In this episode I make some announcements on future plans for the show.

==============================
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==============================
Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

In this episode my good friend, Mike Barrett, returns to the show to share his own story of losing his mother in the last month.

Mike shares with us why he wanted to share this with us so soon after his mother’s death. 

He also goes into detail on how overwhelming everything was. He explains how hard it must be for our patients and their caregivers who have no medical knowledge yet are still expected to make sure difficult decisions.

Finally, at the end of the show, mike shares with us how is faith has paid an important role in his ability to accept the outcome of his mom’s journey.

I hope you will take the time to listen and be encouraged by Mike’s story!

==============================
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==============================
Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

For this episode I decided to share a recent interview I did for the Nurse Keith podcast.

It was a great time to share with Keith’s audience some of my observations from the world of hospice. I believe this was a great opportunity to share hospice with a whole new audience.

Take a minute to visit Keith’s web site, and throw some support his way!

https://nursekeith.com/

==============================
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==============================
Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

In this episode I answer a listener email question regarding death visits.

No two death visits are alike, so in this episode I try to cover some of the basics. 

I cover some of the following topics.

1. Call the funeral home as quickly as possible
2. It’s not about you
3. Don’t always be in a hurry to interject yourself
4. Be sensitive to other cultures
5. To stay or not to stay
6. Post mortem care
7. Clothig

Then I finish the episode telling several stories from my own experiences and some of the things I did well, and some of the things I didn’t do so well.

==============================
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In this episode I answer the following question from a listener.

Hi, any chance of getting a podcast on Service Failures?  I've been in hospice for around two years.  I hear the term thrown around, but can't quite grasp all the details.  I don't see any podcasts or blog posts around this subject, but I suspect the knowledge would be quite valuable.

Thanks,

Jade

I answer Jade’s question in two parts. I start by addressing Medicare’s Conditions of Participation for all hospice providers. For the second half I address service failures in general and how they relate to each hospice provider’s philosophy of care.

The Medicare COPs I review are the following.

1. Election of hospice benefit
2. The IDG/IDT
3. Admissions
4. Discharge Types
5. Face-to-face requirements
6. Individualized care plans
7. 24 Hour Nursing Services
8. The 4 Levels of Care

For agency philosophy we review the following areas that could result in service failures.

1. Visit frequencies
2. Medication Refills
3. Supplies
4. Calling 911
5. Patient dies in discomfort
6. On-Call
7. Anything that the patient perceives as a failure

I also promise to provide the NHPCO overview of the Medicare Conditions of Participation. You can download the COPs HERE.

==============================
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Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

In this episode I focus on the top 6 concepts I believe are essential to promoting the growth of a hospice office.

Ultimately, the administrator is responsible for creating an environment for success. Any administrator who wants to blame others for lack of success, is an administrator nobody wants to follow.

Here is the list of items I focus on during this episode.

1. Foster healthy relationships between sales and clinical
2. Take ownership of the branch
3. Create a consistent and repeatable experience
4. Love your team
5. Develop your clinical director
6. Be visible

These items are what I find to be the most powerful for creating a successful environment. Still, there are other ways to grow a branch.

This episode is about the administrator taking responsibility for the success of their branch. It starts and ends with the administrator.

==============================
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==============================
Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

In this episode I review my strategies when I have family members who are afraid to tell their loved one that hospice is being consulted for care.

I spend some time helping you understand the real difference between patients who can understand what they are being signed up for versus patients who are confused and can’t understand the decisions being made for them.

I talk about using my Clinical Data Sheet during conversation and assessment to gather information and ask questions.

I offer access to my show outline for easy reference. You can download the PDF version by clicking HERE.

I also spend some time explaining how to adjust your conversation to find out what kind of experience (if any) your patient or caregivers have with hospice.

==============================
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==============================
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Welcome to 2024!

For today’s episode I decided to present you with 3 things I feel like every hospice nurse needs to find success and peace of mind!

In this episode I review the importance of making sure we pull into our driveways at the end of the day with all of our work completed.

I point out the importance of making sure all of our charting is done at the bedside. I review some of the differences between a visit nurse and case manager.

My second point focuses on the importance of establishing a work-life balance. I discuss some boundaries with our patients that are important.

I spend a few minutes explaining the importance of involving the entire team which includes the chaplain and social worker.

