elimayrn

I am expecting an offer from a primary care within a large Hospital in the Kansas City area. My background is hospice cm and Home Health with some long-term care. I am looking for a ce activity on CPC+ and Care Management in the primary care setting....

Yes, I accepted their offer and start Nov. 5th. I am thoroughly excited and want to prepare for this paradigm shift in my nursing career to foster my success. CMS does have great general information on CPC+ but none specific to the care manager posi...

I was just hired as Rn case manager with a locally owned company. I'm so excited, I tried for 8 months to get it! I was an LPN for 8 years and now an RN for 1. I want to soak all the knowledge up I can and get up to par and productive as quickly as ...

I recently applied as a home health case manager and received a phone call last night saying she would call tomorrow with an offer. The company in Kansas City Missouri pays per visit. I am not sure how to convert my requested annual salary to a per v...

I did accept the possition and will start Feb. 5th so we shall see! I have 3 years with hospice as a CM and 4 years with HH as an LPN. That should help.

Thanks for all the information, it is very helpful! I definately see your point on improving patient care and efficiency.

Thank you for your reply. That makes sense. Am not understanding the PTO example you gave. Is this to make up for too few visits?

Also how are "pay per visit" RNs compensated for meetings, inservice, on-call hours etc? I will be going from a hospice case manager on a salary to Home Health case manager so this is a big decision for me!

Thank you Nursylinda, This is exactly why I'm leaving hospice. The money isn't worth the trade off for me. I don't want to live to work, just work to live a decent life.

Hello to all and thank you in advance, I am currently a RN hospice case manager X 2+ years. Prior to this I was an LPN working LTC and 3+ years in home health. I loved home health and I love hospice most of the time but now I want to return to home...

Update: 2 years later. I've learned so much in 2 years working as a RN CM with hospice, many in-depth lessons about nursing in general and have gotten in closer touch with my family and myself! Unfortunately the reality is hospice is taking a huge ...

This gets complicated for me also. Where i have trouble is when the facility staff are not providing the best care such as not turning my Pt through the night or wound dressings are not changed. You would think the nurses would want to know and cor...

I've worked as a hospice case manager for 1 year now and still have lots of questions. I have a COPD patient that can't tolerate Lorazepam but gets relief with Roxanol 0.5ml 4-5 x daily. Lately she is waking up SOA and having to take extra doses in ...

Shortness of air. Many at least in my area have gotten away from SOB.

She has no dysphagia, a&o x 3. She's currently taking Roxanol 10mg 3 to 4 times daily and 15mg at hs. I discussed the ms contin with her but daughter said they tried them before and she was loopy so they cut the dose in half and still loopy. T...

Thanks for your reply! I've spoken with my patient and she is willing to try this, I will be calling her doctor today. Thanks for the link I have been looking at this and will be ordering it.

Please repost without all caps. I would like to respond as I have had a very similar past 12 months, state and all.

Out hospice company failed state survey miserably, then failed the follow-up visit. They will return again in a few weeks. Management says state has never shut down a hospice? My sister in law, a nurse for 30 years, is afraid if they do shut us down...

Thank you for replting. No, no involvement in unethical things. To tell you the truth the supervisors/owner are beating around the bush but I know 4 of the dings were HHA related and some management issue. They actually are telling us there is not y...

I'm a new hospice nurse (3 months). I was an LPN for 8 years, now an RN x 1 year. So here's my problem. I have a pt DX COPD, who has been taking Roxanol 1ml at least 6-7 times daily for several months for back pain, generalized pain and he even c/o ...

Wanted to let you all know the patient transitioned to the ms contin fine with no adverse se. He had some withdrawl sx, diarrhea and restless legs, due to him withholding the roxanol a full day prior to the switch - which Noone asked him to do. Thes...

Thank you for replying 4boysmama. Yes he has a known history of drug abuse. While he does have copd he's not on dependant, he has some labored breathing and so with exertion. I don't see true dyspnea. I believe he came onto service way too early. ...

Update on new job, day 4 of orientation and I love it. The company is super supportive, well staffed and Organized. My confidence is peeking out with hope!

Thank you for your replys and excellent advise! Ill definately apply it. Im reading the Hospice Companion which is very good, teaches the responsibility of the IDT at each patient stage, documentation and symptom management. Its great to read your en...

Great news, I spoke with a mentor for the company, the figures were wrong, the real numbers are better, competitive. I'm relieved and more excited about the prospect. I shadow tomorrow and will know by Friday if I'm hired. :yes!: