questions about a hospice care agency job

netglow, ASN, RN · Jan 6, 2012

Oh geez. This is complex.

I will warn you about taking HH or Hospice as a NG - Unless you are absolutely sure that the orientation is comprehensive and complete. Very few agencies follow through, and you can like I did quit to save your behind. Lots of lies and tall tales told in HH and Hospice. However, some are true blue. Many hospices and home health agencies are truly only in it for the money - the entire business is a sham. You can usually tell during orientation when all that is taught is the EMR... Those that are true blue usually only take experienced nurses: MS and ONC preferably. Never work for a hospice that does not also have an inpatient unit option. IMHO.

Field: You will go to homes, you will go to facilities too. Hospitals and LTC often don't directly deal in Hospice for many reasons. Hospitals shy away because they want to be known with doing all to keep you living. Some, now do have palliative care floors. This is relatively new, probably because they find they can be reimbursed. Lots of prejudice still exists with hospice, and as a RN you will run into it often depending on where you go and even depending on the MD/RN you are dealing with at the moment. You will find that the majority of MDs and RNs have no idea "how it works" and will ask you. This never ceases to amaze me. I interviewed with a surgeon a couple weeks ago, and he asked me this very question.

There is a lot to understand about the actual job. I recommend you spend time tooling around the Hospice forum of Allnurses. Lots of info there!

Merlyn · Jan 6, 2012

It's all about the money. Back in the days when I started. There was nothing called hospice. people would be treated at home or in Nursing homes this was before things called LTC.

I worked in nursing homes 11-7 shift. where I could sit with a dying patient hold their hands. If they needed spiritual comfort, I could the rosary for the Catholics, Read from the Bible if they were protestant, and recite Kaddish if they were Jewish. I would try and make their passing as easy as possible. Then a couple things happen. No one like the name nursing home, so they became LTCs. Great new machines, you could now do the work of three nurses in only triple the time. The day shift became crazier, so night shift had to do the meds - the new wonder drugs increased jumping the average patients meds from one or two to 6 to 8 pills at one time. The Government stuck its nose where it didn't belong increasing the paper work about 5x. and the poor patients became clients. There went the time that was spent on the dying patient. Enter things called hospice, taking over the stuff, for a price, that I did. Now nurses with Masters degrees had get certified in things call End of life cycle. In short the nurse that works in the average LTC does not have the time. With all of the 'improvements' we that care no longer can care and that is the real tragedy of Nursing.

sandygator, BSN, RN · Jan 9, 2012

I have been a nurse for 37 years. The first 10 as an LPN. Most of my positions have been in the field of pediatrics, mostly ICU in large University Medical centers. I retied complete "burned out" When I wanted to return to work I started with an agency and was sent to a Hospice Care Center. WOW...I knew this was what I wanted to do right away. No more hurting people (or children) for the sake of curing them. Just a very lovely and loving way to help families and patients through one of life's most difficult aspects. Now I could treat symptoms physically (Pain, N/V) and address spiritual, social, and psychological needs at the same time. Hospice is about LIVING every minute you have left. Living in peace and comfort. Resolving issues, facing obstacles, making amends...so many things! Perhaps "upstairs" it's about the money, but at the bedside, it can be tremendously beautiful and rewarding. I thank God for this last calling for me. :-)

As a new grad, I was called for an interview at a hospice care agency. I was told it is both an office position and a field position. As an LPN working in the local office, I may need to take orders. I may also be sent out to local hospitals or nursing homes to visit hospice pts. This job seems different from traditional LTC or hospital setting. just wondering anyone worked at similar jobs could give me some insights about what you do, what are the challenges, etc.
I am also confused why hospitals or LTC need to have a contract with hospice agencies since they have RN, LPN on staff 24 hours a day. and do these kind of agency jobs require one or more years experiences?