At the end I encourage all of you to stay the course and remain hospice nurses with the goal of establishing healthy habits.

==============================
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==============================
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This episode is all about leadership.

Everyone in hospice is a leader, and being a leader is completely different than being a boss. 

In this episode I provide some practical advice to help make sure we never lose our perspective on what our nurses go through every day. I encourage administrators and clinical directors to do ride alongs with a field nurse at least twice a year. 

I spend quite a bit of time talking about avoiding spending a lot of time trying to place blame for agency failures. In a very strange turn of events, I spend time talking about the dangers of gaslighting when trying to always place blame when mistakes happen.

 At the end of the show I recommend the following books to help us all grow as leaders.

Leaders Eat Last - Simon Sinek

The Speed of Trust - Stephen Covey

It’s your Ship - Michael Abroshoff

Developing the leader within you - John Maxwell

Developing the leaders around you - John Maxwell

Becoming a person of influence - John Maxwell

The 21 Irrefutable laws of leadership - John Maxwell

The 8 paradoxes of great leadership - Tim Elmore

In a pit with a lion on a snowy day - Mark Batterson

==============================
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==============================
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In this episode I perform (if you want to call it that) dramatic readings of 11 posts from my blog.

You can view and read the blog posts from the following links.

The Last Bath

The Last Prayer

Hospice Is Like Haircuts?

Be Like Aunt Joyce

My Friends Keep Dying

A Night at the Park

The Last Kiss

The Guardian

I Remember Angie

Whatever You Say, James

It’s Okay To Die On Thanksgiving

==============================
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==============================
Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

For this episode I take one of my coaching sessions from inside The Hospice Nursing Community and bring it to the show.

This is something I have ever done before. In general, I like to make sure content inside of The Hospice Nursing Community is unique and cannot be found anywhere else.

In this episode, I review 8 different characteristics that I believe are essential for a successful case manager to possess.

1. Reliability
   The agency and its patients will suffer if they have a case manager who calls in all the time and is generally unreliable.
2. Orgainized
   A case manager must be organized to be successful.
3. Integrity
   A case manager needs to be a person of their word. They need to be where they say that will be and do what they say they will do.
4. Humility
   An arrogant case manager has no place in hospice. At its care, Hospice care is serving others. Arrogant nurses struggle with serving others.
5. Honesty
   Hospice comes with a lot of autonomy. It is easily for hospice staff in general to sneak around and get caught up in personal activities when they should be working. 
6. Ownership
   A good case manager takes ownership of their caseload. They don’t wait around for someone else to fix the problems. they are proactive. 
7. Present
   A case manager avoids distractions during patient visits. They also chart at the bedside.
8. Be a Finisher
   A case manager must make sure they walk in the front door of their home with the day’s work completed, because home is our first job.

Every one of these character traits are essential for case management succsss.

==============================
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==============================
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In this episode I answer the following question from May. May has been charged with a hospice startup.

“I always strive to maintain the values of empathy and fairness, and I am committed to being an unwavering advocate for our team and our patients. Currently, we've encountered challenges with documentation using Matrix Care. The process has proven to be time-consuming, and I am reaching out to see if you have insight on how to optimize the documentation procedures. I would greatly appreciate any pointers or guidance you can provide.”

I take the long road to answer May’s question by sharing what I would want to focus on if I were in her position.

I cover the following concepts.

1. Ask yourself “does it scale,” with every new idea or solution.
2. The importance of creating culture
3. Team first. Patients second.
4. Build and maintain a robust orientation program
5. Deep dive your EMR
6. Be a brave leader

During the episode I share that I am currently building what I call “Tip Sheets” for Kantime; the EMR my company uses.

I explain that I will be offering my Kantime Tip Sheets as a product from The Hospice Nursing Community. Please reach out to me via email at james@confessionsofahospicenurse.net or phone at 816-834-9191 to be put on the waiting list. 

During the show I offer May a free membership at The Hospice Nursing Community with access to my Tip Sheets template as well as all my orientation materials to help her get started with this new endeavor.

==============================
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==============================
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In this episode I talk about the importance of asking good questions that help our patients and caregivers move forward in their acceptance of an end of life experience.

