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Palliative Care, DNP

Palliative Care, DNP

Family Nurse Practitioner
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Content by Palliative Care, DNP

  1. Palliative Care, DNP

    What is the fastest respirations you've ever taken in an adult?

    Sadly, in the 40's but that's what it finally took before a family decided to transition a patient to comfort.
  2. Palliative Care, DNP

    Shockingly low NP pay !

    I went into a specialty after graduating because Family Practice doesn't pay. My hospital system offered me $74k/year to work in Family Practice. I make $108k/yr in Palliative. Looks like I will continue to have goals of care discussions and assist with symptom management.
  3. Palliative Care, DNP

    NP Jobs still looking pretty good.

    I work for a hospital system who has a monopoly in my area. There are only 3 job openings currently in the entire system. I know 1 RN who has almost been a licensed NP 2 yrs but is still working as a floor nurse. She can't find a job. Our market is saturated with more NPs graduating every day.
  4. Palliative Care, DNP

    What do you hate about nursing and why?

    My biggest complaint is that healthcare has become the equivalent of the Burger King drive thru. Patients come in and order Care their way. Providers are expected to bow and give them whatever they want. It is no longer about doing the right thing but avoiding having the Patient Advocate called.
  5. Palliative Care, DNP

    Writing order and having Dr sign later..your thoughts?

    I'm not a physician but I can assure you, that I'm not signing any orders that I did not write or discuss. I would also not take kindly to that happening.
  6. Palliative Care, DNP

    Prescriptive Auth in SC

    Planning to relocate to SC. Reading through requirements for the state. Am I understanding correctly in SC that you must have a supervising physician before you can obtain prescriptive authority? I thought I would ask here but will follow up with call to SC Board. Thanks!
  7. Palliative Care, DNP

    How do new grad Nurses that don't have BSN manage to survive this job market ?

    The hospital system that I work for will hire ADNs but they stipulate a date by when that nurse must complete the BSN. Our ICU only has BSNs who are also certified in critical care.
  8. Palliative Care, DNP

    Seasoned Nurses VS Newbie Nurses

    My suggestion is learn as much as you can from everyone you can. There is something to learn from every person from the environmental services folks through management. Take what you learned in school and intermix what you learn on the job. Create your way of providing safe, efficient, and timely care. Most importantly, make friends with the CNAs and ER techs. They can make or break a shift. Always ask questions when you aren't sure.
  9. Palliative Care, DNP

    Palliative Care - Interview with a Nursing Leader

    We work in a team at my facility. We have a MD, 2 NPs, & a PCSW. We provide symptom management for chronic & life-limiting illnesses, have family meetings to determine goals of care, assist with advanced care planning, offer support, and assist with connecting families with hospice when appropriate.
  10. Palliative Care, DNP

    Comfortable dealing with end of life

    Thanks, I do that everyday. My point is these conversations would make decision making a lot easier in the moment. I realize everyone is different and do meet people where there are. Just as you should realize that we see many people suffer due to their family's guilt and need to do "everything."
  11. Palliative Care, DNP

    Comfortable dealing with end of life

    Yes, my family has had all of those discussions. My parents are both DNRs with advanced care plans. My husband's family are the miracle "do everything" people. My husband and I also both have advanced care plans. Our kids already know what we would want. They are 21 down to 14. It's never too early to start talking.
  12. Palliative Care, DNP

    Comfortable dealing with end of life

    Sadly, it is not only in the NICU that people want "everything." Our culture is simply not comfortable with death. It is amazing how many people simply do not discuss the topic at all. I had one woman recently tell me that she would rather decide when to pull her father off of a vent than to discuss a DNR or hospice with him. It is really amazing the things we hear and see.
  13. Palliative Care, DNP

    Soo tired of bedside...

