pfeliks

I give up. What does SOA stand for?

FWIW, I have never thought of my job as a Hospice Nurse to be particularly sad.

You can start by turning off your "caps-lock".

I have been in Hospice for four years. I am lucky in that the company I work for has 2 dedicated on-call nurses. They cover ALL after hours work. Case Managers never have to take on-call.

My hospice is in the process of transitioning from its own proprietary software to HCHB. We are in our "couch visit" phase where we are entering all of our patient's data into HCHB. I still don't know what documenting on a visit looks like. For my couch visits I've been choosing around 6 pathways per patient. I'm guessing that the pathways will drive the documentation. Dose 6 pathways for a patient sound about right?

4 visits a day is the goal at the Hospice at which I work. But visits are weighted differently. Routine=1 Recert=2 admission =3.

Another small thing. When visiting a patient in a facility you are going to taker Vital Signs as part of your assessment. Offer the results of your vital signs to the nurse taking care of the patient. H/She may have a "list" of "to dos" which may include vital signs. You've just checked that box for them. It's a small thing but nurses will often thank me.

At the Hospice at which I work, LPN's are not allowed to take call fro the exact reasons you state. I'm in Massachusetts.

In my three years as a RNCM, I have never had to start an iv or do phelbotmy.

The software that your company uses from EMR is going to drive what your plan of care is going to look like.

If you are thinking that Hospice Case Management will relieve you from "bedside" nursing, you are wrong.

I agree. There is not much information to be found on what end stage will look like. I had a patient with neurofirbromatosis Type2. This was a new disease to me. I went to the internet to search for what to expect at the end of life with this disease. I found nothing! I just had to use my nursing knowledge and realize this patient had a progressive neuro disease. I think sometimes we nurses know more than we think we do.

Just an FYI. You'll need some time as a Hospice Nurse prior to being eligible for sitting for the examination: 'To be eligible for the HPCC CHPN® Examination, an applicant must hold a current, unrestricted registered nurse license in the United States, its territories, or the equivalent in Canada and must also have hospice and palliative nursing practice of 500 hours in the most recent 12 months or 1000 hours in the most recent 24 months prior to applying for the examination."

It sounds to me like your liasons are practicing Nursing without a license. Determination of Eligibility is a Nursing/Doctor decision, not an unlicensed liasons decision.

I work for a small office. 3 full time case managers with a census of around 40. We have 2 dedicated on call nurses. They each work one week on and one week off. They cover from 5pm to 8 am on weekdays and from Froday at 5 pm to Monday at 8 am. When they want a day off they negotiate with each other for coverage. Case managers very rarely are asked to volunteer to cover call.

Why should the Original poster get a subsidy? She states she makes 90K. Subsidies are for people who need them.

5 admissions in one day!!!!!! Impossible.

We're ordering Chinese, are you in?

Our "benzo" of choice for end of life palliation is Ativan Intensol (2mg/ml). No needles necessary. Optimal comfort.

I'm an RN Case Manager and I follow a number of patients at an assisted living facility who all have dementia. One was a 72 year old man with temporal- frontal lobe dementia with combative behaviors. Unfortunately he had a psychotic break and became violent. I cleared the room and eventually he allowed me to take his hands. I spoke calmly and quietly to him and he relaxed his body and affect. I was slowly leading hin to a sofa to sit down. We were almost there when he tackled me to the ground and started to kick and punch me. He is not a frail man,actually quite strong. We ended up having to call 911. It took 3 police officers and three EMTs to get him on the stretcher. He was sent to the ER for evaluation and geri-psych placement. Needless to say I'm a little shaken up. I may have to have surgery on my shoulder as the one I landed on has a hemi-arhtroplasty now with pain and 0 range of motion. I keep going over it in my head. What did I do wrong? I though I had him de-escalated. We discharged him as he is moving out of area for treatment. He is going to come back to our area after a few weeks in geri-psych. We will probably re-evaluate him for re-admission. I requested that if we do re-admit him that I not be his case manager. I'm frankly afraid of him and I think that would interfere with the nursing care I could provide him. Was that an unreasonable request? I already have a good relationship with his wife(HCP)

Patient was "difficult to AROUSE".....DID YOU TRY HARD ENOUGH?....IT'S ROUSE

None!

I've been a RN case Manager for 2 years now. I started out in heme/onc and then did Bone Marrow transplants. I've never had blood drawn on a home patient. What tests are you drawing for? We would only ask for bloods on whose results we would intervene. Our patient's usually have their Coumdin dc'd. I guess we don't think of venipuncture as part of comfort care for someone with a 6 month or less prognosis.

Yes our agency had to pay for the supplies which were not cheap. But as they were recommended by our wound team, the bean counters couldn't deny the charges I also work for a company where most supplies are able to be ordered vendor to patient from any nurse's computer. Orders placed before 1 pm will arrive the next day. It makes life easier. I have a patient right now with lung ca and acute promylocitic leukemia who recently fell and denuded the top layer of skin on her anterior calf. I accompanied her to the ED where definitive wound closure was done. Today I visited her and saw that she would need a Daily DPD. 6 inch border gauze will do the trick.. I was able to pull 2 of them from my emergency carbox and order 28 which will arrive at the patient's house tomorrow It makes life easy as on call will need to make daily visits this weekend and all wound care supplies will be in place. Our office manager will replace the 2 I pulled from my carbox

I had a patient exactly like that and after a wound care consult(iWork for a national company). We used unna boot with zinc,fan folded so there was no circumfrential wrapping. Then wrapped with surepress padding and then wrapped the whole thing with kerlix. Only had to change it twice weekly and it worked like a charm.