RNorBust

You could possibly work agency if you dont need to carry the benefits for the family. You can take off every summer when there is less work anyway and work at the summer camps. Then in Fall when the agency work starts increasing again you can get your shifts. dp

I have seen the aftermath of a patient that had a peripherally inserted line to the artery by mistake... he lost his fingers.

I am an EC grad in Texas. I graduated in Aug 05. I used alot of the College network study guides and they were good. But as earlier stated, You can join many Yahoo study groups and buy them from others at discounted rates. You can also buy them off of Ebay. Also as far as Enrolling in Excelsior before Oct 1, you should check out what the changes are, because if you get your prerequisites done and your first 2 nusing exams, before you actually pay tuition, you may end up saving more money. You dont have to be enrolled in EC to take those first exams. Any questions, please email me. I would be glad to assit

I work telephone triage for hospice. I work 7 on, 7 off; I make 26.00/hr

Our hospice uses haldol for nausea, but usually only if first line drugs haven't worked. We normally use it in conjunction with other meds. Just like any medication, different people react differently to each med. If that was not the case a Phenergan suppository would stop everybody's nausea. Saying that you heard from the nurses that this doctor uses haldol on everybody, versus the scenario that your mom was having uncontrolled nausea and they started haldol for it, is describing two different situations. I have had some family's give very good reports back on their loved one's being placed on haldol. Other family's were uncomfortable with it, and occasionally it just didn't work.. I'm so sorry for the loss of your mom. I lost my mother last September, and it is so hard to go through. I don't think there is a single nurse here that could give an accurate opinion of your mother's care. None of us could without having been apart of it.

Maybe I should clarify what I do. I work a very long shift friday night from 5pm until 8pm saturday. then I work sunday 8am-8pm then mon-thurs 5pm -8am. I do this schedule for one week then I am off for a week. And it continues to rotate this way indefinitely. I feel well compensated for this job because I make a regular RN salary competative for the area that I live in plus an enormous benefit package (30days pto/year, every kind of ins, 401k, stock options, and the list goes on...). Also because we have a full time call staff I rarely leave my house. I have been doing triage since last november and have only left my house 4 time to do a patient call myself. I work from a company laptop, cell phone, and fax machine. I go to the office to turn in paperwork and attend meetings. I absolutely love being able to work at home and make a full time nursing salary. If I agree to work any extra shifts, I get paid extra. If I agree to make visits on my time off, I make a per diem rate for each visit. Our company also pays milage at the government rate and adjusts the rate whenever the government does. I have talked to many hospice nurses in this area of central Texas that are not near as fortunate as I am. As for skills. You are so very right. You have to be able to compationately listen and advise familys in duress. Sometimes they are crying, sometimes they have a complaint and most often they are greatful. You have to be able to quickly critically think, find a way to stay on track with the algorythms, talk patients / PCG through giving medications, quickly identify which LTCF residents are full code status, ect. You have to be really organized. Not only do we have pt's calling in, but we also provide the service of calling patients that arn't doing as well to check on them. We have scheduled visits, and on-call visits. We do EOB and Admits 24/7. I am also fortunate to have family support on call every shift as well. I guess you can tell by this post that I can't say enough good things about my job. I absolutely love it. I am enjoying this summer so much. I work a week, and spend an entire week doing things with my kids. Its like having vacation time every other week.

IF you dischard the patient while they are in the hospital, they will have to be a complete new admission to resume services. Wheather the hospice gave consent for the ER visit or not, most of the time, RHC will be paid as any other medical bill incurred by a medicare/caid recipient. IF it is determined by your medical director that the pt is being treated for a UTI secondary to the dementia.. then it would be a GIP paid by the hospice provider at a per diem rate (usually about 500/day) provided that the patient is at a contract facility. If the patient is ambulatory, he probably should not be on service for dementia, he would need substantial comorbids documented in order for him to meet admission criteria. For Dementia he should have a fast of 6e and lower I belive along with a pps of 40 or less. the fast and pps may actually be lower, I don't have my flip chart in front of me. Anyway, Like the others have stated before me, only the patient/pcg can revoke. That is a statement from them removing themselves from service. If they revoke or if the company finds a way to d/c him from service, he will have to meet admission elegibility to go back on sevice. Does any of this help you?

