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rubysasha

rubysasha BSN

NICU, neonates, newborns
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rubysasha has 11 years experience as a BSN and specializes in NICU, neonates, newborns.

rubysasha's Latest Activity

  1. rubysasha

    GIP physician regs

    rubysasha posted a topic in Hospice

    Can anyone tell me if there is a mandatory requirement for the frequency of physician visits for GIP patients in a free standing inpatient unit? Trying to google how often physicians must physically see the pts while GIP, but I can't find anything. I thought it was required for a physician or NP to round daily, but I have recently been told that is not true. I'd love to see the requirements in some kind of official documentation, but can anyone here share with me how often the MD rounds in their free standing IPUs?
  2. rubysasha

    DOH survey frequency

    rubysasha posted a topic in Hospice

    i have been working for a hospice agency for the last two years, and our last visit from the DOH was in august 2011. ever since august 2014, many of my supervisors have been warning us that we are due 'any day' for a survey. they still have not shown up (not that i'm complaining) i looked on the state DOH website for frequency of inspections, it says: "CHHAs and Long Term Home Health Care Programs are inspected at a maximum interval of 36 months; Hospices at a maximum interval of 48 months, and Licensed or limited licensed home care services agencies at 36 month intervals" i don't want to be rude and question my supervisor for something so insignificant. do you think it's possible that they are confusing home care with hospice regulations? if it is really 48 months, that is 4 years, so we wouldn't be due until august of 2015, correct? or am i reading something wrong or confusing something? when should we really be expecting them? i'm just trying to figure it out because i have not had to do any DOH visits and i'm more nervous about doing it in the homecare setting than when i worked in the hospital.
  3. rubysasha

    alternatives to morphine

    rubysasha posted a topic in Hospice

    does anyone know what the alternative to morphine/roxanol for SOB would be for actively dying hospice pts (unable to swallow)? recently i had a pt who became very nauseous and was vomiting after morphine.. had lorazepam & compazine which helped with the nausea but the morphine was so important because he was a COPD'er.. i know morphine for pain has a lot of alternatives but what can you do for respiratory distress if a pt cannot tolerate morphine? i found an article about nebulized hydromorphone.. anyone have any experience with this? Nebulized hydromorphone for dyspnea in hospice care of advanced can... - PubMed - NCBI
  4. rubysasha

    for nurses w/ CHPN certification

    rubysasha posted a topic in Hospice

    I took the CHPN exam on Dec. 5th. I got my results right after I completed the test and I passed! I got the temporary print out with my score at the testing center that said I would receive my official certificate in the mail within 90 days. I know it's only been a month but my name has not been added yet to the CHPN listing online and haven't received the certificate yet. I know it's early but I guess I'm spoiled because everything nowadays has been so fast! When I passed my NCLEX my name was on the state board of nsg website within like 2 days, and when applied for licensure in another state it took only a few days as well. Also, I told administration at my job that I passed and gave a copy of my print out from the testing center but they want a copy of the actual certificate when it comes. I guess I'm just antsy because I'm still excited that I passed! :) Did anyone else get their certificate or have their name added to the online CHPN listing quicker than 90 days?
  5. rubysasha

    Changing requirements and a couple other questions

    rubysasha replied to hospiRN's topic in Hospice

    I get 56 whopping cents per mile, only do FAST scores for dementia pts, and definitely NO on the nutritional shakes. I think administration would laugh me out of the office for suggestion that one lol.
  6. rubysasha

    Heartland Hospice

    rubysasha posted a topic in Hospice

    I am an RN, I live in NY and work in a hospital's hospice program, so I split my days between seeing inpatient hospice pts, and pts in their homes. I plan on moving to Virginia Beach sometime next year after my husband graduates from his Master's degree program. My family has been in Queens NY forever and in recent years, they've all moved to VA Beach, and we're pretty lonely up here without them. As I sit and wait for my hubs to finish school, I always have my eyes on the VA job market for hospice jobs. Don't get me wrong- when I get down there, I will need a job ASAP and I'm really willing to take something temporarily in med/surg or something just to pay the bills, but my heart is always 100% hospice and can't imagine doing anything else long term. I see positions open with a place called Heartland Hospice but it seems to be like a chain/corporation of sorts... they have locations in 25 states. The hospital I work for now is pretty small, I have a caseload of about 15-20 but I know everyone involved with hospice and I like it that way. Has anyone worked for Heartland Hospice in any of its locations? How is working for this company? I'd love any information anyone may have. Thanks!
  7. rubysasha

    morphine pumps

    rubysasha posted a topic in Med-Surg

    I'm posting this question here and to several other specialty boards in hopes to find a good answer. I'm working on a hospice unit for the last 6 months (which I love). In the past I worked in ortho for 4 years. Anytime I experienced a pt on a morphine or dilaudid pump, they were run through either a PICC or port. I have to admit that I haven't had very many pumps in my experience, usually morphine PO or SL route works fine, or they will need IV push morphine every few hrs or prn, but every once in a while I come across a pt with such significant pain that they need a pump. I have a pt now who needs a pump and does not have a port, the dr wants him to get a PICC line in order to get him the morphine pump he very desperately needs. The pt is willing to go through this, and he's going to do it, but my question is.. why can't a drip be given through a peripheral IV? I understand the IV will need to be changed and could infiltrate etc, and were trying to prevent tons of needlesticks for the pt, but I feel terrible to have a hospice pt go through the entire PICC insertion. I feel dumb asking other nurses I work with because I feel like i'm missing something obvious. Has anyone had any experience using a morphine pump/drip with a peripheral IV? why does it HAVE to be through a PICC or port?
  8. rubysasha

