SoCalRN1970

Your lil patient definitely needs to be seen by their PCP so they can discuss ( patient and MD ) what is available. I have run into this and it's always fallen back to the PCP. Once the patient is out of the hospital, the hospital and the hospital...

I think what I posted lacked insight and proper response. I know nurses are human, errors are made and have been made. My point is that the LVN or LPN has no authority, experience or ability to run the show. The fault lays with the MD who is willi...

BTW, even though the patient was bleeding from wounds and the doctor wrote orders because an LVN SNF nurse insisted upon it. Who do you think is going to be looked at for responsibility? The daughter? Heck no. The MD... who is practicing medicin...

NO matter what you do . Families often try to run the show. I have just accepted it. What is needed is a doctor with a pair who is willing to speak to the daughter and explain that although her input is needed, he write the orders. Period. I ha...

I have worked at a few hospice agencies. Most Medical Directors will allow some basic ok's without orders. For example increasing roxanol from 10 to 20 mg. Inititating atropine etc. I recently was spoken to because I wrote orders on a Crisis Car...

I am frustrated. My manager has never worked hospice before. Has done home health. There is another person acting as a manager, but is clueless. LIke I said. I wasn't necessarily accused of leaving inappriate notes behind in someone's home char...

I have no idea why this person has an agenda. But they do. Supervisors that act like this are enough to make one bonkers and scared out of their wits if they cough they can be termed.

I feel the same way. Caloitter. I will say that I will give this agency no reason to question me at least. I have written pages of communication notes.. if for any reason to cya. The person with the beef issues per se' is the manager who Freakin...

I just find it bizarre that there is such a response to me calling for everything like I was told to do. But I also was told that the MD was upset because I didn't call to clarify roxanol orders for respiratory distress. I have NO idea what I can d...

:twocents:I have worked at a few hospice agencies. Most Medical Directors will allow some basic ok's without orders. For example increasing roxanol from 10 to 20 mg. Inititating atropine etc. I recently was spoken to because I wrote orders on a ...

The things that must indicate appropriatemess for hospice here anyway. weight loss? What was it? What is it now? Skin issues? everything from a skin tear to a red bottom counts here DId she then have one, does she have one now? FAST SCALE Refe...

I am so excited that I just started a new job. The office apears nice, I am out doing my own thing and I have noticed..... teamates at this office toss others frequently under the bus. Meaning, they will speak poorly about someone, I have heard ...

I was in a situation that was not atypical of what we see and deal with on a day to day basis. This patient per se' is a man end stage dementia bed bound, contracted, multiple superficial decubitus. He is in pain with movement or care rendered. Hi...

I will say that I don't plan on using a pulse ox. First of all, how can our agency endorse this item if they don't provide it? How can they callibrate it? How do they know your documentation reflects an accurate level? Hospice patients are never...

Thankyou for sharing. I am so happy you had hospice to be there with you and Bill.

You are do right Irish. I must say though that its pretty upsetting to have this happen to me already. Since my post all is quiet. But I am on guard. I have not worked with catty women in so long. I also can't imagine being called into the office...

COnflict of interests comes to mind. I'd speak to the supervisor so they can set your wayward liaison straight. It's a bit no no in my book

He can take vicoden... he is end stage FAST Fc according to our regs he is appropriate. He eats a soft diet. His vicodin is broken into pieces or crushed according to his family. I have offered elixier.. its a no. Here we are at almost two week...

The disapproval factor may of been there for me. The family was not going to budge on the medication. Denial on many levels is s agood thing for a short period of time, however, incidents like this.. the patient's pain can't properly be addressed,...

OH I definitely know what they are.. just not the "term". I have seen them develope over night on terminal patients who are transitioning.. and if the transition is long.. these ulcers have been know to just erupt. It's really hard on family as ...

Been a Hospice RN 8 years.. never ever heard that term before.. Not here on the west coast anyway.

OH you don't understand.. you can't admit patients on being needy. They have specific guidelines. If they don't meet the criteria, they can't legally be billing for services.. I am more leaning on the agency who admits them vs. the MD who is sick ...

THe guifenisne must be a high enough dose taken consistently to help liquify the secretions. MUCINEX is the the very same drug. I have had to use this or the generic as the dosing with syrup was just too much

I should of clarified yes, my original post mentioned a comfort kit. Those are standing orders. HOWEVER!! Standing or not. When there is a change in condition or a need to start the Roxanil it's better practice to notify the family of this. I re...