We have a cencus of about 230-240, sometimes it goes higher. We have 2 full time triage nurses (I'm one of them) and we have a full time evening 4pm-mn and a mn-8am nurse. WE have a 4-mn and MN-8 and Sat-Sun 8a-8p Cont care staff that can do call visits if we dont currently have a case going. We also have 2 FT w/e nurses that do fri, sat , sun on call visits only. The call goes to the service, the service calls us, then if we can't handle it over the phone, we send a nurse out. The w/e nurses are supplemented with 1-2 of the case managers each weekend on each day to assist with visits if it is too busy because we do have scheduled weekend visits. the Case Mgrs usually have to take 1 call shift a month. Some take more because they like the extra pay for the visits. The triage staff works 7days on 7 off running friday -thursday.

Try to think of it in another context... imagine being a 72 year old man that has lived your life, raised your kids, worked your job, did all that you could do to become who you are, and then you become old and sick and tired. It would be in humane to try to keep it on him if he doesn't want it. It's a primitive right as an adult to make decisions for yourself. You didn't take it off, it was his decision. What we as hospice nurses do is allow patients the right to make decisions and advocate for them when they do...

Being a case manager is going to end up being what ever you make of it. When I was doing it I loved it. There are the hum drum days where there isn't much going on, but the blessing comes when your patient starts to decline and you are needed more frequently, you do more teaching, you spend time with this patient and their family and help them through the last phases.... It is so rewarding. I remember very clearly when I think I really fell in love with the job. I had a patient that was dying, and when she passed, her son in law said to me " thank all of you for what you have done. I am so impressed with it all that I hope some day you can do the same for me...." It is an incredible rush to have somebody thank you for helping them through the hardest time in their lives. I love that I had the time to do it. I may spend only 1 hour at some of the houses that I went to, but there was always that one or two that was starting to decline that I spent more time with. It is a pattern you develop when you have been in it long enough to have patients that you can care for from the time they are referred until the time they die. It is so nice to be able to spend 6 hours with a patient because they are in distress and you are there to ease there discomfort, anxiety, SOB, nausea, whatever the problem they have is... just call the others and reschedule. Anyway, I could spend all day on this subject.

Maybe she had some mild dementia...

A couple of days before my mother died, she was telling me about the angels in her room. She pointed upward toward different areas of the ceiling and described them. Just seconds before she died, I was sitting at her bedside holding her hand. She had been unresponsive since the evening before. She took her hand out of mine and held it upwards toward where she had been pointing at the angels then quit breating... This was quite an experience for me. I was never sure of my faith in God before this moment. I wanted to believe, but I always wondered.. "what if.." I no longer wonder about such things. Through this act and a few other things that went on during her dying process, I found my faith. Her death was my blessing. I felt like it was meant to be this way. We had never been quite as close as she and my sister had been. I felt like it was her gift to me.

I've had the dream thing before. I use to work pedi oncology and when new patients came to the unit I would dream about which ones would die and which ones would go into remission. My dreams were ususally correct which was a little stressful for me. I was quite young then and didn't handle it well

I live in Texas and the assisited living centers that we service never have actual nurses available, only med techs. Now they do have the med techs around the clock. Does your company offer Continuous Care? Would the patient qualify for around the clock care?

i am a hospice triage nurse. i have been in nursing for 17 years. i started out as a case manager for about a year before i transferred to a triage position. i'm not real comfortable discussing wages openly here, but i will say that i receive the same wage benefits as the case managers and the same wage increases, ect.

Congradulations on passing... It's so exciting when you get that news

I think that all states have the rule that if you dont pass you cannot work as a GN... What that hospital is doing is actually against the nurse practice act.

Kudos to you... I personally have gone back to school and am almost the real nurse that I want to be Denise

Kudos to you... I personally have gone back to school and am almost the real nurse that I want to be Denise

I have been an LVN for 14 years. Prior to graduation, I began the job search. I immediately found the job I wanted. I went to work at a large pediactric hospital in a major medical center on the oncology ward. It was very rewarding but after 5 years I left. I began to be depressed about all of the death and dying. I was only 20 when I went to work there and I just couldn't handle it any more. Now, I work in a small rural hospital as a floor nurse. Most of the time it is routine care of the same people with the same problems. You really get to know the patients and their whole families. I also am currantly enrolled in Excelsior. I have only one nursing exam left and 2 prereqs. I'm very excited about my new adventure. Remember that where ever you decide to work, it is up to you to make the difference in your patients... also every where you go, no matter how big or how small, there will always be someone there that can teach you something new and also new skills to learn with every job. Good luck!!! Denise

How about when they call your facility and say "I have this number on my caller ID, Did someone from your hospital call me????" Denise