For this episode I review the fallout I received after posting the following visit schedule.
6 patients who will be known as 1-6
All Charting completed at the bedside.
Patient 1 – 8:00am – 8:45am (no new orders)
Travel 43 miles to Patient 2
Patient 2 – 9:30am – 10:30am (Actively dying)
Travel 30 miles to Patient 3
Patient 3 – 11:15am – 12:00pm (pillbox)
Travel 0 (same building)
Patient 4 – 12:00pm – 1:00pm (pillbox)
Travel 25 miles to Patient 5
Patient 5 – 1:30pm – 2:30pm (new orders)
Travel 23 miles to Patient 6
Patient 6 – 3:00pm – 4:00pm (no new orders)
Drive 5 miles to where my daughter works to pick her up since her car is in the shop. She gets off at 5:30pm.
Worked from 4:00pm-5:30pm to do Recert notes on patients 5 and 6 above. Also completed IDT notes on 3 patients for a nurse who is out sick.
Start nice and early. Chart at the bedside. Be intentional!
I discuss that my main goal of the post was to show that bedside charting can be accomplished in any situation. This post turned into more than I ever imagined with a lot of different feedback. Some was positive and some was negative.
I then discuss the following color wheel, and how it completely changed how I looked at my day. I also share what I learned from the color wheel.
I then engage in some reflection and discussion regarding the color wheel and how it applies to all of us.
To close out the episode I challenge all of us to begin to take the next step in our journey to complete as much as possible at the bedside of our patients.
I also provide some updates on Hospice Nurse Training (click HERE) and how I will be changing the free trial period to 3 days instead of 14 and why I’m making the change.
As always, don’t forget to call, text or email to leave feedback! I would love to hear from you!
In episode nineteen I go into detail my strategies for managing visit frequencies.
To start out the episode I discuss the importance of following agency protocol regardless of any advice I provide. I also challenge leadership to reconsider any expectations that do not make sure patients get visits from their primary nurse for all crisis.
I discuss how increased visits help build the two most important tools we have in our nursing bags.
I compare the hospice experience with a good book and explain what the first 7 days should look like and what the last 7 days should look like.
I discuss situations when we should put patients on daily visits even though they are not in steep decline or actively dying.
At the end of the episode I provide an update on my new website Hospice Nurse Training, and I discuss the upcoming training schedule.
In episode nineteen I go into detail my strategies for managing visit frequencies.
To start out the episode I discuss the importance of following agency protocol regardless of any advice I provide. I also challenge leadership to reconsider any expectations that do not make sure patients get visits from their primary nurse for all crisis.
I discuss how increased visits help build the two most important tools we have in our nursing bags.
I compare the hospice experience with a good book and explain what the first 7 days should look like and what the last 7 days should look like.
I discuss situations when we should put patients on daily visits even though they are not in steep decline or actively dying.
Don’t forget to call, text or email to leave feedback! I would love to hear from you!
Throughout this episode we discuss many of the challenges hospice faces when providing care in LTC facilities.
Towards the end of the episode we address a very difficult situation a nurse named ”Peggy” has recently had to deal with.
At the end of the episode we conclude with some practical advice to help build deeper relationships with staff and leadership.
In my final thoughts, we discuss the importance of considering the bigger picture when working with all facilities. We discuss the fact that working with any facility is about long term goals, and how it takes time to build a mutually beneficial relationship that will ultimately help hospice patients and their difficult journey towards end of life.
Don’t forget to call, text or email to leave feedback! I would love to hear from you!
In this episode I share my strategies for managing patients and their symptoms in the last 7 days of life.
I discuss when to start patients on daily visits, what what science and mathematics I use to calculate scheduled and as needed medications to maintain control of symptoms.
I discuss the difference between transitioning and actively dying patients. I also discuss some changes in terminology that will help cut down on confusion or misunderstanding between hospice staff and our caregivers.
I discuss what kind of schedule to keep when making those visits in the last 7 days of life including visit times and how to help our caregivers feel more at peace with the schedule.
In this episode Brian and I finally coordinate our schedules to record the first of two episodes to address the challenges working interdisciplinary with staff inside of facilities.
This episode was very eye opening for me, and I think it will be for you too.