    Floor nursing was not for me at all. I knew it would not be sustainable for me. I went back to school and I have found that I very much prefer being a provider.
  14. Palliative Care, DNP

    Comfortable dealing with end of life

    We have to provide daily education to physicians where I work. Many equate us with hospice. We are not the God Squad going room to room celestially discharging patients. Palliative Care provides symptom management and support to patients with life-limiting or chronic illnesses. We also assist with Advanced Care planning, Goals of Care discussions, and terminal extubations. We are able to assist with the coordination of hospice for patients who choose to go in that directions prior to discharge. In my area Palliative Care only exists inpatient and hospice would be the closest thing to us outpatient. In my experience, oncologists are the worst with being truthful on prognosis with patients. We are often the first people who advise them that their disease is terminal. Oncologists like to use the words "palliative chemo or treatment" without explaining to the patient that means we can not cure this but may be able to prolong your life some. There are also those patients and families who are advised but believe in miracles. So far, I have yet to come across one miraculous recovery in a terminal cancer patient.
  15. Palliative Care, DNP

    Why do you smoke?

    I currently work with a pulmonology and critical care physician who smokes. He says the stress of running the ICU makes it next to impossible for him to quit. When I was still a floor RN, I worked with an RT that had lung cancer and he was still smoking. My own husband had stopped smoking for 17 years but picked it back up when he opened his own pharmacy 5 years ago I can't get him to stop either.
  16. Palliative Care, DNP

    Should you work as a CNA/Tech before or during nursing school

    I never worked as a CNA during my program. I did make friends and assist every CNA that I ever worked with though. CNAs make or break a shift. They are underpaid and overworked. My parents taught us "that you can learn something from everyone you meet." I learn something daily.
  17. Palliative Care, DNP

    To Suction or Not To Suction, End of Life & Hospice Patients

    In Palliative Care at the facility I am employed we do not deep suction comfort patients. All are given Robinul, scopolamine patches, & sometimes Atropine. We consider deep suctioning to be against comfort. We may suction the mouth but that is it. We do provide family with education on end of life changes as well.
  18. Palliative Care, DNP

    FNP New Grads - Tell us about your first job!

    I have been at my first job for a year now. I am in Palliative Care so we provide symptom management for life-limiting and chronic illnesses, have family meetings for goals of care, assist with Advanced Care Planning, and can coordinate with hospice for patients. Most of the time I like my job but some days are pretty emotionally taxing. The worst part of my job is when we are utilized as pain management for patients that are admitted for surgery or chronic pain patients.
  19. Palliative Care, DNP

    Really, Doctor?!

    Every patient that I order opioids for also has a Narcan order placed. Unless, they are comfort transitioning to hospice.
  20. Palliative Care, DNP

    How many patients do you have on each shift?

    When I left floor nursing, we each had 6-8 patientsa night. It was 8 more often than not & that was 2013.
  21. Palliative Care, DNP

    Post Master's Psych Certificate

    I am looking at post master's psych certificate programs. I'm focusing on programs that match students with preceptors. So far, I have Vanderbilt, Johns Hopkins, and VCU. Googling has proven more often than not the student is on their own. I am not going through that again especially in a specialty such as psych. Does anyone know of any other programs they can recommend? Thank you for your assistance.
  22. Palliative Care, DNP

    Schedule IIs

    I was reading an article that said OK, GA, MO, AR, SC, & WV still do not allow NPs to write schedule II prescriptions. Just curious how Hospice & Palliative Care NPs do their jobs in those states? Almost every patient I see requires a schedule II. Just wow
  23. Palliative Care, DNP

    WHNP or FNP in VA?

    WHNP/FNP gives you more options. CNM still relegates you to only women's health.
  24. Palliative Care, DNP

    WHNP or FNP in VA?

    The job market in our area is limited for women's health. I would definitely say the dual program would give you more options. The Hampton Roads area is saturated with NPs. A dual certification is make you stand out. If you end up in a rural area like the Eastern Shore you will be doing women's health in primary care.
  25. Palliative Care, DNP

    BSN is a joke

    Honestly, I agree there is a lot of BS in the BSN education. I also felt like there was a lot of BS in the DNP. That said, I put in the work because it was necessary to get where I wanted to go. In life, there are so many things we do simply because they are necessary. The value is determined by you. Are you where you want to be? If not put in the work.
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