vapn

We wouldn't discharge for going to the ER, and we would even cover the visit if it was related to the hospice diagnosis. We have rarely discharged patient for "seeking curative measures", like going on a vent or having surgery, but we can pick them right back up when they are done with what they are doing.

It is a different world, but if you know your med-surg and are familiar with basic gerontology, then you should be fine. Take a leap, LTC has its rewards.

That is a great explanation! I'm stealing it. I know this thread is a month old, but the order is completely appropiate. Another thing to keep in mind is that with bone mets, lots of times pain can go from 0-60 in a short amount of time and it is very challenging to get it under control at "60" when there was really no noticeable progression of pain. Also, this was in the ER, which means the patient was likely at home with subtherapeutic pain control for who knows how long, also making it a challenge to get that pain under control. Kudos to you for following that order.

I say you handled it well, but in most states, before performing such a surgery, you must have signed the consent...the one that says that you understand that you will be sterile 30 days before the procedure or surgery is performed unless it is an emergency.