SoCalRN1970

SoCalRN1970

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All Content by SoCalRN1970

  1. Whose patient is this???? assistance please

    SoCalRN1970 replied to AtlantaRN's topic in Hospice, Palliative

    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...

  2. Patients families dictating care and treatment

    SoCalRN1970 replied to MomRN0913's topic in General Nursing

    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...

  3. Patients families dictating care and treatment

    SoCalRN1970 replied to MomRN0913's topic in General Nursing

    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...

  4. Patients families dictating care and treatment

    SoCalRN1970 replied to MomRN0913's topic in General Nursing

    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...

  5. Free Reign for Hospice Orders?

    SoCalRN1970 posted a topic in Hospice, Palliative

    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...

  6. Free Reign for Hospice Orders?

    SoCalRN1970 replied to SoCalRN1970's topic in Hospice, Palliative

    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...

  7. Free Reign for Hospice Orders?

    SoCalRN1970 replied to SoCalRN1970's topic in Hospice, Palliative

    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

  8. Free Reign for Hospice Orders?

    SoCalRN1970 replied to SoCalRN1970's topic in Hospice, Palliative

    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...

  9. Free Reign for Hospice Orders?

    SoCalRN1970 replied to SoCalRN1970's topic in Hospice, Palliative

    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...

  10. Free Reign for Hospice Orders?

    SoCalRN1970 posted a topic in Hospice, Palliative

    :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...

  11. Admitting patients for the sake of admitting?

    SoCalRN1970 replied to SoCalRN1970's topic in Hospice, Palliative

    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...

  12. Team Mates who toss others under the bus...

    SoCalRN1970 posted a topic in Hospice, Palliative

    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,...

  13. How would you of handled this? Family scenario...

    SoCalRN1970 posted a topic in Hospice, Palliative

    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....

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

    SoCalRN1970 replied to SoCalRN1970's topic in Hospice, Palliative

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

    SoCalRN1970 replied to SoCalRN1970's topic in Hospice, Palliative

    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...

  16. Saying good bye to a loved one.

    SoCalRN1970 replied to lsyorke's topic in Hospice, Palliative

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

  17. Team Mates who toss others under the bus...

    SoCalRN1970 replied to SoCalRN1970's topic in Hospice, Palliative

    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....

  18. Marketing VP wants contacts at employees' church

    SoCalRN1970 replied to AtlantaRN's topic in Hospice, Palliative

    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

  19. How would you of handled this? Family scenario...

    SoCalRN1970 replied to SoCalRN1970's topic in Hospice, Palliative

    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...

  20. How would you of handled this? Family scenario...

    SoCalRN1970 replied to SoCalRN1970's topic in Hospice, Palliative

    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...

  21. Kennedy Terminal Ulcers

    SoCalRN1970 replied to CANRN's topic in Hospice, Palliative

    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...

  22. Kennedy Terminal Ulcers

    SoCalRN1970 replied to CANRN's topic in Hospice, Palliative

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

  23. Admitting patients for the sake of admitting?

    SoCalRN1970 replied to SoCalRN1970's topic in Hospice, Palliative

    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...

  24. Super thick & sticky phlegm

    SoCalRN1970 replied to Ruthfarmer's topic in Hospice, Palliative

    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...

  25. RN whos Dad was on Hospice

    SoCalRN1970 replied to muffin7's topic in Hospice, Palliative

    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...