rockchalk_jayhawk

There are many reasons why a family may want to transport the body themselves. My oldest sister passed unexpectedly of a Berry Aneurysm. She was 43. She was in a very disfunctional relationship. She had no money nor life insurance. Her husband would not pay for the funeral home to have her body transported back to her hometown, where she requested to be buried by her infant son. The funeral home would do it for a charge of $1500. My sisters and I did go get her and transport her body back home. But, there are laws regulating when they can do it. I do know to transport across state lines, the body needs to be embalmed. You also need a transit permit from the sending funeral home to the receiving funeral home.

the way i understand the new cop's relating to snf/nf or icf/mr is that the hospice will provide medical direction and management of the patient. you will utilize the facilities staff in a manner that you would utilize a family member. it is the responsibility of the nursing facility to meet the personal care and nursing needs that would have been provided by the primary care giver in the home. presently we have a patient who's daughter works in a clinic. she does all the patients lab draws. is this acceptable, "yes". is the staff at the nursing facility properly trained to do lab draws? if the answer is yes, then i think it is totally acceptable to have them do your lab draws. this would stand true for giving them their routine medications and treatments.

our preferred method of disposing of medication, after counting such medication with a family member or nurse, is using cat litter. if its a liquid medication, just pour it into the cat litter. mix it up and dispose in the trash. if it is tablet form you can still do the same but mix a little water in it. coffee grounds work well also, but not much of a deterrent as they are edible. cat litter is not. and no worries about them going into our water supply. (but if you think about it going to your local landfill, it could leach into the ground water supply.) if you think about this too long, there is no "perfect" solution. good luck.

I have always been told that our call policy is very generous. I have never really researched it much, I just felt it was average. I take call about 10 days per month, including every third weekend. We are paid $15 per day (8am -8am) Monday thru Thursday and $30 per day (8am-8am) Friday, Saturday and Sunday. During the week, if we get called out anytime after regular business hours (anything after 4:30 p.m.) it is all considered call back which we are reimbersed at time and a half. Any mileage during call back is paid at $0.42 per mile.

all our notes are transmitted to our coverage facilities. they will get them the day they are transcribed or the following day if there are corrections to be made. and at times they will still get them the same day. what program do you use for your charting and doing your own orders? do you just use a word processing program or something specific?

hello all, and good day at this time my nurses do their charting by dictating into a dictaphone and a transcriptionist types it. this can be, at times a costly way of charting if the transcriptionist has to type the dictation several times after being reviewed by the nurse for corrections. this is the system that was in place when i became the director 6 months ago. i am now being pressured to find alternative ways to do our charting. i know there are many different methods out there. i want to know what has worked for you? what do you like? are there any excellent suggestions (i'm sure there are)? please help. i will take any and all suggestions, at this point.

We do not currently have "comfort pacs", but we want them. What are your protocols? Our pharmacies are willing to make them up for us and want to know about CII accountability and monitoring? If drugs are not used prior to patient expiring or dismissal or drug expiration, how are drugs disposed of? Is there any in home drug accountability? Do you as the nurse using the med, sign out for it? Completely sort of unrelated issue.... What are your Hospices standing orders and would you mind sharing them? Thanks... Peajay:nurse:

Dan, I started out as an LPN in the ER after I worked Med/Surg for 2 years. Yes, I am in Kansas. Rural Kansas. Anyway I was required to take ACLS and was the first LPN to take ACLS in our facility. I did everything... Draw blood, ABGs you name it and was not supervised by an RN. The only thing I could not do was start IV's or hang fluids ect. and I always had RN back up from the floor if needed. Now we have IV certified LPNs which is great. I think if you proove yourself to be as efficient as an RN any place would be stupid not to hire you. And if you are ACLS certified, (PALS and NRP wouldnt hurt either), and have IV certification I say go for it. No use not trying. There are times I would take a good LPN over an RN anytime. I now work in ICU after going back to school and getting my RN. I still feel the same way. GOOD LUCK Paula RN, KANSAS Gooooooo JAYHAWKS

I am very new to Hospice Nursing although I've been a nurse for 16 years. I've mainly worked in ICu. Here is my delima. The previous director was dismissed under some controversy. I dont know the whole story, although I asked at the interview and was told It had nothing to do with the department. My problem is moral with our volunteers. They trusted the last director and are still very faithful to her. I need to break the ice with them and help them move on. That tommorow is a new day and change is good. There are still very hurt feelings with them. My staff on the otherhand are great. They have been very supportive of me in my new position as Director, and welcome the change. Any and all ideas are greatly appreciated. Peajay.

If you don't mind relocating and living in the middle of nowhere Kansas... Come to North Central Kansas. We gladly will take new grads. And we dont eat our young...LOL. We are always in need of help after the temporary help goes back to school.

I took my PICC line insertion certification in 9/00. The Clinical Education Manual was sponsored by a pharmaceutical company called BD Medical. This was in Kansas so Im mot sure if this will help or not. Here is a phone # and address. 1-800-227-2918 BD Medical 9450 South State Street Sandy, Utah 84070 Apria Healthcare was the sponsor (1-800-726-3481) This information may get you no where or it may provide you with the information you need. Good Luck.

At our facility we, as nurses, are trained to do EKGs. The only nurses getting experience doing them is the evening and night shifts as during the day the techs do them. We average 5 per night. As for interpretation.... Dont go by what the EKG prints out. Its a machine. It doesn't have the whole clinical picture. Ultimately the Dr. reads and interprets the EKG. I have also seen where the EKG has read NSR and there were obvious ST segment changes noted. I do agree that taking a EKG interpretation class would be benificial to any nurse that does EKGs on a routine basis. I work in ICU and we are frequently brought EKGs by the floor nurses and asked "What do you think." One more thing on lead placement. It seemed at our facility the nurses were putting the leads on differently. SO...we went with standard lead placement across the board. We have a policy in place that shows proper lead placement. Every nurse in our hospital wether RN or LPN is tought to do EKGs and have to test on proficiency at yearly competancy checks.

Good morning all. I am in need of some major input. My full time job is working in an ICU at a rural hospital. That job is excellent. For some extra spending cash I work part time in a small nursing home. It is going thru some major changes. And as most people will say..."No one likes change." We are in absence of a DON and have a ADON who is an LPN in RN school who will be acting DON upon passing her boards. There is only one other RN who works in the facility which makes 8 hours a day, seven days a week RN coverage a problem. Administration states "We are not concerned with that issue." That and not having another experienced RN to bounce things off of has the 2 of us wondering about our liability. We realy do not have a superior to consult with. It just seems like the ADON (which is new to the facility) is drowning. She is trying to please everyone and pleasing no one. She is letting go of the GOOD help and keeping people who frequently call in. She will not accept help in any form. She will graduate in May, who knows when she will take boards and its a big question whether she will pass on her first try. WHere do we go for RN advise. Any comments will be taken with appreciation.