ErinS

ErinS BSN, RN

Hospice

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All Content by ErinS

  1. Hate to discharge a patient that is hospitalized

    ErinS replied to AtlantaRN's topic in Hospice, Palliative

    You actually can not make them sign the discharge form. If they will not choose to revoke (which I have found most patient's will choose to revoke when faced with paying out of pocket for huge er...

  2. Dissertation- Help with my chosen topic and CAM

    ErinS replied to jojo812's topic in Hospice, Palliative

    Can you access EBSCO? If not, then sign up with medscape, which has lots of reports available. Design your PICO question. This stands for population, intervention, comparison, and outcomes. Use...

  3. Did I simply shadow a lazy Hospice RN during clinical?

    ErinS replied to SNB1014's topic in Hospice, Palliative

    You pretty much described the way many of my visits go (but in a more negative light than I view them). Hospice is a different point of view. These clients invite me into their home. They invite me...

  4. Free Reign for Hospice Orders?

    ErinS replied to SoCalRN1970's topic in Hospice, Palliative

    Oh my goodness it sounds like you are in a crappy agency! Our MD gives us very liberal orders and does not get upset when we change orders within a range. I don't have to tell him that I am using...

  5. What's the scariest thing you've ever seen as a nurse?

    ErinS replied to Nurse0621's topic in General Nursing

    I was once holding a baby who stopped breathing and turned blue. He had been having periods of apnea, and I was just a float, so the peds RN was having me restrain him while she placed a second IV....

  6. How do you make potassium tolerable?

    ErinS replied to EMSnut45's topic in General Nursing

    Ask for the wax matrix tablets. They are smaller and easier on the stomach. It is just a different version and there is not a big price

  7. Do you as a Hospice Nurse use a pulse oximeter?

    ErinS replied to SoCalRN1970's topic in Hospice, Palliative

    I don't turn up O2 because of pulse ox, but I use high pulse ox as a reason to titrate pt's off O2. I am not a believer in O2 as a comfort measure- it seems like the hospital automatically puts O2 on...

  8. Do you as a Hospice Nurse use a pulse oximeter?

    ErinS replied to SoCalRN1970's topic in Hospice, Palliative

    I do routine spot checks of my patients sats, but it is never something I focus on. I rarely discuss detailed numbers and instead tell the family 'it is normal', or 'a little lower than last time'....

  9. Super thick & sticky phlegm

    ErinS replied to Ruthfarmer's topic in Hospice, Palliative

    We have actually been successful when all efforts to thin and expectorate secretions has failed, in drying them with scopolamine or atropine. While this does not improve lung function, if the goal is...

  10. How does one avoid burn out??

    ErinS replied to SoCalRN1970's topic in Hospice, Palliative

    I absolutely NEVER answer my phone when on-call. I did not do this at first and it was very difficult for me to avoid thinking about work all the time. This has made a huge

  11. Admission without evaluation

    ErinS replied to nhelkhound's topic in Hospice, Palliative

    We will not admit even with a referral if pt does not meet CAHABA guidelines. This is a Medicare requirement and the hospice's responsibility to verify. Also the new Medicare guidelines (for...

  12. Further education in Hospice and Palliative care

    ErinS replied to CLWCHPN's topic in Hospice, Palliative

    I am getting my MSN in education. I hope to go into home care management so I can push for better marketing/budgeting for hospice, and also teach generals like pharm and med/surg with a focus on end...

  13. Do Nurses have to give Bad News and How?

    ErinS replied to lenoxat325's topic in General Nursing

    I work as a hospice nurse and while I do not give initial diagnosis, I often am giving additional bad news. Such as, yes your baby is dying. Yes your wife's cancer is progressing. No, your husband...

  14. Was I right to decline this? Admission with no consents.

    ErinS replied to SoCalRN1970's topic in Hospice, Palliative

    CYA. That is what counts for you! Never admit without consent. Bad things will happen everytime that you do. Like the pt will die before the paperwork is signed (this has happened at my

  15. HAVE YOU EVER THOUGHT? " I should write a book about my adventures in Hospice".

    ErinS replied to SoCalRN1970's topic in Hospice, Palliative

    I have often thought that my experiences would make a great book. It is especially incredible the way people seem to time their deaths to coincide with holidays, birthdays, family

  16. So the family asks me "Is Mom dying?"

    ErinS replied to 357maggie's topic in Hospice, Palliative

    This is a difficult conversation to have the first few times you have it. To tell someone, yes, your loved one is dying. I agree with above post that said she is likely not sedated just from meds....

  17. What is the hardest thing about your job?

    ErinS replied to Vtachy1's topic in Hospice, Palliative

    The hardest thing about my job is that I am personally accountable for 15-20 patients and their families that are going through the hardest time of their lives. They are angry, in denial, grieving,...

  18. Extubation in the home hospice setting

    ErinS replied to Claudia322's topic in Hospice, Palliative

    Our hospice will no longer do this. However, we have had patients come home under care of our home health, and then the hospice MD and RN will go and do the withdrawal. We have had some fiascos, so...

  19. Patient Supplies for Field RN/CMs

    ErinS replied to Kabin's topic in Hospice, Palliative

    At my hospice the CM or CNA or even social worker/md/chaplain call our dme (medical equipment) department and order the supplies over the phone. The person taking the order enters the order into the...

  20. Hospice nursing...reality check....

    ErinS replied to gorgenurse's topic in Hospice, Palliative

    Ideally this could work out, if you have someone to cover your patient's emergencies and your agency is well staffed. So when I have only 12 patients I am managing and none are actively dying, I can...

  21. Admitting patients for the sake of admitting?

    ErinS replied to SoCalRN1970's topic in Hospice, Palliative

    This is Medicare fraud. This practice will hopefully be going away with new Medicare guidelines- they are really trying to crackdown on this stuff. Pt being admitted/recerted in 3rd benefit has to...

  22. How many of you have experienced medication errors?

    ErinS replied to mihualalei's topic in General Nursing

    I have made errors during med pass. I agree that ALL nurses will make a med error at some point. We pray it is only minor, and in the mean time check and check and check again. The biggest cause of...

  23. How can they say I am not a viable candidate?

    ErinS replied to SoCalRN1970's topic in Hospice, Palliative

    Do you have your BSN? Most of the application programs automatically disqualify people based on certain things. If you check 4 years of experience instead of 5 years for example, or pursuing degree...

  24. How does one fight constant ignorance not just Hospice specific?

    ErinS replied to SoCalRN1970's topic in Hospice, Palliative

    Here's one. I have a pt whose uncontrolled blood sugars and edema suddenly normalize without any changes to plan of care. My first thought is: the end is coming. I tell daughter. She panics, we...

  25. Advice before I start shadowing?

    ErinS replied to MissIt's topic in Hospice, Palliative

    Reviewing symptoms of death and dying can be helpful. Honestly, I think many hospice have varied standards of practice (for example, some hospice use lots of fentanyl, some use lots of methadone)....