The questions in this episode are the following…

1. Is what I’m seeing something new?
2. What does the word “hospice” mean to you?
3. What do you hope these appointments will do for you?
4. What do you plan to do when she stops feeding herself?
5. Does he/she seem comfortable to you?
6. What does comfortable look like for you?
7. How can I best help you today?

At the end of the episode I do a little experiment with awkward silence. Ultimately, I explain that we tend to talk too much and listen too little.

==============================
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==============================
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In this episode I step aside from clinical talk, and revisit a phone call I had with listener Chauncey.

Last week I had a great conversation with Chauncey. We discussed the challenges a new marketer can face when working a territory for the first time.

In this episode I discuss the difference between referral sources that provide a lot of referrals versus the ones that only provide a few or have never provided a referral. I call these crock pot referral sources and microwave referral sources.

During the episode I discuss the importance of creating a consistent and repeatable process that will help referral sources build a certain level of expectation.

I talk about developing a balance between selling hospice philosophy and hospice services.

Towards the end I explain that all of hospice is really about trust and relationship. These two things are the foundation for which every hospice should be built upon.

==============================
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==============================
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In this episode I answer the following question sent to me by Pamela.

“Any interest in a show that highlights weekend/evening staff. The challenge I face is communication. If staff do not add thorough notes, email/call me, or otherwise give report, It really makes my job a struggle! Also, remembering we are part of team. I am blessed with a great team, but can see where this position could be undervalued. I personally love being weekend on call! It is like semi retirement. Feel free to reach out if this is of interest”

I also (politely) admonish the Monday - Friday staff on the importance of making sure we complete our charting timely so our on-call staff feel appreciated.

I review some strategies I have used at several companies to help improve communication between the day shift and on-call staff.

I talk about the end of day (EOD) email that goes out Monday - Friday where I work as well as the Stand Down call we do every Friday before the weekend staff takes the stage.

You can download a template of the EOD email from my website downloads HERE.

I finish the episode by spending some time empowering on-call nurses to believe in their ability to provide great hospice care in the absence of completed charting and medication lists.

==============================
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==============================
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In this episode I answer a question from Gina.

In a recent email from Gina, she asks the following question.

“One topic I would love for you to cover is that of high case loads - and what you consider that number to be, what number is considered ideal for excellent, superior care and how to manage/re-work your visit frequencies when those loads are high.”

 During this episode I do cover what I consider to be a normal caseload. I explain that our caseload should really be measured by how many visits we make during a week when our goal is to see most of them at least twice per week.

I explain that years of experience does play a large role in determining how many patients someone can manage at once.

I review how case management changes when the majority of our patients are in LTC facilities.

At the beginning of the episode I put out a challenge to those of us who are in leadership to make very attempt to stay connected to our field staff.

==============================
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==============================
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In this episode I review the 3 large projects I completed in my first 4 months as administrator.

I share the challenges most agencies face when it comes to tracking room and board charges for LTC patients.

I review the extensive orientation program I implemented to make sure all new staff get a solid and predictable onboarding experience.

The third project I completed was a revamp of our referral and admission process that ended in a 90 minute training session with the entire organization.

During the show I mention the series I wrote on what to expect from your hospice nurse.

You can review the series HERE. 

==============================
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==============================
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In this episode I welcome back Shelley Henry from Amity Group to discuss the “Your Opinion Matters” hospice nurse survey she conducted last winter.

During the episode Shelley shares with us the 3 biggest takeaways she got from doing the survey.

1. Redundant Documentation
2. Nurse-to-patient Ratios
3. Compensation

Shelly shares some of her discoveries surrounding redundant documentation that adds almost an entire day to the week.

Shelly also shares with us her tour schedule for October 2023 that covers the national hospice conference in Little Rock, Arkansas as well as trips to Alabama and Boston.

Please be sure to follow Shelley on all her social media platforms. She uses the handle, “For Hospice Nurses,” for all her social media work.

Facebook
Instagram
LinkedIn
TikTok

The Hospice Nurse Your Opinion Matters Survey will return this fall starting in October. Be sure to check it out and share it with your hospice nurse friends!

Click here to take the hospice nurse “Your Opinion Matters” survey starting October 1st 2023!

==============================
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==============================
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In this episode I explore the frequent, maybe even normal, conflict that can arise between sales and clinical.