    morphine pumps

    rubysasha posted a topic in Hospice

    I'm posting this question here and to several other specialty boards in hopes to find a good answer. I'm working on a hospice unit for the last 6 months (which I love). In the past I worked in ortho for 4 years. Anytime I experienced a pt on a morphine or dilaudid pump, they were run through either a PICC or port. I have to admit that I haven't had very many pumps in my experience, usually morphine PO or SL route works fine, or they will need IV push morphine every few hrs or prn, but every once in a while I come across a pt with such significant pain that they need a pump. I have a pt now who needs a pump and does not have a port, the dr wants him to get a PICC line in order to get him the morphine pump he very desperately needs. The pt is willing to go through this, and he's going to do it, but my question is.. why can't a drip be given through a peripheral IV? I understand the IV will need to be changed and could infiltrate etc, and were trying to prevent tons of needlesticks for the pt, but I feel terrible to have a hospice pt go through the entire PICC insertion. I feel dumb asking other nurses I work with because I feel like i'm missing something obvious. Has anyone had any experience using a morphine pump/drip with a peripheral IV? why does it HAVE to be through a PICC or port?
  9. rubysasha

    morphine pumps

    rubysasha posted a topic in Pain

    I'm posting this question here and to several other specialty boards in hopes to find a good answer. I'm working on a hospice unit for the last 6 months (which I love). In the past I worked in ortho for 4 years. Anytime I experienced a pt on a morphine or dilaudid pump, they were run through either a PICC or port. I have to admit that I haven't had very many pumps in my experience, usually morphine PO or SL route works fine, or they will need IV push morphine every few hrs or prn, but every once in a while I come across a pt with such significant pain that they need a pump. I have a pt now who needs a pump and does not have a port, the dr wants him to get a PICC line in order to get him the morphine pump he very desperately needs. The pt is willing to go through this, and he's going to do it, but my question is.. why can't a drip be given through a peripheral IV? I understand the IV will need to be changed and could infiltrate etc, and were trying to prevent tons of needlesticks for the pt, but I feel terrible to have a hospice pt go through the entire PICC insertion. I feel dumb asking other nurses I work with because I feel like i'm missing something obvious. Has anyone had any experience using a morphine pump/drip with a peripheral IV? why does it HAVE to be through a PICC or port?
  10. rubysasha

    nclex monday! 7/8

    rubysasha replied to rubysasha's topic in NCLEX

    congrats!!! i just got my quick results and i passed too! i am SOOOO happy. new york BON usually takes 2 business days to post the license number on the website but they are so backed up because so many people are taking the boards, i may not get a number until next week which is annoying. i know someone who took it friday and still hasnt gotten his. but i'm just thankful i passed! :)
  11. rubysasha

    quick results

    rubysasha replied to rubysasha's topic in NCLEX

    thanks everyone. i did the pearson vue trick and got the good popup but im anxious for the real deal results.
  12. rubysasha

    quick results

    rubysasha posted a topic in NCLEX

    i know ncsbn says 48 hrs for quick results, but when have you seen the link finally pop up? i took my test 7/8 and finished about 1:40pm, will it come up about that time tomorrow or has it happened any earlier for anyone? when i took my lpn boards a few years ago, i feel like i remember the results being up a few hours early but i'm not sure if i'm imagining that.
  13. rubysasha

    nclex monday! 7/8

    rubysasha replied to rubysasha's topic in NCLEX

    i also used kaplan and saunders review books. i did kaplan from cover to cover and the tests at the back of the saunders book. i got alot of SATA and the 'put the steps in order' questions. surprisingly no math, hot spots or audio. i hope the pvt is right, it worked 4 years ago when i took my lpn boards and for anyone i know who tried it.. the only people ive heard it not working for the few people on this board.
  14. rubysasha

    nclex monday! 7/8

    rubysasha replied to rubysasha's topic in NCLEX

    i took the test at 1pm.. 75 q's and i checked the pvt on my phone as soon as i left and got the good popup thank GOD... hopefully its true. i was soooo nervous! but i was out of the test within an hour.
  15. rubysasha

    nclex monday! 7/8

    rubysasha replied to rubysasha's topic in NCLEX

    thank you :)
  16. rubysasha

    nclex monday! 7/8

    rubysasha posted a topic in NCLEX

    i had my nclex scheduled for june 25th until i had a meltdown and rescheduled for july 8. i am glad i rescheduled because i didn't feel ready yet, and i was absolutely PETRIFIED to take it. two weeks later, i don't think i know any more than i did but have been working with kaplan's decision tree/answering strategies. i'm still petrified for monday but i am ready to get it over with. i can't wait anymore, i wish it was monday so i could just do it and stop thinking about it. i know a few people who i graduated with who have passed, but unfortunately found out one of my peers failed her nclex. so i have the rest of today and tomorrow to study and i just don't know what to do with myself... i keep doing questions but i'm frustrated with ATI (waste of money).. their rationales are useless! if i pick a wrong answer, it simply says something like, "that choice is the incorrect answer." GEE thanks, i'm so glad you clarified that for me, ATI. kaplan and saunders have much better rationale in their books and cds however. anyone else taking it this week?? if i fail, i'm going to take a review class with kaplan.. a friend of mine took it and passed last week, she said it was worth the money.
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