Zee_RN BSN, RN

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...

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

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...

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...

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...

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.

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...

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...

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...

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...

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...

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 ...

Disagreement at work yesterday. Which do you use: Left radial artery SBP reading: 70 (I don't remember diastolic) Right brachial non-invasive cuff SBP reading: 109 Which one do YOU use to base therapy on? This was repeated several times, using th...

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...

What does your facility pay for working night shift? (I define night shift as being 7P to 7A or 11P to 7A.) I have interviewed a few nurses lately for our ICU and each have said they won't work nights. Well, no one works steady daylight so I can't ...

I'm taking the easy way out here...I guess I could go look it up on a website or something but I knew someone here would know... When I graduated nursing school, I sent for info on joining ANA. To join ANA, I had to first join state nursing org. Th...

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...

In the Commonwealth of Pennsylvania, I have always been told that registered nurses are not to obtain informed consent for blood transfusions; it is out of their scope of practice. Only physicians can obtain blood consents. Does anyone know where I...

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...

I'll have to call the BON. They've just never been helpful in the very few calls I've made in the past -- downright rude, actually, so I was hoping to avoid that. Thanks for the replies!

In emergency situations, blood can be given without a consent. In nonemergent but middle of the night situations, I've worked in places were (a) the resident -- in a teaching hospital -- was called to obtain consent or (b) the house doctor got consen...

Thank you for that link and the document. Unfortunately, I need documentation specifically about blood transfusions; that is speaking of surgical informed consent. There is mention of a complication the plaintiff claimed came from the administration ...

A quick reply if you have a thought would be appreciated...my friend is staring at these bags as I type.... My friend works at nsg home and she is administering TPN and lipids via separate infusions. I've not done this; I've always had lipids & ...

Yes, I'll take those families over the ones that won't move an inch despite seeing you struggle to get to the patient with your hands full of meds, IVs, etc. I'll never forget having a patient in ICU who was vomiting and six family members were han...

I'm trying to gather information on telemetry unit staffing ratios, including ancillary help. It would be of tremendous help to me (as a manager trying to get a better ratio) if you could answer the following: Type of Hospital: (community or tertiar...