I review what I believe the clinical team needs to do to be more accommodating and show the sales team we are serious about growth.

I also review some things that the sales team can do to help lessen some of the stress they can inadvertently place on the clinical team.

I review the fact that our patients can, at times, misrepresent what the sales team has said or promised to them. The same thing can happen when our patients or referral sources misrepresent what the clinical team has said or done.

In the end we are all a team, and we are all on the same side.

==============================
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In this episode I review some of the challenges we can face when caring for patients with a long history of substance abuse.

During the show I review the psychosocial reasons we will find ways to not admit people who need hospice.

I also discuss how we can easily complicate the qualifications for hospice when we interject our own feelings and fears into the situation.

At the end of the show I share the story of a heart failure patient with special needs, and how we adjusted our plan of care to make sure this patient got the care he needed.

==============================
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==============================
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This is part 2 of my conversation with Kris from The Hospice Nursing Support Group on Facebook.

During part 2 if this conversation I ask Kris the following questions.

1. How does IDT work at the hospice house?
2. Do all hospice house patients die?
3. How do you describe the hospice house to your admissions?
4. What are the pros and cons of being an inpatient hospice nurse?

==============================
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Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

In this episode I welcome back Kris from The Hospice Nursing Support Group on Facebook.

This episode will be the first as we discuss the 4 levels of care that Medicare requires all hospice organizations provide.

During the episode I explain that my conversation with Kris will be broken into two shows due to the amount of content we covered.

For this portion of the show, we cover the following questions.

1. All the different names that are used for Inpatient Hospice Care.
2. Where can Inpatient Hospice Care occur?
3. How did Kris became a hospice house nurse?
4. What is the purpose of the hospice house?
5. What is the typical week like in a hospice house?
6. What are the typical routs of medication administration at the hospice house?

Part 2 of the conversation will occur in episode Thirty-Four of the show!

==============================
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==============================
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In this episode I explore the realization that, if we are honest, we all have feelings of insecurity and inadequacy.

Imposter syndrome is something that we all will face at times in our lives. We will especially face imposter syndrome when we are adventurous and are willing to take on new challenges.

In this episode I review many of the different ways we can experience imposter syndrome and why we might experience it.

I mention a recent article where I explain why hospice nurses are not trying to kill their patients. You can access that article HERE.

I also review a strategy on how to avoid imposter syndrome. Do you want a hint? You can’t avoid imposter syndrome if you are going to engage life!

At the beginning of the show I thank Shelley Henry with The Amity Group. During one of her tips for hospice nurses this week she gave The Hospice Nursing Community a shoutout!

You can follow Shelley Henry on Instagram and TikTok for more help!

==============================
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==============================
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Welcome to part 2 of the top 10 things I have learned in my first 10 years as a hospice provider!

In this episode I cover items 6-10 of my list.

6. Work/life balance doesn’t happen by accident

7. Hospice is about repeatable and predictable behavior in every department

8. Haloperidol is the best first option to treat terminal restlessness

9. Staff centric agencies build the best foundation for success

10. Hospice is 80% psychosocial….for everyone

In this episode I encourage everyone to check out 3 different episodes of the show.

Episode 15 at https://www.confessionsofahospicenurse.net/episode-fifteen-success-in-the-alf/

Episode 16 at https://www.confessionsofahospicenurse.net/episode-sixteen-the-last-7-days/

Episode 17 at https://www.confessionsofahospicenurse.net/episode-seventeen-the-ltc-facility/

I also reference an interview with Mark Randolph. One of the men who started Netflix.

https://youtu.be/HSVbD7RhOHU?si=THv7ehzCNj-4iApa

==============================
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In this episode I welcome veteran hospice nurse, Michelle Ery.

During the show, Michelle shares with us how she obsessed over her patients to the point that she started using substances to manage the anxiety and obsession.

Michelle shares with us what happened to her on Memorial Day of 2020, and how this event was the catalyst that ended up changing her life forever.

Michelle covers her experience in a thirty-day addiction treatment center. She shares with us how this experience effected her nursing license. She also details how her place of employment handled everything that happened.

At the end of the episode, Michelle encourages any listeners who feel like they are struggling with addiction to contact her via her personal facebook page.

Facebook: https://www.facebook.com/MrsEryRN

During the show I also noted that I would provide a link to AA for anyone considering getting help.

