andyg

Latest Activity

1. Revocation

   andyg replied to silverwillow's topic in Hospice

   You can always discharge due to the patient seeking treatment at a hospice non-contracted facility. I am sure when you admitted them you explained which facilities you contract with. This covers you under the guidelines and you can readmit upon the...

2. Attending memorial services, funerals, condolence calls etc

   andyg replied to nurselearner's topic in Hospice

   I agree with all the above. I've been doing hospice about 14 years now and learned long ago yu can't do it all. I always made it a point to go to visitation for myself and the family (it is also very very good PR for you and your company) this does...

3. Administrative differences between Hospice and Home Health?

   andyg replied to chris_at_lucas_RN's topic in Hospice

   Yep I reckon for the most part I am. Since you are a pretty little motivated individual get those others motivated with you and good luck.

4. nebulized ms

   andyg replied to doodlemom's topic in Hospice

   Put my two cents worth in, had some fairly good results in days gone past with some of our end stage COPD'ers, in agreement with the SL working better for pain most of the time but as some have said "what they truly believe will work, what they don't...

5. vital signs

   andyg replied to hcan's topic in Hospice

   Very interesting to see the various thought processes on this issue. It is not a requirement by JCAHO or Medicare to do VS. This would be more of what your agencies P & P manual had in it. My own thought process is that a lot of the time this ...

6. Administrative differences between Hospice and Home Health?

   andyg replied to chris_at_lucas_RN's topic in Hospice

   chris, when I read this I thought it's a wonder you haven't had a bunch of thoughts shot at you. My opinion is they are completely different specialties with completely different goals with completely different COP and standard requirements with comp...

7. Is anyone an admission nurse?

   andyg replied to brainnurse's topic in Hospice

   I decided that we would use admission nurses at our agency for several reasons. 1st it would provide the case managers additional time to spend with their case loads. 2nd the patients and families would get the "same" story from each of the admissi...

8. What is the ideal caseload?

   andyg replied to Hospice4me's topic in Hospice

   Hey there req read, Go to the opening page and log in, go to the 11th bullet under technical assistance, then go to the 13th bullet titled suggested staffing ratios and it's all right there. Good luck andyg

9. How long are your IDT mtgs? And content?

   andyg replied to Cing_angels's topic in Hospice

   We go over about 100 patients in approx 1-1/2 hours and cover the areas actually quite well. In fact the last medicare and JCAHO surveyors sat in on the IDT meetings and was most impressed with the information we covered. I really feel it is not th...

10. What is the ideal caseload?

    andyg replied to Hospice4me's topic in Hospice

    In reponse to req read's question NHPCO has some recommended staffing rations on it's web site. I believe if you go into the main page then into the inside NHPCO then to technical support that they have recommeded staffing ratios for all disciplines...

11. Defibrillators...

    andyg replied to CANRN's topic in Hospice

    There is the internal pacemaker which will keep the heart rate essentially "normal" but it usually does not "shock" and will not really affect the patient because of chemical changes within the body hen the patient is actively dying. The internal de...

12. Any ideas for unrelieved N/V

    andyg replied to spoiled28's topic in Hospice

    Have had some diffcult N/V cases over the last 15 years and the good ole standby for me has always been Haldol on these difficult cases. Usually in cases like these I'v eput in a SQ butterfly in the abdomen and covered with opsite and cap. That way...

13. Defibrillators...

    andyg replied to CANRN's topic in Hospice

    We have run up on this on many occassions. Ususally it has been our experience the "defibs" were placed due to other helath problems in the past and usually has nothing to do with their terminal dx. Once the DNR is in place we will usally start tea...

14. Trends in dying process

    andyg replied to req_read's topic in Hospice

    I totally agree, I do think a lot of the "newer" Hospice nurses really have not had the opportunity to distinguish between religion and spirituality. In our culture a lot of folks still think these are the same. I still have trouble at times with m...

15. how to thank hospice unit

    andyg replied to heartICU's topic in Hospice

    One of our most memorable family events was when a family called and asked me if it was okay for her to bring some food over for the staff to show how appreciatvie they were of the Hospice team. To my and my staff's surprise the whole family (daught...