ErinS

ErinS BSN, RN

Hospice

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All Content by ErinS

  1. Kussmaul Respirations

    When we compare oxycodone and roxanol we generally see the same symptom relief from one to another. I do not think having morphine instead of oxycodone would have made her more comfortable, but she may have needed a different dose. The hospice nurse...
  2. Taking off your Nurse's Cap

    I think there is a big difference between being a daughter and being a nurse. I think that most of what you were doing is what we often see family members doing- helping to bathe their loved ones, providing support and encouragement, asking for thin...
  3. Options for using my RN in Hospice

    Our company uses several nurses with minimal hospice/homecare experience to do our intake. These nurses get orders, build the charts in the computer and coordiante care with md offices and insurance companies. This may be an option for you.
  4. Any hospice RNs work for more than 1 company?

    We have a conflict of interest policy that does not allow employees to work in the same function for a different company.
  5. Is this really what it's all about?

    I believe your hospice experience can be variable depending on the acuity of clients a hospice takes, the diagnoses, and the nurse. Hospice is generally not a field heavy in 'nursing tasks' such as placing IVs, but very, very heavy in nursing proces...
  6. New Grad RN wanting to be a Hospice Nurse-Advice?

    Apply for all those jobs that say 1-2 years, and apply at assisted livings and nursing homes. You really need that solid 1-2 years of acute care or SNF experience when working hospice because of the autonomy. Some new nurses have been hired by hosp...
  7. Hospital Won't Hire Obese Workers

    Well, my thought is that they are not hiring obese nurses and they are not hiring nurses who smoke. Where do we the draw the line on high risk behavior? Should we still hire nurses who drink alcohol, or drive motorcycles? And, a previous poster co...
  8. How are hospice nurses paid? By visit/hourly??

    i am paid per visit, about $43 per visit credit (this is expected to cover about 75 minutes of time). I make very good money compared to the nurses that work in local hospitals, where the hourly rate is $25/hr.
  9. Im Pagan and a Hospice Nurse....

    I would take a month and feel out your coworkers. Find someone who you feel you can talk to, and bring it up. I work in a state with what I would describe as a 'stifling' religious culture, of which I do not partake in the primary religion. In add...
  10. Discharge from Hospice

    Been there, done that. Shame on the hospice companies for continuing to allow this abuse of the system. It is actually fairly common in the hospice I work for to d/c pts. The primary reason is all those debility pt's that are losing weight until h...
  11. I am surprised they are requiring prior hospice experience. We actually prefer someone that has really solid base nursing experience, but no or little hospice experience so we can teach them our way. That being said, I think you need to highlight t...
  12. any tips on comfort measures for a hospice pt??

    Okay, so I hope I can give you some reasons as to WHY we see a lot of what we do. Dyspnea: you will find very quickly that people with dyspnea handle morphine and ativan together very well. In fact, i have never seen these two meds cause severe resp...
  13. CHAP, Joint Commission, or ACHC???

    I think that this would depend on a few issues. One of them being is there one certifying agency that all insurances in your area recognize (I honestly do not know if this matters, but just a thought). I think Joint Commission comes with a certain ...
  14. Productivity in Hospice?

    What is your productivity? I went to the conference in San Diego and I was very surprised at how low productivity was for many hospices, compared to what I am often doing. I do not necessarily feel overworked, but I have to be firm about working 40...
  15. Wound care puzzle update

    So my gentleman with the liver failure with the giant hip wound has some new things going on. The wound is getting worse daily. In addition to getting bigger, the drainage continues to increase, despite starting antibiotics. The wound bed actually ...
  16. Wound care puzzle update

    Although this pt appears to be entering his dying process, the ostomy over the wound seems to have promoted some healing- I think it has just kept the wound the right moisture without being packed pull of really wet stuff.
  17. Wound care puzzle

    Hello everyone! I love wound care, but am in the midst of a puzzle. I admitted a 50-something year old man with liver failure. Hx of etoh and Hep C. So he has a dehiscence post I&D of his right hip. On the surface the wound looks good, maybe...
  18. Bowel regimen

    It depends on if someone is using narcotics. If someone is on narcotics we usually start with Senna-S, 1-4 tabs daily. If that does not work we will usually use lactulose. If someone is not on narcotics, we start with prune or sometimes just fruit...
  19. Share The Weirdest Reasons Patients Push The Call Light

    The best in a long time: Had a pt hit the call light. When the nurse (I work hospice and was just standing in the hall) went in to ask what she wanted the pt responded: "You better keep your voice down out there. President Obama is in the hospital...
  20. Wound care puzzle

    Wounds related to terminal diagnosis: 1. Any wound related to cancer 2. Pressure sores in a debility pt 3. Surgical wounds related to primary diagnosis (so a wound from paracentesis in a liver failure pt) Hope this helps!
  21. Wound care puzzle

    I am feeling like the best bet may be to just turn over the wound care to the facility, and help with dressing changes to relieve their burden and so I can do my wound assessment. In my experience, this kind of wound does not respond well to wound v...
  22. Clamped Chest Tubes

    We use aspira drains. They can be placed anywhere fluid needs to be drained, so we occasionally see chest tubes, but usually we see them for ascites drainage. They have this nifty port that you connect a bag system to, and then there is a squeeze p...
  23. Need some advise

    Go and work on a medical or step-down floor. You will get to take care of lots of people who are dying, while improving your skills. This job would be terribly intimidating if I had not had a solid base of medical skills. You want to be the best h...
  24. Selling your product

    A few hints on informational visits. I talk slower and in a lower voice than normal- this seems to be less intimidating. I also allow 30 minutes of my visit for them to tell me what is going on. This allows me to discuss a specific plan of care fo...
  25. I am not sure what kind of wound you are looking at, but I do hospice and we have a wound care nurse we consult with and then we do the dressings, even though I don't have detailed wound care training. If someone has a wound vac KCI will provide thi...