andyg

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...

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...

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.

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...

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 ...

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...

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...

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

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...

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...

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...

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...

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...

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...

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...

After 15 or so years in Hospice I think several areas paly a role in someone hanging on. I think first and foremost from what I've seen that someone who has been "bad" for many years ie. abuse, neglect of someone, "sinner" etc are more scared of dyi...

Hi, ya'll thought I'd put in my two cents worth. I live in Trenton and have worked in Jackson the last 12-13 years. Welcome all you nursing students and good luck Andyg

Congrats, I'm glad it's going well for you. One word of advice would be to just treat the deceased and the family with respect and you will have little to worry about as far as specific stuff you have written down. These folks just need a little lo...

Felixfelix, I'm not sure of where you live but most of the hospices in this part of the country do not require 4 yrs. (South East). I do agree that it does how you present yourself when interviewed as do all jobs. We have hired new grads but the ma...

Hey ya'll another W. Tennesseean, working in Jackson doing Hospice. glad to see all of you here. Andyg

Hey doodlemom, you don't say where you're located. I know here in TN that many nurses want additional hours and are willing to do extra. So you might try posting at your local hosptial and checking with some of the HH agencies in your area. Anothe...

Hi, JudithLane Many programs I'm aware of do not use LPN's and some do, but you need to consider several things. Yes you can complete in one year but financially an RN's salary is much more and opportunities are actually much better. You didn't say...

doodlemom You can find this inof on the NHPCO website, once logged into the opening page go to technical support then go to the 12th bullet, suggested staffing ratios, and there you go. Good luck with your new manager, hopefully she will utilize you...

Congrats, we can always use more compassionate nurses that are willing to take the jump. One of the books that we use with each of our nurses in orientation (and they get to keep the copy) is "Notes on Symptom Control in Hospice & Palliative Car...

I feel your pain!! Our nurses right now are carrying 14-18 patients per case manager but that's because of the amazing growth we have seen over the last four months from adc in August of 92 and now up to adc 115-120 and administration hasn't approve...