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vampiregirl

vampiregirl BSN

Hospice
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  1. vampiregirl

    ACHPN exam?

    For the CHPN exam in 2015 (different exam/ certification, same credentialing agency), I used the candidate handbook and purchased the core curriculum. I also purchased practice tests from HPNA, which included 2 practice tests. I took the first one as I was beginning studying to identify areas that I needed to focus on and took the 2nd practice test about a week before my "real" test. I think I prepared for 4-6 weeks total. As for the areas represented, I seem to recall the candidate guide pretty much gave an accurate picture. I also know several other nurses who have taken the test and all of us had either different tests or different perceptions of what areas were more represented. Good luck! I encourage any of my hospice colleagues to pursue certification. I learned a lot from studying for the test and I think it has positively impacted my practice.
  2. vampiregirl

    Patient tracker app

    I'm not familiar with an app that does this. I've just used the data/ views available in the EMR to reference what I need. For me, entering this info in an app would be a redundancy. I do use "sticky" notes on my computer screen for quick reference of mantoux dates, cert period end dates and FOV since these dates aren't readily available in screens I routinely view. I used initials for privacy. I would also be concerned about security of such an app unless it had been reviewed/ recommended by my employer. Have you checked though to see if there is a secure mobile version of your EMR that is an app?
  3. vampiregirl

    As seen on TV

    My friends have officially banned me from watching medical tv shows in public places as I cannot refrain from "providing education" (i.e. talking to the tv) about incorrect procedures. It's always interesting with a patient or a helpful family member recommends/ requests something that they saw on tv. I try to maintain professionalism but wow, sometimes that's a challenge!
  4. vampiregirl

    Favorite school nurse resources?

    These are great! I'm a volunteer camp nurse for a week in the summer and I'm adding many of these links to my "toolbox":)
  5. vampiregirl

    Therapy dogs and Allergies

    Great educational, thought provoking thread! I'm not a school nurse but school isn't the only setting where animals are potentially a benefit to patient care (well, and the healthcare staff too!) but other factors unfortunately have to be considered also. Here's a link that contains info that might be helpful to some, who like me, were confused about some of the differences in laws etc. Differences between Service, Emotional Support, and Therapy Animals - SERVICE DOG AND EMOTIONAL SUPPORT ANIMAL LETTERS & REGISTRATION
  6. vampiregirl

    Dr Google scares me

    Exactly! Sometimes patient's are receptive to education about to find reliable sources on the web. And appropriate sites can be a great resource for further information about a diagnosis, especially a new one. And other times, it's a lost cause because "if it's on the internet it has to be true!":facepalm:
  7. vampiregirl

    Getting more wound care Experience.

    The typical goals of hospice wound management (drainage management, odor control, comfort) are different from those in other settings but the assessment of a wound is the same. I would recommend getting a wound resource book to learn more about wounds and practice every opportunity you can on assessment/ documentation. I work in hospice and have both a palliative care wound book I refer to as well as "regular" wound resources. Education about prevention of wounds is another area that you would need to be familiar with for wound care. Some of the risk factors can't be altered for hospice patients but I still do a lot of education to prevent unnecessary wounds. Turning/ repositioning, floating heels, incontinence care, ensuring other interventions aren't creating pressure points etc. Wounds can affect quality of life even for a hospice patient. And I've had to get really creative on dressings for some of the fungating cancer wounds I've encountered. As fragile as many of patient's skin is, I have to diligent about dressings not impairing skin integrity (tape!!!). Do you have a home health care division associated with your hospice? This might be a way to get some wound experience if you ever have the option to get overtime or float if low census and floating is an option. Skilled nursing facilities are another great place to learn/ practice with wounds. That's where I got my initial experience. Most have a designated wound nurse who is a wealth of knowledge.
  8. vampiregirl

