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hospicemom has 8 years experience and specializes in hospice.

hospicemom's Latest Activity

  1. hospicemom

    Calling Doctor to START end of life Med.

    you need an order before any treatment can begin. Sometimes if its the weekend and I know that the MD will not be around to sign all the papers then I will page and get numerous medications started or at least given the order to go ahead and start if needed. But yes, an order before any meds are started.
  2. hospicemom

    lung cancer vs emphysema

    can anyone help me with this. I have someone who was diagnosed with prostate ca after "waitful watching" of a tumor for 7 years. There have been no other testing done except for the biopsy. Recently a chest xray was done and came back abnormal, however he was dx with early emphysema. My question is.... could this possibly be lung cancer misdiagnosed as emphysema? Just wondering what everyone elses thoughts on this. Thanks!
  3. hospicemom

    hospice care plans

    Looking at switching to a different hospice care plan. Anyone out there who really loves/ likes theirs? If so, where did you find it? I cant imagine there is no hospice specific diagnosis/careplanning books out there for purchase however I am not coming up with anything. Please offer some suggestions. Thank You!!!!
  4. example: clonazepam is scheduled TID AND Q4 hours PRN. Question: do you take these as two seperate orders or as one order. To clarify.... If the scheduled dose is at noon and in one hour they are still not managed can you give the PRN dose at that time or do you need to wait until 4 pm to give it? There are many different opinions on this. I believe it is two seperate orders and we should be able to give the PRN dose one hour later. Other nurses believe the PRN can not be given until the 4pm mark to make sure there are 4 hours between doses. Asking for some insight and other opinions on this. Thanks!
  5. I was a hospital nurse for about 3 years before going into hospice. I think its always a great idea to start in the hospital to get the basics on nursing, medications and things, prior to getting involved in any specialty.
  6. hospicemom

    Hospice Certification exam

    hey, thanks for the support. I am hammering away on that study question book and everything else I have. Thanks again.
  7. hospicemom

    Hospice Certification exam

    Thank you for your kind words. However, I did not pass. My score was a 97 and 98 was passing. I also had a lot of ALS questions as well as superior vena cava syndrome and spinal cord compression which unfortunatly I have not had in the years I have been in hospice. There were many questions regarding QAPI as well. I have already rescheduled my exam and will be taking it again in june. I also felt it was more a test on vocabulary. Many questions about mouthcare as well. It was not at all what I was expecting however now I certainly know how to study for it the next time around. Studied my butt off on the medication converstions and what not....one question regarding that was on my test. Frustrating! Tough test.
  8. hospicemom

    Hospice Certification exam

    :)I have been studying using the core curriculum, study guide as well as the flash cards. I take the test in two days. I am not sure as to what to expect but I am getting a little nervous. I have been in hospice about 4 years and took the online sae as well. Crossing my fingers!!!! Any reassuring words would be greatly appreciated!
  9. hospicemom

    average # of nursing home patients

    a patient may be able to have PT if it is not related to the terminal diagnosis. example...lung cancer patient with broken hip receiving PT for the hip is fine and medicare will cover it even with the hospice involvement.
  10. hospicemom

    average # of nursing home patients

    Hospice never pays for the patients "stay" in the nursing home. If the patient has money he/she is "private pay" in the nursing home for room and board. If the patient does not have money they will be medicaid(T19) and they will pay the room and board. If the patient has some money but not enough to last him until his last days then he will be required to use the money he has and be private pay until his money runs out to where medicaid takes over. So basically, hospice gets "paid" from either medicare or medicaid and then divides the money up to the proper places. So Hospice never pays for the room and board but does pay for all other care related to the terminal diagnosis. This is what I understand of it thus far anyway:)
  11. hospicemom

    Disposing of medications at time of death

    great idea!!!!!!!!!!!!
  12. hospicemom


    I guess I am just looking for the nursing part. I need to be able to pull out the policy and procedure for inpatient respite (lets say) and give it to the other case manager to use as a guideline. When you admit someone respite do this.... inpatient related do this.... I know things will be different with each case to a point but there has to be certain regs to follow. I am just pulling my hair out trying to figure this out.
  13. hospicemom


    I am looking for cheat sheets/guidelines for setting up policy and procedure for inpatient related and non related as well as respite. specifically the "how to" stuff. What orders are the RNs reponsible to write and how to sign these orders ie.( T.O/V.O/Nursing order). If anyone can help on this I would greatly appreciate it. THANK YOU!
  14. hospicemom

    md visits in inpatient

    when you have a patient inpatient hospital does anyone know the requirement for m.d visits? i cant find a medicare policy on it and noone seems to know, including the docs.
  15. hospicemom

    What to do??????????secretions.....

    we dont suction either. too invasive as well as the fact the secretions will just come back. plus, usually the secretions are deep airway, not upper airway. sounds worse than it is. scope patch on at first sign of secretions works well usually.
  16. hospicemom

    RN Case Mngr Hospice

    i agree with the palliative sedation. maybe inpatient for a block?

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