Hospice, Critical Care
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Zee_RN has 17 years experience as a BSN, RN and specializes in Hospice, Critical Care.

Zee_RN's Latest Activity

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  1. Death Visit Protocols

    Hospice staff -- what are your protocols for death visits when a patient dies? Obviously, if it is a home patient an RN needs to visit and pronounce. But what if it's 2AM and they are in a skilled facility and the facility staff pronounces? Do you vi...
  2. homecare homebase

    The Plan of Care does not meet compliance standards in the Commonwealth of Pennsylvania either as it cannot be customized (at least for hospice). You can tell hospice is a force-fit into this home care documentation system
  3. KPS & PPS

    When you are evaluating and assessing patients and assigning performance scores do you use the Karnofsky (KPS) and Palliative Performance Score (PPS) or just one of the two or something different altogether? (Such as the ECOG). We use both KPS and P...
  4. Help!!

    My organization is fortunate enough to staff in such a manner that our RN Case Managers rarely take call. They work a regular Mon-Fri 8-5p week (salaried position). They take "on call" only when our regularly scheduled on-call nurses are off; for ins...
  5. Coverage for incontinence supplies

    We cover incontinent supplies including briefs, chux, creams, wipes ... but we do not provide pull-ups as Medicare has classified them now as "underwear." Some hospices do, though. We have opted not to.
  6. question on aide coveage for hospice

    Our aides are scheduled 7 days a week...although few patients are actually seen every day. Some are, though. We like to start patients off with daily visits to get a full understanding of what they need; then we adjust their care plan based on the up...
  7. Bipap

    I would have ensured the patient was comfortable prior to removing the bipap. Bipap is not an absolute contraindication to hospice...but in a hospital setting, I can see where it would be viewed as incompatible with goals of care. I have had patients...
  8. Frequent Falls

    What are your procedures for patients who fall frequently? (Or any patient falls, for that matter). We spend A LOT of administrative time dealing with those frequent fall patients, particularly those in nursing homes. We complete an electronic occ...
  9. Thinking of leaving hospice

    I work for a small, for-profit hospice. Average census around 63. We have dedicated on-call nurses who cover the evening/nights (5pm-8am weekdays) and the weekend (Fri 5p to Mon 8a). The only times our regular RN CM take on-call is if the on-call nur...
  10. Visit Frequency

    Thank you! That has been our organization's approach as well. I've seen it done differently in another agency. The new reimbursement plan, as well, will be based on the frequency model as you described...higher reimbursement initially, then decreased...
  11. Visit Frequency

    When you order visit frequency for the RN upon admission, do you count the admission assessment visit as a visit? In other words, if you admit a patient and order RN visits 2 times a week, do you schedule one more visit or two more visits for that we...
  12. Plan of Care

    My organization uses an electronic health record system with a very confusing Plan of Care option, more suited for home care than hospice. My question is .... who updates your NURSING plan of care? I'm seeing nursing problems identified by an MSW on ...
  13. Question About the Certification Exam

    I'm registered for the exam on June 8. The only thing I'm worried about is opioid-equivalent equations and such. I've never done that stuff. How much should I worry? And what is the BEST resource for studying? I have the Core Curriculum and I read it...
  14. The Other Professions of Nursing

    Yeah we have that script too. I WILL always ask the patient the first part "Is there anything else I can do for you right now?" with a easy and relaxed attitude. I will NOT outright lie to the patient and say "I have the time..." I anticipate caring...
  15. The Other Professions of Nursing

    Mover: because you have to transfer the patient in the semiprivate room, and all his furniture and medical equipment, to another room because the lab test just came back +MRSA. Or because he wants a better view. Or because he's transferred to a lowe...