Not doing what I was hired for

monkeybug · Sep 14, 2012

Another vent again. I was hired as a hospice nurse into my company 5 months ago. I was told there would be " a little bit of palliative care". Well, its only me the supervisor and the director in the hospice division of our HH company because they can't keep. Uses ( one left after me being there for 3 weeks) and that can't find anyone. So I am stuck with all of the palliative care. I hate palliative care. I do hospice revisits, but my intention was to be a hospice nurse, as I was told, not the person to just pick up the crap no one else wants to do. Almost 6 mo ths and I haven't done a hospice admission or pronounced. My supervisor knowingly dumps the most awful patients on me that she opens up and announces " I hate this patient, you go see it". I am the dump job nurse, left busting my butt to see the patients no one else wants to see, not even what I was hired for. And my supervisor said " get ready, the palliatives are picking up and they are all yours"So, tomorrow is a progress meeting with the supervisor, director and educator. I have mentioned my desire to really the lean the hospice that I desire to do, they say " yes, we'll start doing it, and they never do. I want to say something again. I am at wits end at this Job, sick of working my butt off and charting all the time on my own time. My happiest times in this last few months I have worked here was in the last 3 weeks where I had 10 days off for a lap chole! It's the only time I have felt free and destresser. Not worrying about having to wake up at the crack of dawn to do paperwork or going to roach infested homes of dirty people who can't take care of themselves and no one else wants to see. My tolerance is gone. I feel like I'm gong to say everything I mean tomorrow and it won't be good.I'm a former icu nurse. Loved it there and had to leave because I couldn't do shift work with my family situation. It's been aMost 2 years since I've been gone and I'm friendly everyone there and they say all I have to do is ask if I want to come back. It's a great system. I wish I could figure out a way to do it. With all that ranting I lost sight of the question. Should I speak up tomorrow? I chose hospic for a reason. I did not want to be a palliative care nurse. I don't mind doing it when needed, I'm a team player, but I want to do what I was hired to do and have a passion for.

I think everyone is being a bit hard on the OP. It's hard to have a good attitude when you are blatantly being dumped on ("I hate this patient, you go see it" is what your supervisor said, she didn't say she hated the patient.). If you are hired with something in mind, and then you are being asked to do things that you hadn't planned on just because someone with a bit of power "hates" the patients, you probably will have a bad attitude about it. Everyone is picking out her statement about not pronouncing, but she also mentioned not getting to do admissions, either. I know very little about hospice vs. palliative, but if all the dirty/unpleasant/buggy homes and patients are being saved for you just because your supervisor "hates" them, then it's probably hard to have the best attitude about it. I make home visits, and dirty homes, pets, and difficult patients don't bother me because that's what I signed up for! I knew ahead of time what was expected of me, it was clearly spelled out. I understand that it's not everyone's cup of tea. And if you are told that something is going to be a small part of your job and then it becomes the whole of your job just because it's too unpleasant for your supervisor to do, a positive attitude is probably hard to find. The OP quite possibly cares for her clients very, very well. Just because you are cringing on the inside doesn't mean you can't go in and do a job well with a smile plastered on your face.

I really like allnurses, but there does seem to be a pervasive attitude of superiority. "I would NEVER" do whatever the poster is doing. And it's great that there are so many super nurses here, who are pure in thought and mind and deed, but there are some of us who actually might still be able to do an outstanding job even while we dislike the patient, and cringe at the thought of having to deal with them. She's not falsifying records, saying she's doing the job while she's actually not. She's doing it, and she probably came here thinking she had a safe place to vent, and instead she's being made to feel that, because she doesn't wholeheartedly embrace a situation with the fervor of Mother Theresa that she's doing something wrong. Quite frankly, some assignments in nursing suck. Some patients suck, because there are people in the world who are unpleasant, slovenly, and filthy. Yes, they need help just like everyone else, and they should get it in non-judgmental way. And she quite possibly does that. I doubt she's saying "awful" and "crap" in front of the patients, she's saying that here, where she probably expected some support. Too bad that very little has been forthcoming. I would worry more about the supervisor who is talking about HATING patients than I would the one who's actually buckling down and caring for them.

mazy · Sep 14, 2012

My supervisor knowingly dumps the most awful patients on me that she opens up and announces " I hate this patient, you go see it". I am the dump job nurse, left busting my butt to see the patients no one else wants to see, not even what I was hired for. And my supervisor said " get ready, the palliatives are picking up and they are all yours"

It...?

Mulan · Sep 14, 2012

I really like allnurses, but there does seem to be a pervasive attitude of superiority. "I would NEVER" do whatever the poster is doing. And it's great that there are so many super nurses here, who are pure in thought and mind and deed, but there are some of us who actually might still be able to do an outstanding job even while we dislike the patient, and cringe at the thought of having to deal with them. .

.... :up:

mom_coach_nurse, LPN · Sep 14, 2012

Geez, the nerve of these hospice patients having not kept up with their house cleaning. /sarcasm

CrunchRN, ADN, RN · Sep 14, 2012

This should be good........................

netglow, ASN, RN · Sep 14, 2012

Well, hospice can often be more of a scam than a job.

