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Kaisu

Hospice
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Content by Kaisu

  1. Kaisu

    What is a bad day?

    For me, there really are no bad days. There are challenging days, when new symptoms develop rapidly in multiple patients seemingly at the same time, or when team members have car problems, or develop illnesses. Generally, even the "bad" days are rewarding. There is nothing like bringing peace, comfort and calm to patients and families when they are nearing the end of life.
  2. Kaisu

    Opoid crisis and providing hospice care

    I have no problems obtaining whatever narcotics my patients need. It is so easy that I have had the thought that at some point, things are going to get tougher. I can't imagine the regulatory agency will not look at the amount we go through and start to tighten things up. I hope not. Our patients are dying and deserve all the comfort measures they want and need.
  3. Kaisu

    Hospice Pay?

    I think it depends on the agency and the service area, the competition, etc. I started out making more in hospice than I did in med/surg.
  4. Kaisu

    Looking for ideas

    I would present these "higher ups" with the details of the methods you mentioned, as well as the fact that you came to a forum looking for ideas, that unless they can come up with ways to "make" adults conform to corporate goals they can kindly stop harassing your overworked butts. Makes me angry when some dimwit sits in a meeting and comes up with so called solutions that are not solutions at all. Whew - Rant over.
  5. Kaisu

    GA Paramedic looking for guidance

    Medic to RN here.. not in Georgia but I can tell you - Go for the RN. I knew when I started nursing school that hospitals/floor nursing was NOT for me. My 4 months on med/surg after I graduated drove that point home. I worked home health and now hospice. It is wonderful. I have autonomy and a team. I get all the excitement I want, and the job is immensely fulfilling. The fact that it pays much better than even critical care transport is a bonus. Nursing is a huge field. It may take people time to find their niche, but when you do, you won't look back.
  6. Kaisu

    Help! New EMR System

    I'm using HCHB on my phone. Android Samsung Note 5. I find it works very well. I love having everything I need on one device. It did take getting used to , but I have no major complaints.
  7. Kaisu

    Thoughts on being an old nurse in a new place

    I spent 20 years as my own boss in systems consulting. I was the expert. I was the one that was called when others had taken a shot and failed. It was comfortable. I left that and became a paramedic. Not only was I a new medic, I decided to get my first job 2000 miles away in a different state in a different system. Some people felt I would never make it. It took 3 years before I was considered "solid" and a few years after that before people were telling me that if their loved ones needed EMS, I was the one they would want to respond. I was honored. Then I went to nursing school. First med/surg job was beyond scary. Then I went to home health. I scrambled like crazy - again. When I became comfortable, I went to hospice. Of all these new starts, hospice feels like home. Nevertheless, I am scrambling again. I think there is something wrong with me... LOL.
  8. Kaisu

    Patient sent a friend request

    I'm pretty sure I know what you guys are going to advise, but I'm putting it out here anyway. Although we do get close to patients, I try at all times to remain professional. Today, I was shocked that one of my hospice patients sent a friend request. I do not want to offend him in any way, but I don't think it's appropriate to blur the boundaries. My plan is to blame company policy. What say you?
  9. Kaisu

    Worst Nursing Scrub Color Worn?

    Black. Death called - He wanted the uniform back...
  10. Kaisu

    My New Job!!

    I am delighted to hear this. I too am absolutely privileged to work in a wonderful agency. It really makes all the difference in the world. Please post again to let us know how its going.
  11. Kaisu

    Share your real world thoughts

    Working in pairs would be amazing. I saw a lot of gnarly stuff running 911, but I always had a partner with me who had my back and vice versa. I have thought often that with some of the situations we run into we are in as much danger and we have no one to bounce stuff off of. A second set of eyes would improve care substantially. I don't imagine that is an achievable dream tho...
  12. Kaisu

    Share your real world thoughts

    1. What best describes your job? RN Case manager - uh I guess that means nurse 2. What is your #1 Achilles Heel in this industry Currently it is brutal driving times because of the area I work in. The reimbursement is excellent and the company is a real joy. 3. Do you work for multiple home care agencies? Just the one 4. Do you currently use an electronic form of documentation? Yes - We use Pointcare 5. Do you track mile for reimbursement? Yes. easy to document on the chart and add non-visit travel as well 6. What do you love about home health? The autonomy, being out and about in the community, the time I can devote to teaching, focusing on one patient at a time and the money. 7. If you could eliminate one aspect of your job which would it be? I detest non-responsive PCPs. 8. If you could design or change an item what would it be? I would love a specific nursing bag with custom designed pouches to organize all the wound care supplies, ostomy, foley, blood draw stuff etc etc. 9. How long have you worked in home health? 1 year
  13. Kaisu

    Excited to transition to HH

    It sounds like you have many of the big factors for success in place. It is key to work with a supportive and reputable agency. I cannot over-emphasize that. Another important thing to remember is that while you are alone in the home, you have a team behind you. Especially while new, reach out. Find mentors and go to people that you can run things by. A good agency will hire good people that will be happy to help. Be prepared initially to spend a LOT of time on your job. The first OASIS admission documentation took me 2 1/2 hours. EEK. (I can do one in about 40 minutes now). I spent hours in the field and then evenings and weekends catching up. It gets easier and you will be amazed at how efficient you become. Gut check often. If it is a good fit, you will be excited and happy to go to work. Everybody has days when work is not fun, but you should feel like what you are doing is meaningful and makes a difference. Good luck.
  14. Kaisu

    Miles on my car

    I bought a brand new car and then was dropped into a rural area due to staff shortages. I have put on almost 10K miles in less than 3 months. On one of my trips over a very bad road I took a hard to see dip at too high a speed. 3500$ in damage to the underside of my beautiful car. I justify it this way. - With the hourly travel pay and mileage compensation, I earn my monthly car payment in just over 2 weeks. I think of the bright shiny thing as a tool - a tool I use to do a job I love. As the previous poster said, it is just part of Home Health.
  15. Kaisu

    What does this presentation mean? NOT HOMEWORK.

