Triage and on call

[cargalrn]

I just got a new seven day on seven day off on call Hospice position. What are typical reasons why and RN would go out other than intractable pain or a death. I understand admissions, death visits, and routine visits. For example would one go out to a facility for a skin tear on a Saturday? Can you give me a picture of what your typical calls and visits are? Thank you very much

[CrochetNurse154]

PRN visits vary in nature. Most visits are for an uncontrolled symptom of some sort i.e. intractable pain, dyspnea, terminal restlessness, uncontrolled oral secretions etc. However, I've gone out on PRN visits to troubleshoot catheters, changes in LOC, new onset s/s of an infection and everything inbetween.

[cardiacfreak, ADN]

Normally, my on call visits are for symptom management, but I have been called out to deliver supplies and medications. I once had to drive 65 miles to deliver tylenol, GGRRRRRR.

Most other calls for falls and death visits.

[CrochetNurse154]

Normally, my on call visits are for symptom management, but I have been called out to deliver supplies and medications. I once had to drive 65 miles to deliver tylenol, GGRRRRRR.

Most other calls for falls and death visits.

Delivering meds?? That's a HUGE no no where I work. We actually had a nurse get fired for picking up Tums to take to her patient.

[anashenwrath, ASN, RN]

Ugh my heart breaks for our on-call nurses (especially bcs the RNCMs have been covering for one of them for the last three months!). On-call gets called for anything (ignoring actual out-of-control symptoms, admissions, and deaths). Boo boo? Fall with no injury? Anxiety? Out you go! Not only that, but triage is not the most dependable... patient called triage with c/o low bsfs in the morning...triage didn't let me know until almost 4pm!

The plus side is, you can tell triage (at least in my company) to HOLD on putting a visit on your tablet until you speak with the patient. For example, I called the low-bs patient's nurse and she confirmed patient always runs low. Then I called patient and confirmed BP before lunch was 129. Called triage and said everything was cool, then wrote a note and left report covering everything. I always try to triage on my own: call the patient or family and talk it through. ALWAYS make it crystal clear you are more than happy to visit, but let them know you wanted to call first and talk out what was going on.

When I was covering, I didn't have to go out too much. Maybe three nights a week? I honestly don't think on-call is a bad gig. But if people call and say "Gram gram is on hospice for COPD but she has a canker sore that's really bothering her! WE NEED A NURSE" Yeah, you'll be going out to look at it.

[cardiacfreak, ADN]

Delivering meds?? That's a HUGE no no where I work. We actually had a nurse get fired for picking up Tums to take to her patient.

We have a form that the pharmacy signs stating the medication we picked up and then patient signs stating delivery. I am wondering though, if you have a home patient that cannot get out, who delivers the medications if their pharmacy doesn't deliver? What does your on call do in the middle of the night if someone is having symptoms out of control and no medications are available in the home?