Stacey01

I am currently enrolled at WGU. I started Nov1 in the RN to MSN program and have already completed 2 classes. Please note that one of the changes starting with the Nov 1 class is a Professional Leadership and Communication course for all RN-BSN and RN-MSN programs. This requires you to sign up for an 8 day cohort that you MUST attend online for all classes. The work is very easy-- there are 13 tasks to complete and turn in, but it is pretty simple work. The biggest issue was not knowing that this was an online mandatory attendance before I enrolled in the program. I had to do the 8 pm- 10 pm cohort so I knew I would be home from work in time, and it made for a long day. There are lots of options regarding time and how quickly you want to get done- 2 days a week, 3 days a week, 4 days a week, etc. I am currently in biochem. It is a lot of reading.. a lot of material to cover and if you aren't super proficient in chemistry it is a little overwhelming. However, from talking to previous students, the old biochem had several assessments required that included making models of DNA, etc. This one does not. This one only has an objective assessment which is a 70 question final exam (once you have passed the pre assessment. )

Milk of Magnesia and merthiolate mixture to decubs..then patient turned on their side and their butt cheeks taped to the side rail so the heat lamp could hit the affected area . ICU nurses drew all the ABGs for the hospital Having to do 3 intubations a quarter to stay proficient because we intubated any patients that required it at night- respiratory therapy went home at 9 pm and didn't return until 8 the next morning Cardiac output measurements done with iced saline Being the only nurse on duty in the ER from 11-7 while the Dr. slept - no secretary so the nurse checked the patient in, got the insurance information, then took them back and did the assessment and ordered all labs and X-rays necessary BEFORE you woke the Dr. The only exception was an incoming level 1 and you woke the Dr. to give orders to the medics. Putting in in various lines at the bedside , sometimes with fluoroscopy and sometimes without. Glass suction bottles Narcotics and heparin in tubexes with rubber caps Nurses wore white ( and navy blue sweaters ) Punching the the time clock Milk and molasses enemas mixed up in dietary and sent to the floor Triple H enemas- high, hot, and helluva lot Metal trachs and having to remove the inner cannula to clean it, then reinstall- nothing gagged me more than respiratory crud Only one Dr. In the house all night - the ER doc- so if there was a code and he was busy, the ICU/CCU code nurse ran that code . I remember the first time I had to do this at the ripe old age of 21. I was a wreck but the Dr. gave the best advice - they are already dead if a code has been called..anything you do can only help My mentor quizzing me on rhythms and treatments during a quiet spell...while she smoked her cigarette in the ICU lounge I started my nursing career in a very small community hospital , in the combined 10 bed ICU/CCU that was also under the same manager as the ER.. so we rotated between the 2 places. It might not have been a university hospital environment , but boy did I learn. Thanks for the memories AN....all these posts brought a smile to my face this morning.

I've been a hospice nurse for what feels like forever ( I did leave for a short time a few years back...while I was a hospice nurse, my mom became a hospice patient and though my coworkers were wonderful -- not only in their assisting me with her care , but as friends...I was only able to continue for about a year after she died. I needed a break). Time management is crucial in any home based nursing, but especially hospice. As others have stated, you can plan your day but we know what they say about best laid plans . No one dies on a schedule, so you just never know how your day is actually going to play out. The poster that stated to front load your week was spot on. I do that every week in hopes of gaining some ground by midweek. I also rely very heavily in point of care documentation. I know many will say this is impossible, but I do it regularly. When my day is done, I do not want to spend hours charting at home . My folks are used to seeing that computer come out so I can document changes as I talk with them. I assess and then sit down and document as much as I can while chatting with them. I do not chart and ignore them, but it can be worked into your visit. Anything left over is often done sitting in my car before I head to the next house. I just had 6 folks die over the course of 10 days...but my case management census had been at 24 which is a boatload of folks. My days don't always end at 4:30 but the bulk, if not all, of my charting is done when I get home. You don't need to write a novel. Learn to be concise and to the point...it's about accuracy, not about the number of words. You are still early in your hospice career and will learn lots of new trick to help along the way. As discouraged as you sound, don't let this get the best of you. Hang in there. It sounds as though you certainly have a hospice heart..the rest will come. Best of luck.

Although pleurex catheters are more common, if there is a need for paracentesis it is done.

We can provide 6 days per week. Our aides currently rotate Saturdays. As our census grows we are contemplating adding Sunday's as well.

I have been a nurse for 31 years...a bit more than 10 of those years as a hospice nurse. Prior to hospice I worked in ICU, ER, PACU, Home Health, ortho/ neuro trauma , and for a brief period was an ADON at a skilled nursing facility ( * shudder...God bless those that can do that...it wasn't for me). My hospice time was broken up . I worked 7 years..took a much needed break ( after the death of my mother who was enrolled in our hospice program) ..and then re entered hospice a few years later. First and foremost, I agree with many of the other responses that you really need a solid set of skills before pursuing this. But aside from that, you need the confidence in yourself and your capabilities. I have seen often, newer nurses, who were confident but not really skilled and those that were skilled but lacked confidence. Either one is detrimental for a successful home hospice experience. You are out here , without the ability to poke your head out the door and ask for some help from your peers. You need to know what you're seeing and how to manage it. At our program, and most others as well, we work a lot by standing orders ( or palliative care orders)... Medication ranges that we can institute when we need to based on symptoms. But you need to be comfortable with doing this. You also need to be able to focus. Your schedule and your case management list is yours, and yours alone to manage, and you have to be organized and be able to prioritize and change things on a whim without getting overly stressed/ upset. Most days in hospice is anyone's game...things change on a dime. And then you need the heart, or compassion, for hospice care. It's not an easy road most days , but I can't imagine not doing it. You can learn skills, you can learn how to manage a caseload, you can learn meds and palli orders...ll.but no one can teach you how to be compassionate at the end of life. Best of luck to you.