khooker200

Also, the MD has to sign an order to obtain a kit. The first incident I would have revoked and sought out another hospice plain and simple. And yes, the kit is in your home, it is actually your possession per new laws. We cannot even dispose of them anymore legally at time of death because it technically belongs to the patient and family. Everything that happened to you is everything that is wrong with certain types of hospice agencies trying to profit from this hard and terrible time for patients and families.

OP, it sounds like she may have gotten referred to a for-profit agency perhaps? Either way, if the patient has difficulty swallowing, cannot take their medications, and family is requesting to open to comfort kit for EOL symptom management, you do it. I cannot think of any reason in that situation that it would be appropriate to say no. Also the response time is very questionable. Usually Condition of Participation dictates we respond within an hour. Now as an ON-Call RN for Hospice, this is becoming more and more unreasonable to ask of us considering the work load we are carrying, but it should never take 5 hours for a visit of that nature. Scheduled dressing change, maybe, but not for symptom management issues.

I am probably leaving hospice after being in it for over 5 years. It's sad because it isn't the patients or the work that is making me leave. It is the unrealistic workload and geographical area combined with overtime you do not get paid for. I am tired. Pure and simple. It was worse when I was a CM so I switched to ON-Call weekends so I could go back to school. We expanded our geographical area tremendously in the last 18 months and so I am now driving one way over 40+ miles to see patients at 2 AM. Most of the time it is Assisted Living Facilities that call non-stop and you have to go, since they cannot take phone orders or handle being triaged well. I work sometimes 14-16 hours days without so much as a bathroom break due to the drive time, and trying but miserably failing to meet that one hour response time expectation. Did I mention I have to cover nights on those days as well and have more than once been out all or part of the night, without sleep, just to be called back in to work another 14 hour day, NOT including charting time. We also have to do scheduled admissions and scheduled visits the CM assign as well. Due to our census increasing by about 100 patients OVER what our normal was when I took the change in job, our scheduled visits have also more than doubled. I asked about adding staff or at least having a back-up person we could call in case we were drowning or needed to sleep (lord forbid) and it was denied, only to be even busier now. The final straw has come down to being asked to do an admission after 2 ft of snow fell, with ice currently falling, parts of the interstate shut down in a state of emergency, and the admission was over an hour drive away on a non-hazardous weather day. The patient was not dying, and is still currently on our census with plans to discharge for stabiilty/not being appropriate. But because it was an ALF, I was told "we cannot upset them due to they give us referrals". We are a non-profit, and this is not the mission statement that I so valued in the beginning. We are increasingly about numbers and not patient care, and definitely not for the safety of our workers. There are times I really feel I am going to fall asleep driving home. In a 65 hour call shift, I work literally most of that and get paid for 40 hours, and still have charting and reports to finish up on Monday (which I am not paid for). I have been offered a position in Peds at a local hospital making more money and I am thinking of taking it. I have aspirations to be an FNP, and think the experience and stable schedule would be beneficial, though I am going to miss my passion.

Hi Zac! I am a graduate of ACC Nursing Program in 2007 and currently a student at the UNCG cohort that meets at ACC. I also work with an instructor still currently there at ACC. I can tell you there isn't an "accelerated" option once you enter the program. You will probably get credit for some of the coursework considered as pre-requisites, however, you must complete all the required classes such as Statistics and Microbiology before you can be accepted. It is a highly competitive program as well, so you have to have nearly a perfect GPA if you expect to start within whatever time frame you have. It is an excellent program regardless and I never felt like I was not prepared to enter the workforce or take the NCLEX for that matter. They have extremely high standards. Locally, the hospitals preferred our graduates from ACC over UNC, Duke, and UNCG graduates because they can hit the floor running. That says a lot from an ADN program. You can work without issues if you start the night program, but keep in mind they only accept to the night program every so often, and again, once you are in the program you are limited to their schedule and cannot deviate. If you want flexibility in course load and how many credit hours you take each semester, let me suggest the UNCG option to you. You will be able to adjust your schedule every semester and graduate with a BSN- which will be required anyways if you get a job in a hospital setting. UPDATE: The other thing you may not know of as well, is that the program once you enter is 2 years no matter what. Longer if you go part-time at night. It takes most another 1-2+ years to complete the pre-requisites that you MUST have done prior to entering the program. I hope this all helps. If you think of any other questions just let me know!!