New CNA Hospice experiences

Hi,
I've been working for Tidewell Hospice for over a year here in Florida. I am currently a CNA. I really like my job, but I must also say it's not for everyone. The question you should ask yourself is, have you had any experience with someone dying close to you that you cared for? How are you dealing with death in general? The work you will be doing is very special and very rewarding, but it's also the most critical time in life for a family and patient. It is our job to do anything we can to help the patient and the family get through this tough time.If you have any questions....write me.

wish you all the best.

Hi Anna,

I used to be a RN in Germany and worked on a unit with many cancer patients,but never worked in hospice before. I applied straight after I became a CNA to hospice, because they just had the best all around package on what I wanted.
Of course there are gonna be times that are very hard when one of your patients dies, but usually the team you work with is very supportive and share the same feelings you have. We have good meetings as a team where we can talk about our feelings and how to deal with them.

Beate

I'm still not used to dealing with death. It's a very weird thing to deal with.

Even in a nursing home, everyone eventually dies. Some of them go out to the hospital and never come back, and others are placed on hospice care and die in the facility. When someone in LTC is dying the rest of the residents don't go away... you still have to run around like crazy for them. I find myself getting irritated when this happens- it's like, "really? You rang your call bell to have me get you a freaking cup of ice or crack your window?" when normally I wouldn't think twice about those things.

Before I got my CNA I worked as a full-time caregiver to an old woman who eventually went downhill and died. That was my first experience with death and every time I care for someone on hospice it brings me back to that.

I am a CNA and have worked home hospice for 3 yrs and love it. It is not for everyone. Prior experience I had been a ER Tech years ago-wanted to go back in medical, tried CNA. I have seen many who do not handle it well-including nurses. Since you are new I would recommend that first you get your skills tuned by working in a nursing facility for at least 3-6 months, many places require min 1 yr CNA experience first. If you still decide hospice - get ready for cancer, it is horrible and ostomy bags have to be emtied, some will make you puke. Get ready for rewrapping bandages over wounds, skin tears. Patients are great, you have to be stable and strong-you will have patients who are young and scared . You have to do a lot of documentation, families are sometimes difficult, get violent with eachother and will constantly ask you questions. There are many does and don'ts but you will be trained on it should you work for a facility or company that specializes in hospice. Hospice workers are great supporters of eachother and everyone does what has to be done when it needs to be done, supplies are never short.

Hi Anna,
Just read your post: congratulations! Hospice is so awesome!...I love it, I love it, I love it!
Got a minute? Cup of coffee? (may want to put your feet up?)
In 1999, my dad became very ill, so we had hospice for him, per the Dr.'s recommendation. (What the ?? was hospice? I didn't know! You would be surprised to know there are MANY who haven't a clue! Even one of my dad's doc's called hospice the "Euthanasia specialists." (Can you imagine?)

The hospice nurse (RN) came in for the initial eval. and gave us some papers to look over. My mom is a retired RN, (from back when they had to wash/reuse the surgery sponges! Ha!) but poor mom was too frazzled to help by the time I got there-from out-of-state, and I sure didn't know what to do.
They had some meds sent over via courier (I thought that was a blessing) with instructions on how to admin. them.
They had a CNA who came out M-W-F to assist in bathing -she was there about 14 minutes, did NOT seem to care;was more interested in her fingernails (which were growing/curling back to the fingertips they were so long).
Things weren't going well; after 3 days of calling and not being able
to speak to anyone at the hospice, (RE: his symptoms, pain, etc.-to make a long story short) we did the big no-no and called an ambulance.
He was put on dialysis (prior renal CA, but this time, it was to get the med. out of his system) and what do you know-he was lively, cracking jokes, eating, etc. which he hadn't done for the previous 3 days. He was more comatose than anything.
In retrospect, I believe if they had not reacted as if I was the "poor dtr. who didn't understand her dad was dying," instead of asking the right questions, or sending someone out to eval. the situation, they would have seen he was over-medicated and promptly instructed us in what to do... I know, sometimes it happens, but they didn't care/were overwhelmed and did nothing...that's MY gripe.
Since there were still issues of pain and much discomfort to deal with, we called another hospice and may I say they are not all alike!
Wow!
TALK ABOUT A DIFFERENCE!!!
These guys were so good; these people were genuine; their hearts were in their jobs.
No one involved was perfect-including us, the family. I didn't expect that. I didn't need hand holding (not all the time, anyway!) but certainly I wanted my dad to be as comfy as possible-as well as my mom.
The care they shared w/ us had such a profound effect on me that I have committed myself to working in hospice for the rest of my life.

