AtlantaRN

AtlantaRN RN

Med Surg, Hospice, Home Health

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All Content by AtlantaRN

  1. Sad sad situation, but not hospice appropriate yet.

    AtlantaRN replied to AtlantaRN's topic in Hospice, Palliative

    Medicaid reimbursement is so low now, that alot of specialists won't even accept medicaid

  2. Drug Diversion

    AtlantaRN replied to eileenis1's topic in Hospice, Palliative

    i had a patient who was NEVER on a bowel regimen, claiming to be taking the 120mg/ oxycontin/day......................................................................we would count and count, and...

  3. Sad sad situation, but not hospice appropriate yet.

    AtlantaRN replied to AtlantaRN's topic in Hospice, Palliative

    This wife has been blind her entire life, she has 6 children and only one has really stepped up to the plate to help. He was exhausted, as was husband because wife with sundowners is up all night...

  4. Have you ever heard of vicodin making pt too sleepy so changing to fentanyl patch???

    AtlantaRN replied to AtlantaRN's topic in Hospice, Palliative

    Today I got a call from one of the field nurses, administrator instructed staff to "give to the hospice nurse the tramadol and lortab." Wanting the hospice nurse to destroy the meds because...

  5. new hospice job

    AtlantaRN replied to CJsGirlRN's topic in Hospice, Palliative

    I completely agree with the "when i'm off-i'm off".... Hospice nursing is demanding, and you HAVE to set boundaries---or you will burn out quickly. Do your best for the patients and the families-any...

  6. Have you ever heard of vicodin making pt too sleepy so changing to fentanyl patch???

    AtlantaRN replied to AtlantaRN's topic in Hospice, Palliative

    script came from local hospital ER on pts last er visit. nope-not filling that script, ever.... administrator was nice to me when i visited on sunday, told her of my concerns. Asked her to take any...

  7. Have You Ever Refused to Go Into a Terrible Neighborhood?

    AtlantaRN replied to westieluv's topic in Hospice, Palliative

    No is a complete sentence...............................Nothing is worth risking your life. I'd take a write up if they wanna get fussy..... We had a patient in inner city Atlanta. He was a dear, but...

  8. Hospice nurse "survival kit"

    AtlantaRN replied to mrsraisinkain's topic in Hospice, Palliative

    tequila in a flask......just sayn lol well, they want us to be "happy" right! i like the dark chocolate, wine, milk chocolate, wine

  9. HELP!! What about what the PATIENT WANTS?????

    AtlantaRN posted a topic in Hospice, Palliative

    Marketer calls office, need to eval pt at local hospital-SEE IF SHE MEETS GENERAL INPATIENT CRITERIA, dtr wants nh placement........ I meet md coming out of patients room, md states "does not want...

  10. HELP!! What about what the PATIENT WANTS?????

    AtlantaRN replied to AtlantaRN's topic in Hospice, Palliative

    she is still on service, and now glad she accepted

  11. Have you ever heard of vicodin making pt too sleepy so changing to fentanyl patch???

    AtlantaRN replied to AtlantaRN's topic in Hospice, Palliative

    patient states no pain, patients niece defers to administrator. pt with a dementia history, able to make needs known, said she would try medication, but says not

  12. Have you ever heard of vicodin making pt too sleepy so changing to fentanyl patch???

    AtlantaRN replied to AtlantaRN's topic in Hospice, Palliative

    we've dealt with this facility before, the administrator (with the last patient we had there), was wanting me to decrease patients keppra that she had just started on saying "at the hospital she was...

  13. Have you ever heard of vicodin making pt too sleepy so changing to fentanyl patch???

    AtlantaRN replied to AtlantaRN's topic in Hospice, Palliative

    oh yes, told her that patient must be tolerant to 60mg morphine daily to justify changing to a 25mcg fentanyl patch according to the duragesic package insert (found online). Patient says she isn't...

  14. Have you ever heard of vicodin making pt too sleepy so changing to fentanyl patch???

    AtlantaRN replied to AtlantaRN's topic in Hospice, Palliative

    she produced a prescription dated 4 days prior to hospice admission, saying she didn't want family to have to pay for it....since she was going on hospice. When she said vicodin made pt too sleepy, i...

  15. Letting Go. What should medicine do when it can't save your life?

    AtlantaRN replied to HickoryTree's topic in Hospice, Palliative

    Most physicians look at death as personal failure. Somehow if they just would have managed a patients care, they would have been successful at preserving life. This just isn't so. We all have our...

  16. part time Rn casemanager, full caseload and Lvns in office

    AtlantaRN replied to americanTrain's topic in Hospice, Palliative

    To the original poster-- Scenario #1-the only way I could do 26 visits in 3 days would be if 9 patients were at the same nursing home (then 9 visits a day at one location). Scenario #2- Id rather...

  17. On Call Schedule.....that is workable

    AtlantaRN replied to onewithhospiceheart's topic in Hospice, Palliative

    Day shift m-f 8a-5p are hourly. On call is salaried. I do weekend on call 5pfriday to 8a monday. One of the day shift nurses is backup call for me 8a-5p sat and sunday-they get $2/h to be backup,...

  18. Do all hospice patients now have IV's?

    AtlantaRN replied to Blackcat99's topic in Hospice, Palliative

    we have iv's in the field, but it's becoming more rare, thank goodness. most pts are managed with suppositories and sl roxanol, atropine, etc. easier to handle in the home expecially for an on call...

  19. New Hospice Case Manager

    AtlantaRN replied to AddieRN's topic in Hospice, Palliative

    onaclearday: YES, the second one is the little red book it is alot like the hospice pharmacia book....i like algorhythms.....if this, then this....really helpful, especially when tired.....it breaks...

  20. I Need to do Something...

    AtlantaRN replied to westieluv's topic in Hospice, Palliative

    I understand-that phone rings and your adrenaline kicks in---flight or fight. Even if it's just a phone call without needing a visit, you are still awake for several hours. You can't take your...

  21. I Need to do Something...

    AtlantaRN replied to westieluv's topic in Hospice, Palliative

    I am salaried weekend on call 5pfriday-8amonday. I have a backup nurse from 9a-5p on saturday and sunday....some weekends it's a beautiful dream and i only have to work 10-12 hours; other weekends...

  22. HELP!! What about what the PATIENT WANTS?????

    AtlantaRN replied to AtlantaRN's topic in Hospice, Palliative

    Still a full code....still gip but

  23. HELP!! What about what the PATIENT WANTS?????

    AtlantaRN replied to AtlantaRN's topic in Hospice, Palliative

    Family called 911 because pt declining, (they didn't notify hospice, the emergency room did), she does meet GIP criteria now. Continues to be a full code. To go to a nursing home today

  24. Don't know what to do.....

    AtlantaRN replied to wifeandmomoftwo's topic in General Nursing

    I would go floor to floor at every local hospital and speak to the directors-with your license information. Apply everywhere. Monsterboard.com is a great place to look online. Home health...

  25. Do all hospice nurses work 50 to 60 hours a week?

    AtlantaRN replied to momorn's topic in Hospice, Palliative

    This is the reason I went to weekend call. I was a m-f day shift case manager for 3 yrs. First company i worked hospice was for 2 years-and they flat burned me out. Present company, i worked for 1...