It's a big jump from working in hospital ICU and then doing hospice (home based I'm guessing?)

Hospice/home health is 99% documentation

Lots of people think it'll be a better work life than the work life they had - rare, it's all consuming often.

OhioCCRN, MSN, NP · Sep 14, 2012

Agree w/ the superior attitude... as if your're somehow less of a nurse if you vent. Urgh! OP i feel your pain

SkipBeat · Sep 14, 2012

Man........people are really racing to get on that high horse or ride the sarcasm train!! OP I think you should lay down your thoughts to your supervisor and let them know some changes will have to take place. It's not right that they swindled you into doing a different job than what you signed up for. If they are not willing to make changes there isn't anything you can do about them, but you don't have to stay there. I'm sure there is some employer who would appreciate a nurse like you.

2BRN123 · Sep 14, 2012

so how did the meeting go?

Guest343211 · Sep 14, 2012

Another vent again. I was hired as a hospice nurse into my company 5 months ago. I was told there would be " a little bit of palliative care". Well, its only me the supervisor and the director in the hospice division of our HH company because they can't keep. Uses ( one left after me being there for 3 weeks) and that can't find anyone. So I am stuck with all of the palliative care. I hate palliative care. I do hospice revisits, but my intention was to be a hospice nurse, as I was told, not the person to just pick up the crap no one else wants to do. Almost 6 mo ths and I haven't done a hospice admission or pronounced. My supervisor knowingly dumps the most awful patients on me that she opens up and announces " I hate this patient, you go see it". I am the dump job nurse, left busting my butt to see the patients no one else wants to see, not even what I was hired for. And my supervisor said " get ready, the palliatives are picking up and they are all yours"So, tomorrow is a progress meeting with the supervisor, director and educator. I have mentioned my desire to really the lean the hospice that I desire to do, they say " yes, we'll start doing it, and they never do. I want to say something again. I am at wits end at this Job, sick of working my butt off and charting all the time on my own time. My happiest times in this last few months I have worked here was in the last 3 weeks where I had 10 days off for a lap chole! It's the only time I have felt free and destresser. Not worrying about having to wake up at the crack of dawn to do paperwork or going to roach infested homes of dirty people who can't take care of themselves and no one else wants to see. My tolerance is gone. I feel like I'm gong to say everything I mean tomorrow and it won't be good.I'm a former icu nurse. Loved it there and had to leave because I couldn't do shift work with my family situation. It's been aMost 2 years since I've been gone and I'm friendly everyone there and they say all I have to do is ask if I want to come back. It's a great system. I wish I could figure out a way to do it. With all that ranting I lost sight of the question. Should I speak up tomorrow? I chose hospic for a reason. I did not want to be a palliative care nurse. I don't mind doing it when needed, I'm a team player, but I want to do what I was hired to do and have a passion for.

I guess I don't understand. What is it about the hospice patients compared with the palliative care patients that you like better? Don't they require documentation too? Wouldn't it be plausible that some of their homes would have roaches in them?

I have a home care case now where there are roaches--after spraying and moving the baby and family to another apartment-less roach infested, but there are clearly still roaches there. I feel like I am on roach patrol every time I go there--and I am always scared that somehow I will bring a roach or pregnant roach home. I try to be really careful. Plus the family doesn't speak English, and this can be a challenge. But I feel for them and their baby. I don't let go of the case, b/c I know others don't want to go in there.

I really wish poor people didn't have to live this way. They have limited control, b/c it's the apartment complex issue. Apparently, once someone else has roaches or once there is a big infestation, it's almost impossible to get rid of them. It's sad. I keep hoping the father will find a better job and can get his family out of there.

Back to my original question, what's the issue with pallative cases versus the hospice cases????

JMBnurse · Sep 15, 2012

I was an Oncology and Inpatient Hospice nurse a few years back and I don't really understand this. My understanding of "palliative care" is any treatment where the sole purpose is to provide comfort, rather than a cure. An example would be radiation only to shrink a tumor to keep it from pressing and causing pain or seizures, but not to cure the patient. That being said, all "hospice" is "palliative care", unless you are administering radiation and that is the problem. I don't get it.

Is it that you prefer to see the patient on the day they are admitted to the hospice program or on the actual day they die and none of the in-between time? I must be missing something because I don't understand the distinction between the care you want to provide and the care you are being asked to provide. Most traditional hospice care involves pain control, hygiene and other daily comfort measures. In my experience there is not a lot else involved, other than the documentation. Comfort is the care you provide in hospice- whatever that includes for the individual patient.

It seems to me that it is not what you thought it would be and so my advice to anyone in that situation would be to resign and find another job that you enjoy, such as your previous job. Life is too short to work at a job that makes you miserable most or all of the time.

As an aside, it seems as though your supervisor may be in the wrong field, as well. Hospice Nursing is not for everyone.

allnurses Guide · Sep 15, 2012

Thank you JMBnurse for putting all the questions I had in a succinct and understandable fashion!