    I may be way off base here but I hear unilateral lower extremity edema and pain and I think blood clot. Notwithstanding, medical evaluation totally indicated. Great assessment data by the way.
  16. Kaisu

    Witness to violence

    I went into a home to do a start of care for an elderly female discharged from hospital after an acute exacerbation of a chronic condition. Present in the home was the patient's elderly spouse (also in fragile health) and a middle aged son who is developmentally challenged. As I approached the patient, the son began raging at his mother - "I hate you you b****" and struck her in the foot with a wooden back scratcher. The foot began bleeding. The elderly male moved toward the son and the backed off into a corner. I assisted the female to another room - still open to the area the confrontation was occurring in. The patient was terrified and called 911. In the corner, the son took two swings at his father. The father pulled a tazer out of his pocket and held the son at bay with the tazer. The son is middle aged with bulging muscles and hands like hams. His jaw was clenched, his fists were balled up, he was standing on the balls of his feet ready to attack. His eyes were filled with rage. The mom handed me the phone and I related the events to the dispatcher. My instincts were to get out of there as fast as I could, but I was torn because the mom was bleeding. The dad backed the son into a far bedroom and guarded the door, still holding the tazer. I helped the mom to a chair and began bandaging her foot. Before I was finished, the son re-entered the room, this time, without the dad. He was acting like nothing had happened. No one referred to what had happened. I was scared that if I said something, he would go off again. I finished the bandage job and went into my car to wait for the police. Five minutes later, the dad came out and gave me the phone number for the son's mental health worker. I told him to go back in the house and protect his wife. I felt like I had left her in danger and it was awful. I spoke to the mental health worker who did his best to convince me that the son was really a "nice" guy and it was the stress of his parent's illnesses and a stranger in the house that had caused the son to go off. The mental health worker told me that the son had never physically hit a non-family member. I flatly informed the mental health worker that I had been doing this a long time and I know what I saw and felt. The mental health worker gave me information about an acute care placement where the son could be taken. My agency immediately placed the patient on a non-admit list as it was unsafe. Thank God for supportive agencies. My big problem. My heart is hurting for that patient. I cannot send in personnel and that patient will not get the care she needs. I am open to any and all suggestions. Thank you for listening.
  17. Kaisu

    Witness to violence

    This is an opinion based on years of calling APS while running EMS and now in HH. APS in this state is a joke. I have yet to see one effective APS response to the myriads of times I and others have called. I don't know if they are short handed or unable to marshal resources or what the problem is. Calling them is something I do to CYA as a mandated reporter, but as far as resolving situations, I could tell you horror stories that I have personally experienced. It is not an answer in any sense of the word.
  18. Kaisu

    Jail or Hospice job for new RN?

    I am very curious as to what part of the country can a new grad get a hospice offer. Here, and as far as I was aware, in most parts of the country, hospice jobs go to nurses with experience. As far as which offer to accept, what is your interest? Both are specialty fields with emotional/psychological implications that will fit some personalities and be absolute nightmares for others. Check out the specialty areas on this site in both Hospice and Corrections to see the kind of issues these nurses deal with and try and figure out which one is something you want to do. I don't envy your choice. With no experience in either it seems very difficult to chose well. Good luck
  19. Kaisu

    7 Questions About Near Death Awareness

    In the days before she died, my mother described scenes with loved ones that had passed before. She would look up toward the corner of the room where the ceiling and the wall met and say things like "Oh look, they are getting ready for a party." She told me that she would be attending my son's wedding with her brother, who had passed before her. Mother died a month before my son got married. I really believe the veil that separates this life from what comes after lifts for those preparing to leave. It was full of mystery, yet a profound and beautiful thing.
  20. Kaisu

    Need a little encouragement

    It sounds like where you are failing is in attention to detail and followup. It is your responsibility to find out when deadlines, etc. are and to comply. This is an essential part of nursing. You have a lot of reasons for why you are failing, but the bottom line is these rules are not just for you. Everyone is expected to comply with them and the ones that continue do. I would encourage you to clean up your act. Do what is expected of you in the time that it is expected. If you get that straight, then you can be successful. It you do not, than no matter how much you "feel" you are meant to be a nurse, it will not happen. Good luck to you. You can do this.
  21. Kaisu

    RN to LPN

    I don't believe the OP was putting down LPNs. I think she is looking to work while she sorts out what to do about failing the NCLEX-RN.
  22. Kaisu

    Why is it always my job to go further?

    I find your decisions and judgement sound. I question the culture in your place of work. It sounds like an echo chamber or possibly a gang up.
  23. Kaisu

    Rasmussen grads, can I get a shout out?

    I am a former paramedic and now an RN. My daughter went to Rasmussen in Green Bay. She is an RN in Appleton. I did the bridge program at NWTC. If you PM me with your email address, I'll send it my kid.
  24. Kaisu

    What in the world is this rhythm?!

    What I see is a short PR interval. I've never seen that clinically, but a google search reveals Lown-Ganong-Levine Syndrome.
  25. Kaisu

    Pain patients being denied their medication!

    This is really great news. I have been following this thread to find out how you made out. Seems you managed perfectly. I am gratified.
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