opinions on this. I almost always listen to pt's lung, heart, and bowel sounds but only do a bp if I feel it is necessary or if it is my once a week...

  21. vital signs

    doodlemom replied to hcan's topic in Hospice, Palliative

    I'm not an on call nurse but I do not get a bp every time I go to a pt's home - only when there's a need and during my assessment

  22. nebulized ms

    doodlemom replied to doodlemom's topic in Hospice, Palliative

    oh - no offense taken. Sorry if I sounded offended. Didn't mean to

  23. Palliative Care...what is the referring criteria?

    doodlemom replied to minneRN's topic in Hospice, Palliative

    There is really no such thing as a palliative care "benefit". Nursing homes will get a slightly higher medicaid rate if they put a patient on a palliative care bed (depending on what state you are...

  24. Palliative Care...what is the referring criteria?

    doodlemom replied to minneRN's topic in Hospice, Palliative

    However, there is no medicare criteria in order for it to be covered by them - of course many PPO's or HMO's require referrals from PCP's just as they would any specialist. A palliative care physician...

  25. nebulized ms

    doodlemom replied to doodlemom's topic in Hospice, Palliative

    Actually, it's not new. The first time I tried it with a patient was about 10 years ago. It just never has seemed to work for my patients. This other nurse said that she uses it pretty