Alcoholics Anonymous

I also encourage anyone who feels inspired by Machelle’s story to call the listener feedback line and leave her a personal voicemail.

==============================
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==============================
Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

In this episode I return to reviewing my series on Avoiding Hospice Burnout.

I cover several issues that I have observed causing major burnout for hospice nurses.

1. Are you waiting for hospice to get easier?
2. Are you unwilling to work an 8 hour day?
3. Do you struggle with autonomy?
4. Are you unwilling to turn off your work phone after hours?
5. Are you unwilling to learn to chart at the bedside?
6. Do you have to always be right?
7. Do you have to fix every problem?
8. Is it you or your agency causing you to consider leaving hospice?

During this episode I don’t pull any punches. The issues above are what I have seen be the leading cause of burnout for hospice nurses. If we are unable to master the list above, this work may not be what we should be doing.

I don’t want anyone listening to this episode to quit being a hospice nurse. Still, this work is not for everyone. It’s okay to realize that hospice is not for you.

At the end of this episode I spend some time discussing The Hospice Nursing Community. This community has a private group dedicated to hospice leadership.

In the last week I have taken a hospice administrator position here in the Kansas City area. I will be sharing some of my experiences in the private group for hospice leadership.

I also share that I have made a change to the pricing structure. The monthly subscription is now $19.99 and there is also an option to pay $199.00 for a lifetime membership that does not expire.

==============================
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==============================
Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

I’m back behind the microphone as I return from a month-long break from the show.

In this episode I take on the challenge of discussing hospice leadership. 

I review some of my own challenges in my leadership experience. I also spend some time discussing the last 7 months I have spent in the field, and how much stress and emotion is involved.

I also mention that I would share some of my favorite leadership books here in the show notes.

Leaders Eat Last

It’s Your Ship

Developing the Leader Within You

Developing the Leaders Around You

The 21 Irrefutable Laws of Leadership

The Eight Paradoxes of Great Leadership (highly recommend)

I discuss some of the behaviors by hospice leadership that I think can be very toxic. I also share my thoughts on how leadership should handle staff members who are struggling.

Ultimately, I believe that the success of any hospice agency should be attributed to the field staff. Failures by the agency should first be examined by leadership to make sure the problem isn’t process related.

==============================
As always, don’t forget to call, text or email to leave feedback! I would love to hear from you!

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==============================
Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

In episode Twenty-Eight Chanel King returns to continue our discussion from episode Twenty-Seven.

In this episode we discuss Psychological first aide. Chanel reviews some of Maslow’s hierarchy of needs and integrates them so well into our understanding of the challenges we face when caring for the dying.

We spend the majority of this episode discussing boundaries and the good and bad that come from crossing those boundaries.

Chanel drops a real truth bomb on us when she says, “We are more alike than different.” In a world where media tries to convince us that we are actually more different, Chanel’s perspective is a breath of fresh air.

Towards the end, Chanel shares with us the concept of a Recovery Strategy Care Plan which can be referenced as the anacronym, RSCP or “Recipe.”

You can download the RSCP by clicking HERE. Scroll down till you find the orange flower and click it. Right below the flower you can actually schedule a free 30 minute session with Instructor king to help you create your care plan. I recommend you take advantage of this right away. I don’t think Instructor King will have this kind of availability in the future. She’s a big deal!

I also remind everyone to be sure and get a google voice number if you have to use your personal cell phone. You can learn more by watching this YouTube video HERE.

I also mention a new blog series I’m writing called, “What to expect from your hospice nurse.” You can access the series landing page HERE.

In this episode I also mention that I will be taking the next month of. I need to engage in some self care as well. I can’t preach boundaries if I don’t exercise some for myself!

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As always, don’t forget to call, text or email to leave feedback! I would love to hear from you!

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==============================
Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

In this episode I introduce Chanel King to The Hospice Nursing Podcast!

Chanel King (Instructor King) is a Peer Support Specialist for medical professionals.

In her introduction, Chanel shares with us some of her own traumatic experiences and how the last couple years have transformed her life and led her on a journey to providing emotional support to thousands of medical professionals.

In this episode Instructor King answers a voice mail left by Erin who asked how we can handle grief for our dying patients. Chanel also reviews what compassion fatigue might look like.

