A day in the life...

[KYRNCA, BSN]

Hello... I've been an RN since 2009 and have worked in a variety of settings... nursery, pediatric plagiocephaly clinic, Remote chart abstraction and most recently at a skilled nursing facility (medpass).

I have been offered a Hospice position (where I'll visit 2-4 patients in a day) but with no experience in this field I'm not sure what to expect. I'm somewhat concerned with my limited bedside experience since I've spent time working from home and at an outpatient clinic setting. On a plus side I have spent the past year working in a skilled nursing facility and have really enjoyed.

So, can someone offer any advice and/or give me an idea what goes on on a day in the life of a hospice nurse?

Thank you in advance for any input!

[TammyG]

I am so glad you are considering hospice and I hope you will give it a try, if you feel that you are right for it.

A typical day is 4-5 patients. You will not be seeing only 2 patients unless they are 100 miles away!

I start my day by getting up and checking email to see if I have any new admissions or if any of my patients were seen overnight. I may have calls to make -- either because a patient had a change overnight, or to let patients know I will be coming by. There are always calls to return from patients looking for visits, to discuss new symptoms, or needing refills. So I usually did not leave the house until after 10 am.

Each patient is different. Some patients are fairly stable and the visit is more social than anything else. (We love those patients!) But at every patient visit you need to do a thorough assessment, inquire as to med status, symptom management, or personal/social issues that may need the social worker or chaplain. There is a lot of equipment management -- most patients have a bed and accompanying (mattress overlay, overbed table, extension, etc.) and often have nebulizers, oxygen equipment, suction equipment, shower chairs, walkers or wheelchairs. Stuff breaks, needs change. This may mean calls to the equipment company.

Patients all use supplies that have to be ordered. Chucks, adult diapers, soaps/creams, swabs, whatever. This all needs to be ordered which may require you to get on line or make a phone call.

You may need to call the doc or NP to get a new order or refill.

You may need to call the social worker or chaplain.

You may need to call the nursing assistant or coordinator to arrange for more or less nursing assistant visits or to ask them something about their observations of the patient.

If the patient is having new symptoms, you will need to discuss them at length with the family and give instruction on nursing management (turning, cleaning, applying meds, etc.). You may need to call the doc to discuss new symptom management.

You may need to arrange continuous care or inpatient care if the patient's symptoms are worsening.

You may need to do a procedure. The most common procedures we did were foley changes/insertions, access a port, draw blood (central line or venous puncture), occasional IV administration of drugs, bandage changes and wound management generally.

And that is just for one patient. Repeat x4-5!

Oh, don't forget you need to document ALL of the above. Plus do weekly/monthly reports for interdisciplinary team.

I loved being an RN CM. It was the best job I ever had.

[KYRNCA, BSN]

Thank you so very much for your reply. I want to find a way to refresh my skills, I haven't done a foley since nursing school í ½í¸«

[TammyG]

You are out there on your own with no assistance, so you do need to feel pretty comfortable doing those procedures. Plus a family of six will be watching you. I forgot to mention that we also had a lot of patients on TPN, and a lot of patients on med pumps which need constant adjustment/changing and that type of thing.