Books for a New Hospice RN

  1. HI there... I just accepted a position as a hospice nurse. What reading material would you recommend so I can be as prepared as possible?
    Bonus points if you know of a skills refresher course in the San Diego area.

    TIA!
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  2. 4 Comments

  3. by   nutella
    Congratulations!

    Are you going to work in the community?

    Consider a membership in the :
    http://hpna.advancingexpertcare.org/

    Essential books - which I have used and continue to use:

    HPNA

    978199332342 |

    Other Essentials :

    http://geriatrics.uthscsa.edu/tools/...eilly_2008.pdf
    (print out and keep close by ...)

    http://www.nhhpco.org/s-content/uplo...iteriaCard.pdf

    Patient Symptom Management Guides - CCO


    Phone Apps Essentials:

    App Library - CCO - symptom management

    Fast Facts : Palliative Care Fast Facts on the App Store

    Navigation : Google Maps - Navigation & Transit on the App Store

    Other:
    two 1 inch ring binder in which you can place your "hospice nurse brain" - organization is king in community hospice nursing! One binder for all the "information" - phone lists, cheat sheet that has information about the routine medications that your hospice uses, list with funeral homes in the area, and so on. The second binder is for all the forms - especially pronouncement forms, communication forms, medication grids, contracts, admission paperwork etc.

    Small car organizer or similar with essentials for road warrior nurses: phone charger with cable !! (otherwise you end up in trouble when using your phone as primary GPS), notepad, hands free option for the phone, pens, small trash bags (4 gallon bags), Febreze or similar, travel size lint roller.

    I also had some supplies in the trunk including water, snacks that can withstand heat/cold like crackers, extra set of scrubs, umbrella, small kid size shovel for winter and broom, small plastic box for info brochures, education material etc..

    If you are going to work in home hospice (which also includes assisted living and nursing homes, perhaps the occasional visit in a hospital), start with the core curriculum - it is one of the best books for palliative/hospice nursing. It is important to understand the underlying ideas and concepts because this kind of nursing is different....

    For the binders and what else to have in your car:
    When you go through orientation ask the nurse who orients you, if she has a binder/ organizer and if you could have copies of what she considers essentials. Some places already assemble it for a new hospice nurse because we all rely on similar systems to organize.

    When you are getting closer to the end of your orientation and you are getting ready to make your first visits alone, make sure you ask your orienting colleague and in addition some other senior nurses who seem friendly if you could have their cell phone number to call in case you have a question. Most will be ok because that is another thing with home hospice - you are by yourself and naturally there will be situations where you need an opinion or are unsure of what to do. Most will be ok and even offer you to call them "anytime" - program those numbers right into your phone!
    Make sure you always have the on call nurse number as well if you overlap.

    Sit down one day and program all numbers in your phone, which will save you so much time later! Your fellow nurses you trust and you will call, your team members, manager, educator, supply company, pharmacy where you will order medication for hospice, non emergency number for the local fire dept if you have to call for "lifting assist", the nursing homes and assisted livings that you will frequent and the local hospital, large physician offices that you deal with regularly, hospice medical director, and so on...
  4. by   KYRNCA
    Hi there... I have made notes and downloaded all the suggested apps. I'm excited and understandably nervous since this is all new to me so THANK YOU so much for your reply and all the helpful tips!
  5. by   nutella
    Quote from KYRNCA
    Hi there... I have made notes and downloaded all the suggested apps. I'm excited and understandably nervous since this is all new to me so THANK YOU so much for your reply and all the helpful tips!
    Hi - I think it is normal to be nervous - home hospice or hospice in the community is so different from most other nursing!!

    I really liked that we had standing orders for all our patients, which gives the hospice nurse some discretion on what to order and recommend and also for the family who is being taught to take care of their loved once.
    Generally speaking, I think that it is much easier to keep a patient comfortable at home with hospice as opposed to acute care with comfort measures only because even though the goals are the same, acute care is the worst setting for that to happen. Nurses and physicians and everything else is set up and geared towards extending life and the lack of experience with CMO /hospice care makes it much harder to get good symptom control...

    I used so many skills in home hospice including accessing VADs, inserting foleys, wound care, teaching to patients and families about primary care and medications, and I also have done a fair amount of nursing care hands on when this was needed. Hopefully, the organization has a good orientation program and you will feel supported and like home hospice!!

    One word about the documentation:
    There is a huge amount of documentation nowadays for hospice - all on the computer. Admissions can easily take up to 4 hours with everything including the initial paperwork, assessment, teaching, documentation. The documentation to satisfy Medicare is interesting because it consists of a lot of checkboxes but I found that to actually help other team members understand what is going on and what my plan is, I needed to write a narrative in addition. The downfall of home care and home hospice is when nurses do not document right away or right after the visit at point of care and hope that they will have time later. This hardly ever happens I found because there is always the call you get from the family or the office to do an extra visit or to pronounce a patient etc..
    First I was not too eager to use the laptop in the home or facility, but that changed once I figured out that documenting at point of care was really to my advantage. To make my life easier and my documenting faster, I got myself a computer mouse that I liked and a small mouse pad and would use the computer in the homes as much as possible to enter data right away. Between visits, I typically finished the documentation and narrative in the car before driving to the next visit. Once I stuck with this routine, I was able to finish all my documentation and visits within the normal work time - the problem is that many hospices hire you salaried knowing that most nurses struggle with the documentation piece and always end up working from home for several hours. Admissions I found difficult to complete in the home and on the road because of the sheer amount of work to do but lets say I would admit somebody to hospice and have to do acute symptom control as well and teaching - I would usually stay there for a while until patient is comfortable. In those cases, I found out that setting up shop next to the patient with my laptop was really helpful in getting the documentation process started.
  6. by   KYRNCA
    Hello again ... I was hired as an hourly employee so based on what you said its a good thing. Unfortunately they do not pay anything per mile so I hope I don't end up driving all over the place.
    As far as nursing skills... Most of my background is either working at the well baby nursery or at an outpatient clinic treating plagiocephaly (no nursing skills used there) so I haven't started a IV, done a foley or accessed a VAD since college (2009). That scares me the most. I have tried finding a refresher course around me with no luck. My only hope is that the nurse training me is patient and willing to help me re-learn.
    The company that hired me is super new so I'm not really sure what to expect of the training.
    How much time do they allow you for each visit?

    Once again thank you so much for your insight!

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