During the episode, Chanel reminds us all of the “Faith and Work” audio series I shared during one of my earlier episodes. You can find that series by clicking HERE.

Chanel also shares with us a concept called a Safety Plan. We can use this plan to help us recognize when we are struggling emotionally and need to re-center ourselves. Chanel and I are working on a plan for me right now. It has been an amazing experience! I can’t wait for it to be completed!

This safety plan can be downloaded from the landing page on her website located at http://ThisIsBase.mn.co. Scroll down and click the big sunflower to access the safety plan.

While you are there, please consider singing up for your free membership. Instructor King provides a lot of free content including live streaming sessions covering many topics. You’ll be glad you did!

Stay tuned for Episode Twenty-Eight as Instructor King will be joining us again to continue this conversation!

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As always, don’t forget to call, text or email to leave feedback! I would love to hear from you!

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==============================
Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

In this episode I reimagine Part 8 of Avoiding Hospice Burnout for nurses.

I discuss the following concepts that will help create a healthy environment for staff and co-workers.

1. Listen-Validate-Communicate

2. Assume positive intent

3. The Speed of Trust (Get the book)

4. Getting burned

5. Gossip

6. Being authentic

At the end of the episode I take a few minutes to address leadership. It is my belief that leadership holds the greatest power over the culture of the office.

A good leader will take personal accountability for how staff treats each other. I believe that organizational staff will emulate their leaders both consciously and subconsciously.

==============================
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Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

In this episode I review the last year and which episodes were the most popular. I discuss what those episode tell us about this community and what it means for the coming months..

The top 6 episodes from this last year are as follows.

Episode 16 “The Last 7 Days.”
Episode 10 “On call strategies with Tania.”
Episode 3 “For the record.”
Episode 6 “Plan your work. Work your plan.”
Episode 11 “Orientation strategies part 1.”
Episode 15 “Success in the ALF.”

In this episode I discuss one of my most recent blog posts where I journal the last seven days for one of my patients.

Click HERE to read, “The Last Bath.”

I also discuss solutions that include my PRIVATE community, this show, and something even more powerful….personal accountability.

I review some of the private group services available at The Hospice Nursing Community. Specifically, I discuss the private groups only for hospice leadership.

In closing I discuss the importance of changing habits to achieve more success. I also encourage everyone to find ways to avoid burnout and have more work satisfaction. I encourage a review of my “Avoiding Hospice Burnout Series” I wrote in 2021.

Happy New Year from The Hospice Nursing Podcast!

==============================
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In this episode I discuss my communication strategy when communicating with patients, families and facility staff.

Instead of trying to discuss specific scenarios, I review my overall 6 strategies I use to communicate effectively.

I don’t describe these strategies as the umbrella I function under. They are more like a roof. A roof is complicated. There isn’t just one item that provides the cover we need for our home. There are 2x4 and 2x4 wooden supports. There is also plywood sheeting that needs to be applied before the shingles can be attached.

The six roofing supports are as follows.

1. Be Non-Confrontational 
2. Listen, Validate then Communicate
3. There is nothing wrong with a quiet room
4. Let people be wrong if it helps them feel better
5. Stop feeling pressure to know all the answers
6. Be like a four-year-old kid

Please don’t forget to complete the “Your Opinion Matters” survey being conducted by Shelley Henry.

==============================
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==============================
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In this episode I interview Shelley Henry with Amity Staffing.

Shelley shares her 20 year experience in hospice and how it lead her to starting Amity Staffing.

She shares with us some of her strategies on bringing awareness to the challenges hospice nurses are facing in the field.

We discuss some of the details of her “Your Opinion Matters” survey for hospice nurses.

Shelley shares with us her social media journey, and how she is trying to help hospice nurses in her own unique way.

I highly recommend you follow her. Please use these links to follow Shelly on your social media outlet of choice.

Facebook
Tiktok
Instagram
linkedIn
Amity Staffing Contact Page

Be sure to take a few minutes right now and complete the SURVEY!

We spend a few minutes at the end allowing Shelley to share some of her hospice insights with us.

At the end of the episode I provide a few updates for The Hospice Nursing Community.

This Friday, December 8th, the website will take on a whole new look. I am rolling out a $10.00/month plan that will give you access to 90% of what is happening inside.

