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vampiregirl BSN, RN

Hospice
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vampiregirl has 11 years experience as a BSN, RN and specializes in Hospice.

vampiregirl's Latest Activity

  1. vampiregirl

    Question for In Hospital Nurse Educator

    Another thing that makes a huge difference is making sure any inservices are well organized, as interesting as possible and geared towards what the audience needs to know to apply that knowledge. Materials ready to go, equipment working etc. Even if the subject matter itself is dry (I.e. required yearly education), add a brief, relevant video slip to the presentation. Organize the material in a different way. Add an acronym to remember info. Present an analogy or do a brief demonstration to illustrate an important point. Anything to catch the learner's attention and promote recall. Nothing is worse than watching the exact same presentation for x years in a row. Staff notices if the educator has put for effort to prepare for a presentation!
  2. vampiregirl

    Question for In Hospital Nurse Educator

    In addition to more formal education suggestions listed above, I also found that when I was a staff development coordinator in a SNF that if staff had easy access to information they were more likely to reference it as needed. For example, if a patient on a unit had an specific type of drain then I had manufacturer's info/ troubleshooting bookmarked or even a shortcut on the desktop on that unit's computers so that nurses didn't waste time searching for info.
  3. vampiregirl

    Best car type for on the road home health visits.

    Hospice nurse here, but I've also worked home health... I love, love, love my Honda CRV. Good fuel mileage, dependable, nice ride, electronics meet my needs (screen big enough for my GPS to be read easily), handles well in poor weather, enough room. Even after you find your perfect vehicle, be diligent about routine maintenance. Makes a huge difference.
  4. vampiregirl

    Therapeutic communication for anxiety

    Lots of great suggestions on this thread! One trick I've found is to ask the child (or adult) what they do to calm themselves down when they get anxious. Many times, it's not the first time this has happened and they may know what helps them.
  5. vampiregirl

    CHPN Study Material?

    I'm guessing you are referring to the "Detailed Content Outline" that you can download? If so, I agree - this wasn't super helpful for me. I did find it helpful in the respect that it helped me to figure out what areas I was familiar and not familiar with. The HPNA sells "Core Competency" texts on it's site. This is very detailed and I found it very helpful for studying for the CHPN. Best of luck to you! I found I learned so much studying for my CHPN that I am able to apply to my clinical practice. I highly recommend this certification.
  6. vampiregirl

    Public or Private: Which is the Best Nursing Program?

    Regarding cost... When I was completing my RN to BSN several years ago I was very surprised to find a local private college for which tuition was competitive with the public/ community colleges. I'm sure this isn't the norm but it's worth it to conduct research to determine which program is best for you. I also considered many of the other factors recommended by previous posters. I ended up with a great experience and education.
  7. vampiregirl

    Difference between case management and home health visits?

    I've worked home health for 2 different companies in the past and care plan writing was part of my job at both companies. I will say though, the care plans were fairly simple and uncomplicated. Typically they are related to the goals of care (why someone is receiving home health services) and the tasks associated with the care provided. I would encourage you to find out exactly what writing care plan entails at your job.
  8. vampiregirl

    How to get into hospice

    This typically sounds like a lot but hasn't been in my experience. I have a "checklist" that I use that simplifies this for me. My checklist lists all the typical follow-ups required after a patient death and I just contact (and document) the contacts appropriate for each patient. If there is a unusual contact that will need to be made post-death for a patient, I typically ensure I have all the contact info ahead of time and make a note in the EHR. Part of the challenge of hospice case management is establishing good systems for yourself that keep you organized. Once you get this in place, it makes that aspect smoother. But like anything else, it takes time to get these in place.
  9. vampiregirl

    Palliative Care Patient Care

    Palliative Care is a wonderful area of nursing with a focus on symptom management to improve quality of life. Palliative care can take place concurrent with treatment for diseases. Hospice is a specific type of palliative care for individuals with terminal diagnosis as they approach end of life where either the patient does not have any further treatment options or they chose not to pursue any further treatment options. As to the position you are inquiring about, I'm guessing the job description might help you determine if clinical aspects are involved. Best of luck to you!
  10. vampiregirl

