AtlantaRn1

First question-what is the territory? Coverage area? If you are in an urban area and are stationed at a facility you could see 6-8 pts a day based on their acuity. But if you are seeing Home patients you may only see 3-4 in a day. In my experience at a previous hospice south of Atlanta $50/routine visit (30 min), $75 extended visit (45min), admission $100 plus mileage. That was when I did case mgt 2008-2014

I think you will Enjoy hospice. But be prepared that it has moments where you will feel you are working fast track again. I do on call so I'm like the fireman-fix a problem and move to next problem.

On call provides my life with a much needed detachment from the demands of day shift hospice. I'm on nights f, sat, Sunday. Gentle hugs from Georgia.

How do you adjust your bowel programs? For instance. If you start all pts on senna-s on admission, then add norco, do you automatically up to another senna product? As weekend on call im noticing a disconnect with patients receiving adequate meds/interventions for bowel issues. for instance, this weekend visited a bedbound Pt. Dear wife reported giving him fleets enemas & suppositories for the last 8 days, but he just can't poop well. Ok. I give him a high hot & hell of a lot soapsuds enema, abdominal massage counterclockwise while guy is nearly standing on his head. It was enough to move things downstream to his rectum so I could disimpact, but today he will most likely need another soapsuds enema to clear residual. we are great about asking about pain relief but what about the quality of our patients bowel movements? Thoughts? Thank you in advance for your input. This has always proved to be a community with a wealth of information.

During the time you were working/that's your pt. I'd have done same.

Textbook of palliative nursing-Ferrell and coyle Obtain through Compare New and Used Book Prices | Buy, Rent, Sell Textbooks. I paid &7-$10 for copies I've obtained. Over the years when I precepted new nurses I've purchased this book for them it really helps as for the palliative medications that we use for the emergency kits familiarize yourself with all of the medications and their uses. Levsin is great for nausea. Not just secretions. Never give haldol to Parkinson's Pt or any kind of movement disorder.

Palliative nursing, especially in an ipu is for symptom control. It's all about support and symptom control. When I'm on an interview, I provide the interviewer with information they are not allowed to ask. This has always provided me with a job offer. I'm an older nurse-we don't travel-I'm a homebody. I work extra shifts. I'm all about being s team player. You will get the job

First-census. Does this company have 50 pts or 200? Coverage area. 50 mile radius of office is standard. Time to get to each visit-once call comes in you have 5min to call facility/family/Pt give instructions n get out the door within 10 minutes and arrive to pts location within 1hour. W your background you should do fine. I do 3-15h shifts Friday, Saturday, Sunday. We have 190 pts. I am primary rn with 2-lpn runners. It's doable. But remember with each call and visit-there is charting. I would commit to only 3-night shifts. Or just the two day weekend shifts.

Bless you. You've gotta do what you e gotta do. At the end of the day-if we don't care for ourselves we really cannot give to others. After 21yrs I've considered other settings to hang my shingle. I'm ultra conscious now-this weekend every time I was able to return home-scrubs were washed on hottest setting n I showered. I eventually I'm hoping I will be an educator with my company. Until then I've gotta be diligent w standard precautions.

I'm dealing with this same situation currently. I will never place my bag on anything without a chux barrier ever again.

Never again will I ever kneel next to a pts bed without a barrier. I know better. Myself n 5 other caregivers got scabies. I, however, am the only one that brought a bed bug hitchhiker home. Pest control quote is $900 for heating my home to 130 degrees to kill the critters (I'm the only one getting bit-thank goodness)-pest inspector said this was caught early 🙌🏻

Had a pt this weekend , nh sent to local er, Then called the service, pts sat 70%, rr 50, said pt found w tubing pulled off concentrator and they had no idea how long she was in this condition, normally they would call hospice first but pt in dire condition, and admitting rn did not send an e-kit. So I went to local hospital, they gave her a couple of breathing tx, n started her on cipro for pneumonia. Facility rn was ****** there was no ekit for patient and relayed this to my manager. Case mgr for the facility tells mr today that facility doesn't want dnrs to go to the er- they want them treated at facility- nurse said "facility has an e box w resp tx's n ativan po n im, also morphine iv or im but no liquid roxanol. And "if u don't know what to do, you can always call the doctor.". WHAT? Facility told me what THEY had done, emts were there when I called back. I've been an rn for 15 yrs w last 4 in hospice. I know how to handle w breathing tx, o2 n roxanol to slow down respirations. The admitting nurse needs to b sure all pts have ekits so on call can handle emergencies. She knows this bc she had been an on call nurse. Rant mode off, I just need someone to listen, thank you! Atlanta rn.