Apprehensive about starting Hospice Nursing

[jenny_g]

Hi all, I am brand new to this board, and actually to the entire website.

I am getting ready to start orientation at a hospice agency next week and starting to feel apprehensive.

I have not been working at all for the past 2 years in order to stay home with my first and only child. I'm sure I would feel some apprehension going into any field!

As an LPN I did a year of Med-Surg, then lived and worked at a mission hospital in Haiti for a year (covered every area!)

To help support myself through RN school, I stayed with a hospice pt. once a month for a 4 day weekend. I was employed directly by the family so they could have a break. The pt. had hospice and the nurse would oftentimes come while I was there. The pt. died about 8 months after I started staying with her.

After graduation, I worked in an orthopedic clinic and then was doing Home Health nursing when I decided to be a stay at home mom.

I love the setting of Home Health nursing, the chance to really get to know the pt. and family. My goals though, as in most other fields of nursing, was always to assist the pt. in recovering or learning to adapt to the disease process, etc.... and ultimately dismiss them.

With Hospice, dismissal will come with death. How as an RN brand new to hospice nursing, should I prepare myself emotionally? Can some nurses just not handle it? How do you keep a healthy perspective? How do you not become so attatched that you go home and can't eat because your pt. just died? Or keep from being detatched b/c you know death is imminent?

I want to be an excellent Hospice nurse. Maybe there is no reason for alarm. Maybe it will all fall into place. Thank you for any input.

Jenny, RN

[jnette, ASN, EMT-I]

Jenny, your questions are valid, and I appreciate your giving serious thought to your move into this field.

I don't know about you, but for me... nursing is GIVING.

In hospice, you already know the outcome... and that you cannot change it.

However, you have a magnificent opportunity to GIVE ...relief, comfort, touch, a warm smile, an extra blanket, a cool cloth on the brow, a hand to hold... and support. You give simply by not fearing the patient or his/her ultimate outcome. You give by improving the quality of what time and life is left.

Hospice is unique in that you KNOW what to expect, and you can throw yourself into making every day the very best for this patient and the family.

This appeals to me as one of the greatest, most giving, and most rewarding fields of nursing, as it is truly all about the patient, and nothing about "me".

[Lily of the Valley]

I am new to this forum but i agree with jnette that yout concerns are valid.

As hospice nurses, it is important to remember we are facilitators. We support the patient and the family as one unit. We give them the tools to ease the transition.

Our personal agendas have no place here, only the patient/family unit's goals. This is not as easy to apply as it may sound. We want our patients out of pain, not anxious, and a myriad of goals we set up in our care plans.

But we must be sensitive to and respectful of what our patients request as their needs and desires.

It is so easy to get close and attached, to become the warm nurturing center of our patients' lives. Maintaining a professional stance is a tightrope, balancing between adoption by the family and being aloof and disconnected.

You do more good maintaining a sense of objectivity, as guide, teacher, listener, facilitator, not investing so much emotion that one becomes a member of the grieving family.

Turn to your team for support, not the family.

I see I am already being long winded

It is an exciting and challenging path you have chosen to travel. You will be probably find yourself with your own grieving process for those close to you you have lost. Again, be aware and look to your team for support.

I wish you well

Lily

[KraziNurs]

jenny-

[color=#00bfff]be confident. it sounds like you have a well rounded background in nursing and you obviously have the desire to be an excellent nurse. i have been in hospice less than a year but in nursing about 13 years. find support within your team. hopefully you will have a preceptor that is a wonderful example to follow, but if not, seek someone out. during my orientation, i followed several team memebers and learned something from them all. i am blessed to be part of a great nursing team and there is always a more experienced nurse i can call for advice. don't be afraid to ask for other's opinions - you will learn a lot by doing that and it may save you from making the wrong decision. nurses are always willing to share with newbies. "seasoned nurses" have excellent resources and a wealth of experience that they are happy to pass along to others. jump in with both feet. this may be the most satisfying work you have ever done. good luck!