I can have 4 hours of sleep. Most people, "Oh, crap. I gotta go to work!" I wake up and think, "Oh, yeah, I get to go to work!" (Oh yes-it's that good!)
Hospice is one of those specialties which gives you way more than you could ever give, though you will try.
I have learned how important it is to have someone there that understands what is happening and how to physically, emotionally and sometimes spiritually comfort their loved one, the children/grands, etc. (Even the family pets!)
That's not why I love it-just part of it. One wants to do something that matters in one's life; what could be better than knowing how to comfort a sweet little old lady: Gently placing a cool cloth on her forehead? Providing a fan and keeping the room cool and quiet so she can rest? Holding her hand so she won't be afraid (especially when you are the only one there-no family)? Or knowing on which side she rests better? Making sure she smells clean and sweet and her hair is nice, nails done (if that's important to her), esp. when people come to visit. I could go on and on...

CNA's are the eyes and ears of the nurses who can not be with them as much as we are. I work in continuous care; it's called crisis care in some areas. If you like caring for one person for 8-12 hr. shifts-you will learn SO much! This is for you!
If one pays attention during their time with the patient, you will learn some things that work and some that don't, in the way of assisting someone in being comfortable.
If I had to list a few "biggies" for someone brand new (though you are no longer brand new!), I would put these:

1) If you will humble yourself and learn to be a good servant, that's half the task.
YOUR attitude can mean the difference between your patient having their pain and/or other medicine when they need it, or having to wait and watch while they needlessly suffer. (Oh yes! I've seen nurses who took it out on the patients because of MY attitude!) Not anymore! I will kiss both cheeks, if I must!

2) Read the Plan of Care and follow it. If they want you to bathe them 2 X's, then do so. If they want B/P, hr and temp. q 30 min. and documented, do it. The case manager will usually have her fingers on the pulse of the whole situation, not just the family. There may be a reason for it no one else knows (pending litigation?)-doesn't matter. We work under the supervision of the Nurses. Trust him/her to know what they are doing, yourself to do well and you'll do fine.

3) Make sure you do not, under any circumstance, administer any medication. It has tempted a few cna's in my time; after all, the pt. is sick, you think they need it right away, no one is around...however, it is not the right thing to do. No matter whether you get caught or not-it is wrong. This would be better under the heading of
number 4,

4) "Work and stay within your scope of practice." If you aren't sure, ask. If you have any questions, ask. If you don't understand, ask yet again! Better to be called a big dummy than to do something horrendously wrong/harmful! No one I ever knew was fired for asking the correct way to do something.
If you will stick to this, you will become known among those you work with, and beyond- to be trustworthy. (Just maybe not the brightest, at first!)

5) Do your job, put your heart in it-dare to give a damn! One can always spot the ones who care from the ones who don't. The occasional letter comes in from the family about how much we are appreciated and it does feel good-but WE KNOW when we've done well and when we haven't. Letters are nice, not necessary.
And-
It's okay to cry a little. After all, it's sad to see those left behind to suffer a loved one's death, right?
It's normal. However, don't let yourself go overboard. (Once, there was a caregiver who was sent home because she had carried on so when the pt. died, she scared the family!) It takes the "moment" away from what should be the focus-the one who died.

Check yourself. You are there to do a job and you represent your company. Behave accordingly.
Do not get "overly friendly " with the family/pt. Don't tell them about all the tragedies in your life, or try to "match" their sorrow with a story about something that happened to you.They may seem like they have taken a liking to you, and you to them. They are in a more vulnerable emotional state. Don't exploit that by having them console you! (Very bad form.) One can remain professional and still bond closely in ways which supersede the usual pt. caregiver relationship. I have seen many a shocked expression when the family requests someone ELSE return in their place. It's happened to me-it hurts. (You may think I'm pretty smart? Nope. I just made a lot of mistakes, some worse than others-but I stuck it out because I care.)
You will love it, or you will hate it-so I'm told.
We all have our special little gifts and thank God for all of us that, without one of us, the world would be a more difficult place to live.
If you have read all this-sorry. I tend to write novels in areas I'm most passionate.
Have a wonderful, safe, blessed week.
I am soo thankful this forum is here, and that the moderators are nurses!
Woo Hoo!

Warmest Regards,
jacqueline

Jacqueline,
I am starting a new CNA hospice in-patient job on Tuesday. Thanks for your awesome advice. I truly enjoyed reading your job experiences!

Bridgette

This thread is so helpful! I became a CNA (as of today actually) so that I can work for the hospice that my mom and her friend started a few years ago and to get some patient care experience before nursing school starts this Fall. I start on Monday and I am really nervous. After reading these responses I feel a lot better. I really think that I have a heart for this and that I will be able to do a lot of good. Thanks for the great and detailed responses!! =)