    Hospice LVN vs RN

    Where I currently work, we have an amazing LPN who does visits. She works part time, typically 2 days a week. At our agency, the RN case managers do the admissions. LPN's can do admits but regulatory requirements stipulate an RN must do an admission assessment within 48 hours of admission. It's just less complicated for everyone if the RN does the admission. Any orders must be co-signed by an RN - that's not a problem for any for us. Our case managers make the initial care plans and update them. Medicare requires that an RN perform an aide supervisory visit every 14 days. Other than that, LPN's can perform anything else allowed by their scope of practice. I don't know that I'd say one environment is "less stressful" over another as a general rule. So many factors go into this. I worked SNF/ LTC prior to coming to hospice. I enjoy focusing on one patient at a time. I love education, there's a lot of this in hospice. The schedule is more adjustable. Documentation is still important - depending on the charting system and agency policies, charting can take awhile. I certainly don't miss huge med passes in nursing home life! Typically I work Monday - Friday 0800-1630 but frequently have charting in the evenings. I have call one night a week and every 4th weekend. Call typically isn't awful but occasionally gets busy. We are all hourly. As for experience, it just depends. Some agencies have great orientation programs for people with limited experience. Other agencies only accept people with lots of experience. You are typically by yourself in the field so it's important to be proficient in skills (catheters, blood draws, wound care, etc). Great assessment skills and interpersonal skills are two on the most important skills. I think I've answered most of your questions, but let us know if you have more!
  11. vampiregirl

    Got The Vaccine! Share Your Experience

    So encouraging to hear from nurses who have gotten the vaccination! Thank you so much to those who have shared their experiences. I think this will go a long way to reassuring others. There are risks with any vaccine (or medicine or procedure) but the benefits are far outweighing the risks for most people at the current time. I'm so thankful we have another tool available against COVID-19. A couple of friends have already received theirs with very minor, if any reactions. I'm scheduled in a couple of weeks:)
  12. vampiregirl

    Smoking and Oxygen policy

    The hospice I work for allows smokers with oxygen to be admitted. This is assessed for and discussed upon admission. We implement several items to the care plan including assessing for safety risks every visit and education. Prescriber must be notified and updated if risks identified. Another tool we use is any oxysafe device - there are several different brand names I believe. The nice thing is these devices can be used in the place of a standard tubing connector so they are not hard to place. We have not had anyone who has flagrantly disregarded our smoking safety concerns (since I've been here - going on 2 years now) so I'm not sure what the outcome (regarding discharge) would be. We have had to instruct some caregivers to keep possession of smoking materials unless patient is being directly supervised with condition decline, patients weren't happy but agreed. While this device doesn't eliminate the potential risks to the smoker, it does help to reduce to the risk of fire spreading and to other occupants.
  13. vampiregirl

    'Taking Call? Am I missing something??

    I'm a hospice nurse who has one night of call of week and rotating weekends. I realize this is a different perspective... but I really like having a consistent day of the week I'm on call versus changing/ rotating days. It allows me to plan around this so much easier. Where I work, there's a small amount paid for the call shift however any time worked is at time and a half. I would get more details of the call aspect - find out if there are time response requirements and how often people get called in. Both of these factors would impact my decision making.
  14. vampiregirl

    Hospice questions

    Welcome to hospice! In addition to the resources recommended by NRSKarenRN, I recommend the AAHPM Palliative Primer; I use this resource daily! HPNA Membership has also been invaluable. Depending where you live, there may be a local chapter as well. As far as deaths during severe weather, your agency should have specific procedures. One thing to remember, a dead person isn't going to get any deader - there is no urgent patient symptom to address (I don't mean this disrespectfully, just to illustrate the importance of the hospice nurse driving safety to the destination). In my experience, family members get more frustrated when they are given inaccurate time estimates - if you are honest with them, typically they are reasonable. Customer service is so important immediately after a death. How a phone call is handled can make a huge difference. Some support can be done over the phone on the initial phone call. Under most circumstances (there are exceptions), taking a few minutes to allow them to process the death, reaffirm the quality of care the family provided, ask what the current concerns are, explain what the next steps are etc. I often inquire if they are waiting for other family members. If not, sometimes I confirm funeral home preference and ask family permission to give the funeral home a heads up or even arrange a tentative time. I've even had longer drives where I've pulled over to phone check the family (especially if a single family member is with the deceased) enroute or even contacted another hospice team member to provide some phone support while I'm enroute (if severe road conditions and I need to 100% focus on the roads). When I arrive, I always make sure I'm calm and collected. I don't mention if the drive was awful. This is about them and their needs.
  15. vampiregirl

    RN to Paramedicine and Covid

    I would recommend checking with your state ems commission to see if there is an option you would be eligible for.
  16. vampiregirl

    On Call

    From others I've talked to some of these decisions are dictated by agency policy. One nurse I know worked for an agency that required a visit for every call. I work for an agency that leaves this to the nurse discretion. Deaths automatically get a visit. Otherwise, I don't know that I can clearly differentiate between what constitutes as a visit or just a call (or calls). So many factors play into this. I offer a visit with almost every call. If I get multiple calls on a patient I tend to encourage a visit. If we are managing a symptom, I will typically do a phone check in an hour or so after new orders are implemented to assess effectiveness. Also, sometimes visits are for patient/ caregiver support and those visits are just as important.