This includes my personal journaling of many of the hospice cases I am managing right now. My focus is to give my members an inside look on how I manage my patients in the last 7 days of life, and how I communicate effectively.

==============================
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==============================
Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

Ten weeks ago I left my role in leadership and went back to case management.

In this episode I review some things that I have had to learn as well as some things that have been reinforced.

I also discuss my assignment to a hospice friendly facility, and the strategy I used to gain favor with the staff.

I discuss the importance of communication, and I also discuss some of my own struggles to adjust from leadership to full-time case management.

I review how to be a leader from a case manager position, and I discuss some psychosocial strategies I utilize when case managing.

At the end of the episode I discuss some major changes coming to Hospice Nurse Training including a name change and tiered pricing for members.

==============================
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Welcome to episode 57 of The Hospice Nursing Podcast!

In this episode I start with the top 5 things I have learned in my 10 years of hospice experience.

1. Case management is the foundation of all hospice care
2. Case management success is in the details
3. There is not just one way to do hospice
4. Model the behavior you want to see in others
5. Your current company isn’t as bad as it seems, and the company you want to move to isn’t as great as it seams.

While covering these ideas, I make sure to point out that nobody is doomed to failure just because they don’t’ have case management experience.

I also explain that keeping a patient on hospice care is more dependent on the details than it is on the big picture.

I share my thoughts on leadership, and I explain that leaders can’t expect their staff to behave in a way that isn’t modeled for them.

At the end of this episode I explain that all hospice providers have their flaws, and we shouldn’t expect our next employer to be perfect.

==============================
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In this episode I go into depth on best practices for the admission process.

I cover the following points in depth.

First impressions
Time Management
Admission in-home schedule
Importance of calming presence 
Review of services
Records review
Consents

Click HERE to download the clinical data sheet and watch an instructional video.

I provide some additional updates on Hospice Nurse Training community and all the extra content available for members.

==============================
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In this episode I pick back up on my ”Avoiding Hospice Burnout” blog series with part 7.

Check out the whole series by clicking HERE!

For this episode I review the fallout I received after posting the following visit schedule.

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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.

Click HERE to view 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!

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==============================
Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like 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.

==============================
As always, don’t forget to call, text or email to leave feedback! I would love to hear from you!

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==============================
Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

In this episode I announce the creation of a special website I have launched for my listeners.

Hospice Nurse Training!

At the end of the episode I give away 5 free memberships to this new community. Listen to the episode to get the instructions!

In this community you will be able to count on the following deliverables.

1. Live Q&A following each episode (2nd and 4th Monday Night)
2. Monthly recertification round table (zoom call to help you)
3. Monthly work shops - First one opioid titration with deliverables 
4. Camaraderie with like-minded hospice nurses
5. Private groups for each specialty (on-call, RNCM, Administrator, PRN)
6. Weekly disease process discussion groups
7. Weekly prayer live streaming
8. Daily hope, help and encouragement (keeping negativity at a minimum)
9. Less than a dollar a day (2 week Free trial with launch party and give always on October 1st)

==============================
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==============================
Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

In Episode Seventeen Brian returns to discuss strategies for success in long term care facilities.

We answer several great questions from The Hospice Nurse Support Group on Facebook.

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.

==============================
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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.

Towards the end I discuss the opioid conversion chart I created. I have added a download to the ”download tools” area of the website. I also created a video explaining how to use the conversion chart.

==============================
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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.

==============================
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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.

1. Some visits are just long
2. See everyone twice a week
3. Understanding the two types of nursing visits
4. Be the calm in every situation
5. Avoid power struggles
6. No triangles
7. Don’t invent problems
8. Know your patients
9. Chart at the bedside to end the visit

I also share the following visit schedule I performed right after I 

================================================

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 

================================================

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.

==============================
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Welcome to part 3 of my orientation strategies!

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.

==============================
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y 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.

1. 4 visits per day is perfect when orienting new nurses to hospice
2. Every day should end with all work complete and nothing left for the next day
3. The more questions we ask our patients/caregivers the more likely they are to discover the answers on their own.
4. Not everyone learns the way I learn. I need to adjust some of my trainings to be sure to incorporate multiple styles of learning.
5. Hospice is a heart job

As promised, you can find an updated menu at http://confessionsofahospicenurse.net that will take you to available downloads from my sight. 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. 

