4boysmama

I very much doubt that you will lose our license over this, but you might lose that job. While it is appropriate to delegate personal care to the aides when available, it is also well within our scope of practice to provide that personal care and you should have done so instead of leaving the patient alone while you went to search for another aide.

I would need more info on this before offering an opinion. There are folks tat I would have no problems doing the meds you listed all together, and there are ones I wouldn't - it all depends on their opiate exposure/tolerance, disease process, etc. One thing, however, that stands out is if she is needing oxycodone 15mg every 4 hours scheduled on top of the fentanyl - why hasn't the PCP d/c'd the oxy and gone to a higher dose on the patch? the 75 is clearly not effective. Even with my hospice folks, I don't like to have that many different opiates in the rotation. I would want to d/c oxy, go higher ont he fentanyl, and use the roxinol for breakthrough (with or without the fioricet, though I'm not really a fan of fioricet in general.)

Im a community-based palliative/hospice full time RN. we get 5 weeks PTO, which includes vacation and sick days. Holidays do not come out of this bank - if we work the holiday we get 8 hours holiday time banked (that we can either cash out or use as vacation time). we do not ever getting called off for low census/etc, so I'm not sure what would happen in that scenario (it just never happens in our particular speciality, because we have patients scheduled every day for visits). We work one winter holiday, one summer - and get paid time and half for the holiday we work. there's 6 paid holidays, so for the ones that you dont' work we get paid regular 8 hour day. Weekends every 6 weeks, and we get off a comp day week before and week after when we work that weekend. time off requests during holidays (thanksgiving to new years) need to be in by October 1. Time off for june-august needs to be in by april 1. Last year it became apparent that there was no system for granting summer vacation requests (no advantage for seniority or for early request - I put in my requests jan 1, and still didn't get several of the days I requested). manager heard and earful from many of us on that, so now they are planning to do a first-come-first serve)

in my current situation, work enironment wins hand down over more money. If my financial circumstances were to change, then I would consider rappy environment for (much) more money, but it would still be a tough choice

congratulations!! where did you take the chemo/bio 2 day class?

how is that even legal? DOes your state have a DNR registry?

it means that you can start applying when you're 90 days out from graduation, and then must take and pass nclex within 90 days from graduation. eligible for licensure means that you have satisfied state requirements for education and are qualified to take the nclex. since you have already graduated and are awaiting your att, you are eligible to apply right now. However, be aware that most hospitals will not go through the hassle of the hiring process until you've already passed and have your license

have you exhausted all options to get assistive devices for repositioning/transferring? I would start there before quitting...

as someone who worked sub-acute/rehab, my very first question is WHY in the world are you doing dressings and treatments on nights? That stuff should all be done 7-3 or 3-11. It's absurd to be disrupting their sleep to do treatments.

yes, programs will require proof of health insurance (as well as current immunizations)

our hospice medical directors are my go-to for the c2 scripts. they are always available by cell phone and willing to fax scripts to our hospice pharmacy (enclara) with a very quick (usually less than a hour) turnaround. in the absence of cooperative hospice MDs, I would do as the previous poster uggeted, and ask for copious scripts with partial dispenses with start of care orders.

yep, it's not covered by most hospices because it's ridiculously expensive. I had one patient who we just did dextromthorphan 10mg/5ml (give 20mg/10ml) with the quinidine 10mg/1ml liquid (give 10mg/1ml) once daily for the first week and then twice daily ongoing - WAAAAAAY cheaper than the neudexta and it's the identical meds/dosing.

agree with the others that cardio is not our most imminent assessment with persistent headache and BP that high. what could be the culprit there?

nope nope, nope, NOPE. they're paying her 70k a year to OWN HER. 24/7/365 is not a sustainable employment plan.

i responded to your other post and now seeing this. honey, as gently as I can say this...you need to cut and run from that agency. they do not care about their nurses, nor the patients. it is not possible for you to give good end of life care to patients with a caseload of 30. it's just not. you are not a whiner, you are not weak. they are setting you up to FAIL, period. I worked for an agency like this, and I lasted 9 months. it was the WORST 9 months of my life. soul-sucking, and i swear by the end I thught *I* was the crazy one. I wasn;t - the situations they put me in, repeatedly, were crazy. you need to get out, and find somewhere that will appreciate you and your hard work.