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This is an area that has costs hospice agencies a lot of money. It is extremely important to know if the hospitalization is related to the diagnosis or not. It is also important to communicate with the hospital staff so that they know the patient is ...

No this is not appropriate. It has nothing to do with the person, just the title. Law requires an RN to supervise and this is very clear. While the LVN could take on some of the responsibilities that don't involve supervision or clinical decision mak...

In Utah, a hospice agency can only serve locations within an hour's drive of the office. We restrict our service area to 3 counties. We are urban, however. A rural hospice will by nature need to cover a much larger area. I would not refuse a request ...

Welcome to nursing. We've all been there. This is the reason that it is generally recommended that you have at least one year of med-surg or related experience before getting into hospice. But since you are already there, first of all don't beat up o...

Your job is triage, put out fires. Resist the temptation to "fix" everything and focus on the immediate needs of the patient. Good communication with your team is a must and you should be given the resources you need as far as medical records and sup...

Probably is time to leave. Why jeopardize your license for unsafe practices?

For profit or not for profit, it doesn't really make any difference in hospice. The not for profit agencies I have had acquaintance with don't necessarily do a better job for the patient. In fact, competition tends to promote better patient care. So ...

My recommendation is that you should have case management experience first, before working as an admission nurse. The admissions nurse is the first contact and the way you set things up will either make the case manger's job easier, or more difficult...

Sounds like the problem isn't with your nursing skills, but rather with a hospice agency that has serious issues. Find yourself another employer. You deserve to be treated with the respect due a professional. There are good agencies and bad agencies.

Narcotic drips can be given through a peripheral line! The problem is that if it is going to be long term, the IV will need to be changed out according to your hospice policies. Also, IV sites have a way of failing, which would mean the potential of ...

Yes this is a very difficult field of nursing and can be emotionally taxing. I can't imagine doing anything else, though! They say it takes a special kind of nurse to do hospice. I look at it a little different. Every nurse has a set of skills and ab...

RN Hourly, $26 in Utah plus mileage

No med-surg isn't the only way to get into hospice, but it is the best. I would not recommend getting into hospice without a good year of med-surg or related experience. The demands of the job require that you be able to work well independently, have...

Wow! Your heart was in the right place and clearly the facility's heart wasn't. I doubt there are any state laws requiring e-kits in facilities. The facility did leave themselves (as well as your hospice organization) open to a law suit from the fami...

I'm going to take the certification exam in a couple of months, and I would like to be as prepared as possible. I would like to know what study materials others have used and how helpful they found the materials. Wish me luck, I hear it's difficult!

Thanks for the reassurance. I have ordered the Core Curriculum, the study guide and the competencies guide. I wouldn't even try this exam if I didn't have a few years of experience in hospice. Hopefully the combination of experience and studying thes...

No, we would never do this. We would send in a nurse to give the injection, however we probably would not use IM haloperidol anyway. There are so many other options available. Sublingual haloperidol (2mg/mL) works quite well. There are also topical a...

Yep! I know exactly what you mean!

This sounds like a pretty complex issue and one suited best for a spiritual care coordinator (chaplain) or a social worker. As far as what you can do, let your patient say anything. Trust and rapport is the most important aspect of any nurse-patient ...

Depression is a clinical diagnosis. If you are prone to depression, you are likely to experience it regardless of what specialty you choose. Perhaps you should look to yourself to see what's going on inside, before looking at changing your area of nu...

What I will never understand is how bullies remain in their positions. There should be zero tolerance in the workplace. Maybe if more employers find themselves on the losing end of a hostile working condition suit, they might think twice about letti...

It is difficult to get an inpatient position. I had hospice experience and still couldn't get an interview in an inpatient unit. I would encourage you to keep trying, and if you can take some CE in palliative care, that would look good on your resume...

Dr. Jones it's just a flu shot!

Sure, go ahead and pick up acute care shifts. It won't hurt and it would be good insurance. For the first two years I worked per diem for an agency in addition to hospice. What I found though was that I disliked working in the hospital so much, that ...

Yep, me too. I worked in the hospital and travelled as well, for a total of 15 years. It was really time for a change, and hospice fit the bill!