    New nurse and I had a breakdown at work

    To the OP... You've gotten so much great insight and suggestions from others. The tough part will be figuring out what will work best for you. This would be one of those times that a crystal ball would be really, really helpful! I used to be able to do nightshift no problem. Much to my surprise, I tried a night shift position earlier this year and it just didn't work for me anymore. The affects were obvious in many different aspects of my life. I eventually took a position on another shift when it became available and slowly things improved/ returned to normal. Although some posters urged caution with your educator's and manager's recommendations/ support, I would consider the options they have presented. Obviously they see the potential in you. If YOU decide that a day shift would be better for you/ your family, then you have that option. Good luck with whatever you decide. And if what you chose doesn't work out exactly, that is OK. You are at the very beginning of your nursing career - for many of us the beginning wasn't without challenges and we survived:)
  9. vampiregirl

    I want to try camp nursing

    The Association of Camp Nursing website (campnurse.org) might be a good place to start for information about camp nursing. Also, maybe consider contacting your local YMCA or YWCA to see if they offer a camp or are connected to one. I volunteer one week each summer for a camp, it's a great experience.
  10. vampiregirl

    Are We Letting Our Patients Suffer?

    I agree that at times the pendulum has swung too far the other way. As a hospice nurse, I've cared for patients who have not had pain adequately addressed until hospice admission. And then they've had a significant improvement in quality of life once the pain (and other symptoms) are managed. At times it seems like assessment of symptoms and appropriate interventions are taking a back seat. Different types of pain require different interventions - for example if a patient reports leg pain, bone metastasis and pain caused by tumor pressing on a nerve are effectively addressed by different approaches. A pulled muscle or cellulitis are two other causes of leg pain and treatments are different. Another consideration of pain control is monitoring opioid use. If a patient is requesting refills too soon, is it because the patient is taking more meds than prescribed? Even then, is it because the prescribed dose is ineffective or is the patient forgetting they took a dose and taking another too soon? Or are the meds unaccounted for due to another reason, such as diversion? If meds and pain control are being closely monitored from the start then any concerns can be addressed early. Sometimes this means changing the med route or quantity dispensed. Or it may mean involving other resources. But the bottom line is, that patients are receiving appropriate assessment and pain control interventions instead of just "blaming" the opioid issues for a provider being "unable" to effectively address the pain.
  11. vampiregirl

    "Green House" model

    That's a different concept, I think that is more popular somewhere in Europe. But that one sounds fun too!
  12. vampiregirl

    "Green House" model

    Good questions! I already asked about behaviors - they have a psych provider contacted but it doesn't sound like they have many behaviors. I didn't see any when I toured. This model has better staffing and is more individualized to the patients - I suspect that contributes to few behaviors. The houses are designed for safety for dementia patients and they are not in the same "home" as the rehab patients where I will be. Hmmm. I will have to inquire about total care though.
  13. vampiregirl

    "Green House" model

    Glad to know I'm not the only one not familiar with this concept! The facility is a state licensed SNF with the beds certified either Medicare/Medicaid or Medicare (for the rehab homes). They also accept private insurance and have a few private pay patients (long term care). Welcome Home - The Green House Project
  14. vampiregirl

    Is it camp season yet??

    Glad I'm not the only one feeling a little melancholy today and "camp sick" today. Camp is such an amazing experience and one of the highlights of my summer. I'm already looking forward to my week of volunteering next summer.
  15. vampiregirl

    "Green House" model

    I'm journeying back to LTC/ rehab world, but with a twist. I've accepted a position with a company that has successfully opened several Green House model "homes" in my area. I did my research (about the agency and the Green House concept) and think that this job will be a good "fit" for me and my skills set. I'm hearing positive feedback from a current nurse who works there (and I worked with at another agency), a friend who was a patient there and from several professional contacts I have in the local medical community. Curious if anyone else is working in a facility that uses this model of care, I'd love to hear what your thoughts are... All the threads I found were quite "old" and I suspect this model of care has evolved from when it first was being implemented.
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