Hold on to your hats, because this episode comes in at a little over 90 minutes. Hopefully, you find it to be as inspiring as I do.
Brian shares with us his journey from hospital ICU, through a 16 year hospice journey and why he decided to move to ALF leadership.
Throughout this episode there is plenty of practical advice. There is also some insight into what it can be like to run and work at an ALF.
By the end of our visit my appreciation for the staff inside of an ALF skyrocketed. Inside of the hospice community there is just too much complaining regarding our ALF partners. As we wrapped up this episode I was filled with a new appreciation for the hard task ALF staff have.
If I were to sum up the whole episode in one word in two words it would be, ”Accountability.” That accountability is on our part. The only people we have control of is ourselves. That is an obvious theme in this episode as it is in just about everything else that comes out of this website.
I hope you will embrace this episode and find it to be the kind of motivation you need to help you be that much better when you are working with our friends in ALF.
Don’t forget to call, text or email to leave feedback! I would love to hear from you!
For Episode Fourteen I pick back up on my burnout series. In this episode I address some of the biggest reasons nurses get stuck for long periods of time with their patients.
Here is a quick list of topics I discuss.
Some visits are just long
See everyone twice a week
Understanding the two types of nursing visits
Be the calm in every situation
Avoid power struggles
No triangles
Don’t invent problems
Know your patients
Chart at the bedside to end the visit
I also share the following visit schedule I performed right after I published part 6 of my burnout series.
6 patients who will be known as 1-6 All Charting completed at the bedside.
Patient 1 – 8:00am – 8:45am (no new orders) Travel 43 miles to Patient 2 Patient 2 – 9:30am – 10:30am (Actively dying) Travel 30 miles to Patient 3 Patient 3 – 11:15am – 12:00pm (pillbox) Travel 0 (same building) Patient 4 – 12:00pm – 1:00pm (pillbox) Travel 25 miles to Patient 5 Patient 5 – 1:30pm – 2:30pm (new orders) Travel 23 miles to Patient 6 Patient 6 – 3:00pm – 4:00pm (no new orders)
Drive 5 miles to where my daughter works to pick her up since her car is in the shop. She gets off at 5:30pm.
Worked from 4:00pm-5:30pm to do Recert notes on patients 5 and 6 above. Also completed IDT notes on 3 patients for a nurse who is out sick.
I ask my listeners to let me know what they think of the above schedule. Was this a good schedule I should be proud of, or are there problems with it?
In Episode Fifteen I will discuss the above schedule and what I feel like I learned from it.
Don’t forget to call, text or email to leave feedback! I would love to hear from you!
In this episode I review that last two weeks of orienting my new nurse. I discuss how impressed I was with her ability to read a room when we made an emergent unscheduled visit.
I review how we performed 3 recertification visits and I introduce a new tool that can be downloaded using the “Download Tools” section of the web site. There is also a youtube video on how to use the tool available on the download page.
To close out the episode I discuss the challenges all hospice nurses experience due to our ability to tell the future in certain situations.
Don’t forget to call, text or email to leave feedback! I would love to hear from you!
Welcome to part 2 of my series on the my strategy for orientation of a new nurse.
In this episode I explain how I feel like I learned the most. My biggest take away from the week was that I need to create a more robust training program for new visits. I’m great at having all my visits organized and planned out. I need to put together a more detailed plan for the week for introducing new staff to hospice, hospice philosophy and hospice guidelines as required by medicare.
When I finish creating this program, I will share it with my listeners/readers and make it available in my ”tool download” section of the website.
Here are my main points from today’s show.
4 visits per day is perfect when orienting new nurses to hospice
Every day should end with all work complete and nothing left for the next day
The more questions we ask our patients/caregivers the more likely they are to discover the answers on their own.
Not everyone learns the way I learn. I need to adjust some of my trainings to be sure to incorporate multiple styles of learning.
Hospice is a heart job
As promised, you can find an updated menu item above that will take you to available tool downloads. Be sure to watch this menu over the next week as I will be adding a Hospice Test to the menu for download to use when helping new hospice staff learn the regulations.
Don’t forget to call, text or email to leave feedback! I would love to hear from you!
