lesrn2005

I completed the BSN online with St Pete in May 2011, great program, advisor was excellent, always got back to me in a timely manner. I did the entire BSN online, minus Spanish II, just couldn't grasp foreign language online. Excellent program!! I think I paid $368.00 per credit while attending.

I took spanish 1 online and made an A. It was a lot of work - harder than most nursing courses. I signed up to take sp 2 and ended up dropping twice due to health reasons. Signed up to take this Jan 2011, and just praying for a C this time. bought flash cards, study books, spanish for dummies, the whole 9 yards just to pass this time. Pray for me. Also, looking for a tutor. Oops sorry old post.

Sounds right to me.

Hi Trauma: how long did the adult health CNS take you to complete? How long for the MSN? Thanks.

Hi FNP: The NP's I worked with in "the field" did/do write orders for meds and wound care but it is done under the Doc. I have had one NP that ordered Hospice for her Home care patients also. Hmmm?!

Extremely sad stories.

I had 253 questions and passed! Go ahead, try the trick.

Dear FNPGrad: You have very good advice so I'm asking for your input here. I am interested in doing NP for Hospice, I currently work as a Hospice RN inpatient unit. Have done many years of field nursing for Hospice also. I especially like the psyche part of Hospice nursing with pts. and families. I will be graduating this Dec. 2010 with BSN and was thinking about doing NP school. So following your advice on previous post, it seems I'm in the right work area currently. Any other suggestions?

How about abhr gel? Our doc orders this frequently for nausea and it seems helpful.

I left med-surg having only worked for 9 mos as a new nurse and went into Hospice nursing. Best job I've ever had! Still have it! 100% better than med-surg. You'll see - take that leap of faith.

Now is the time to make sure you are exercising at least for 30 minutes in the gym. I know this sounds crazy, but it will help. Get your heart rate up and break a sweat. This will relieve some of the stress and tiredness you're feeling. Also, straighten up your diet. Cut the sugar, and I believe these changes will help after a few weeks. Drink lots of water. Good luck!

Do you work at J. Haley VA? That is where I will be interviewing in one week. Is the pay good? I'm a nurse for 6 years.

I did hospice nursing home and alf care for 4.5 years and have switched to inpatient care for the same company. Loved the nursing home care portion and developed a wonderful repoir with the staff. It was good because I knew that when I was off, the staff was taking care of the patient around the clock. That is the advantage of hospice nursing in the ecf arena verses the private homes. I transferred to inpatient unit with hospice to meet my school needs. Inpatient is extremely busy 4p to midnight shift, I never stop running. Best thing about working inpatient is I don't have the paper work following me around like it did when I worked nursing homes as a case manager. When I'm off, I'm off! How I spent my day in nursing homes? I did an assessment on the patient, provided wound care if it was the right scheduled time, called doctors, spoke with family, updated care plans, etc.. The staff passed the meds and medicated the patient with prn's if I asked them to. Great working relationship. The facilities were usually very pro-Hospice and loved my visits because they knew I would put out the "fires".

I was seeing a pt at our inpt center for education regarding his tube feeds through a replaced g-tube. He will go home with Hospice visiting and providing further education. His diagnosis is esophageal CA so I'm not sure about his prognosis. He's A&O x 3, ambulates, no real pain issues. I'm sure he's appropriate, I just don't see him passing soon. Also, our doc is ordering more iv pushes and fluids, so we'll be starting iv's/heplocks to give the meds. Just seems weird to me that we're having more pts admitted that do not always seem appropriate. I know its related to medicare cutbacks and keeping census up to keep our doors open. I don't know, seems like we're doing more outside the realm of Hospice. How about everyone else? I believe in the Hospice philosophy but it seems different with new regs.

I think H-H-H- means "High, hot, and a helluva lot".

BCGrad: Did you work full or part-time while doing FNP program?

Can someone tell me if the nurse educator is and MSN in education? Thanks in advance!

Pay attention to your red flags.

If the meatus is tricky to find, I turn them on their left side (I am right handed) and go in from behind with a silicone catheter. The silicone is firmer and does not move around.

Too funny!

I visited a Hospice patient ( hospice nurse here) who has a history of ileus - which Docs had said a while back that it resolved itself. I'm visiting her and she says she has to throw up. Up comes undigested (3 hrs. old), lunch. States she has a pain in her abdomen. She's A&OX3 with some forgetfulness. C/o of nausea, I checked her bowel sounds, and they were distinct (I realize now could have been the "roiling" stomach??). I check the BM book which charts "L" for stoolsX2 that day. I spoke with her nurse and asked if "L" means large or loose. She states "Large". Side note: Patient has been taking vicodin for arthritis type pain for several months and taking 1 tab BID in the past few days. I did a rectal check and inserted a phenergan suppository and there was a small amt of stool (soft and grainy) in the vault. Anyway, during the night she eventually demands to go the hospital from the nursing home, and is diagnosed with an SBO. She'll be coming back tonight to the nursing home for comfort care only, she's 93 and has refused exploratory surgery in the past for her abdominal pains/ileus. Her son is currently refusing any surgery for her. I remember reading Docs progress note/or hearing somewhere that she would not survive the surgery that he had wanted to do previously. Regarding my assessment, what should I have done differently?

I read your previous posts months ago and wondered when you'd update. Congrats to you!!

Hi, Please explain the difference displayed between the two: essential and drug-induced. What would I be seeing. Thanks!

Sounds as if daughter needs education! Very touchy situation but you need to educate her to the dying process and IVF's are a stressor for the body to deal with when shutting down. She can refuse these even as next-of-kin and request comfort care only. How about that social services person and the DON? Are they on board with Hospice? Enlist their services to speak with the doctor directly about giving appropriate orders to make this man comfortable. I dealt with a similar situation and the DON (very pro-Hospice) and I had an arrangement that if a Hospice nurse needed orders from the difficult doctor, the DON would call and get the orders for the Hospice nurses. Took the heat off of Hospice. The NC sounds like appropriate idea.