==============================
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==============================
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I’m back from a 6 month break from producing the show!

In this episode I explain why I chose not to record any episodes in the last 6 months. I then review some of the things I learned during a massive growth spurt at my agency.

I review the importance of self care, and I share some of my own personal health issues this year.

I share what I learned about the importance of an orientation program. 

I explain the importance of hospice leadership being willing to get out into the field and help during times of crisis.

Finally, at the end of the show, I explain that everyone has physical and mental limitations and how I am no exception.

==============================
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In this episode I start a series explaining my strategies for orientating new nurses.

I read an email from listener Holly and how I got my inspiration for this series from her. I also read an email from Kelly that I received the day before recording this episode and how it ties in quite nicely.

Here are a few of my main points.

1. While in orientation the new nurse should aways ride with everyone. No following in his/her own car.
2. Set the standard from day one that hospice is an 8-5 job.
3. Be strategic about the very first visit the new nurse will be a part of and explain why you chose this for the first visit.
4. The most important tools you have are Influence and Trust.
5. People never forget how you make them feel.

Don’t forget to call, text or email to leave feedback! I would love to hear from you!

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==============================
As always, don’t forget to call, text or email to leave feedback! I would love to hear from you!

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==============================
Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!

In this episode I have the distinct pleasure of interviewing Tania. She has over a decade of weekend on-call experience. This interview is filled to the brim with practical advice for success with your on-call visits.

Tania shares with us how she ended up becoming a hospice on-call nurse and how it works for her family.

We address the 7 following subjects:

1. Establish why you are making the visit with the family
2. Identify the type of visit (Only 3 real categories)
3. Car Stock Ideas
4. Documentation
5. How to separate family from work on the weekends
6. How to handle challenging environments
7. Tania’s favorite resource for families

My two favorite quotes from the interview.

”Sometimes, you end up where you need to be,” and ”No visit is ever wasted.”

My favorite part of this interview was the very end. Tania shares with us how she uses Barbara Karnes’ Blue Book for her families when she visits. This is the most powerful and intentional use of this book I have ever seen. I plan to implement this strategy starting this very week!

==============================
As always, don’t forget to call, text or email to leave feedback! I would love to hear from you!

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==============================
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In this episode I share why it has been exactly one month since I published my last episode. I also explain why it might be a few more weeks before my next episode.

Most of this episode was shared without extensive notes and just an outline. The outline was 3 simple points.

1. Turn off your phone
2. Don’t have favorites
3. it’s not about you (or me)

I recommend 2 books with one of the books also available as an audio message by Andy Stanley.

Choosing To Cheat - Renamed ”When work and family collide”

Choosing to Cheat Audio Message

I also highly recommend ”Boundaries” by Henry Cloud and John Townsend.

As always I highly encourage you to check out my ”Avoiding Hospice Burnout Series” page for all my articles related to hospice nursing burnout.

As promised here is the youtube video I played during the show.

https://youtu.be/RGTfEfVcMqA

==============================
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During this episode I read a portion of an email I received from a listener when I asked her if she had any questions I could build a show around. In that email she asks me what my sacred activity is.

After much thought, I have decided to share my sacred activity during this episode.

The truth is that I am completely incapable of doing this complex and emotional work under my own power. This work can be overwhelming to the mind and soul at times. In this episode I explain how my faith and spiritual practices help me provide the kind of medical care and emotional support my patients and their caregivers deserve.

I also promise to upload a sermon series that really helped me balance my faith with my work habits. That series can be accessed HERE. I have also added it as a menu item on my website.

I explain in detail the following 6 concepts I try to employ every day to the the best I can be.

1. Repetition is a mode of learning.
2. I try to remain in constant contact with my own brokenness.
3. I try to always see what someone can become instead of what they currently are.
4. I remind myself daily that all persons have eternal value and existence.
5. I remember that I can leave all my fears and concerns at my place of worship.
6. I can’t always control outcomes, and I will never survive this work if I try.

I also share the two following quotes by C.S. Lewis that can be viewed from the website version of my show notes. 

https://www.confessionsofahospicenurse.net/?p=588

==============================
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James@confessionsofahospicenurse.net
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