Can a new graduate be a hospice RN?

Specialties Hospice

Published

Hi there.

I just finished my 1st year of nursing and will graduate next May. I have pictured myself as a hospice nurse, even before I entered nursing school! I was with my step-dad who battled lung cancer for 7 months before he passed away. His death was the first that I have experienced, and I was surprised by the experience. I was witness to him slowly dying day by day, lose of his independence little by little, pain (which was managed very well), and eventually he lost his hope (which was the worst of all for me to see). When he died, surrounded by his family, I felt relief that he was no longer suffering...no more pain. I am a spiritual person, and I found the experience of being with a human as they transitioned from earth to heaven, very rewarding. I felt honored to have been there...I was also relieved that he didn't die alone! That was my worst fear as his disease progressed. I was very sad at the loss of my step-dad, but never felt anger as I knew where he went...no more pain, no more suffering. From then on, almost 2 years, I have wanted to be a hospice nurse. Even though I am spiritual, I realize that not everyone is, and I am not preachy about my beliefs. I am just explaining my experience.

I would like to hear from hospice nurses, if I can be trained as a hospice nurse right out of college, or if I have to "do my time" in a specialty such as Med-Surg? The thought of working in Med-Surg makes me nauseous! I would not be a good Med-Surg nurse, as having 4 or more patients to focus on at one time will not leave me any time to build a proper rapport with my patients. As I am still a student, having only 1 patient on clinical at a time, I haven't figured out how a nurse priorities care -- medications, wound care, trach treatment, foley insertion, and head-to-toe assessments! During clinical, I tend to spend more time with my patient than my classmates. I love talking to them and getting to know them. Being a hospice (or a home care) nurse appeals to me as well, because I would be with one patient at a time (as least from what I have read/heard). I am 32, never married, no kids, so being on-call, working nights/weekends isn't something that would bother me. I have lots of friends and family, and I do know that having a social life and taking care of myself would be of importance as a hospice nurse, so I don't burn-out. I just don't want to be any other kind of nurse, other than a hospice nurse!

Does anyone know of agencies who hire graduate hospice nurses? I currently live in PA, but will ultimately like to relocate to CA where I am originally from.

There is a hospital in my area that offers a 6-month internship for new home-care nurses. The first 3 months are spent in Med-Surg/Oncology and the next 3 months are spent training as a home-care nurse. I am thinking about applying for that, but there is certainly no guarantee that I would get it!

Any advice you have would be appreciated. Thank you! :redbeathe

Specializes in Pulmonary, Cardiac.

oh and I am a rn case manager, but I dont have a RN under me. I do all my case management which includes patient care.

0 Votes
Specializes in PICU, NICU, L&D, Public Health, Hospice.
What if the company has a team: RN, CNA and RN Case Manager?

Anybody have that arrangement? I'm learning about this, and wonder if the RN Case Manager ever in this grouping above, rolls up her sleeves and gives patient care. If you do have to cover call, are you then the bedside RN, administering meds, all care etc? or no? Wondering if this is a total admin/manage job title, and no patient care? Or, do you do mostly the admin/manage and have to jump in when needed to do total care.

This confuses me as far as who does what.

I am familiar with RN Case Manager/LPN/HHA/MSW/PC teams who cover specific regions or facilities, this would apply to field work. In all hospice organizations familiar to me the RN Case Manager is a hands on patient advocate. That is the team member who generally has the deepest relationship of trust AND responsibility. Even in our in-patient facility, the RNCM provides direct care to some of her case load everyday. If the CM has GIP patients on her team, she has very specific assessment and documentation requirements. (I use "she" because we have no male nurses in our IPU). Many hospice facilities have nurses who manage the patients, and nurses who manage the nurses and the beds...they are called a variety of things; nurse supervisors, managers, team leaders...

It would be surprising to me for an RN case manager to not ever visit the patient, talk with them, do the assessment, discuss the patient/family wishes/wants/dreams...

0 Votes

Me too. Someone I know speaks of accepting a position where they will be RNCM with a bedside RN and CNA for the pt. This person is supposed to visit x2 weekly to 7-10 NH inpatients as contracted hospice. Told tons of charting is the biggest thing to do. BUT also mentioned about call. I asked specifics about the job re this "call" and it didn't sound as if they even really asked. This person is a new grad. I expressed my concerns about this as I am also looking for a job. I mentioned that if there is not direct pt care, except helping out as a second pair of hands on occasion, one might have to acknowledge that they might not be able to get a pt care-related job in the future after say a year of this or more after graduation. Of course if this person has "magic" skills in coordinating resources and paving the path for family and patient, that is so necessary and to me a even trade so to speak. :redpinkhe Just not sure about leaving hands on nursing in the dust, if you understand my thoughts...

I have not called myself to inquire, but have been snooping some threads to see what's what. I do know that if you are not prepared with specifics, and the company is on an expansion kick, you will get only the info from them that would make you want the job... BTW this NG is pushing some of us to apply and has not started their job even yet, wonder if there is a sign on bonus in it for this NG if we should get hired. Makes me wonder.

0 Votes

mschelee, supposedly you get 2 weeks orientation.

0 Votes
Specializes in PICU, NICU, L&D, Public Health, Hospice.

I wonder, does the "office case manager" oversee the work of more than one RN?

0 Votes
Specializes in ER, Cardiac, Hospice, Hyperbaric, Float.

I have been reading this thread and wanted to put my 2 cents in. First, I would say it is possible for a new grad to be a hospice RN, but I would not recommend it. You are pretty much on your own, and it really helps to have a lot of background where you have assessed a lot of sick folks already in your career and gotten a real feel for the "disease process" in general. I rely so much on my past experience and knowledge - I have no idea how I would function without it. As another poster said, the docs basically rely on your assessment of the situation.

Someone mentioned that if the hospice is on an expansion kick, the company will tell you what you want to hear in the interview. Unfortunately, I know this from experience. I will add that some companies on an expansion kick will also go out of their way to push nurses to certify anyone and everyone that is referred for hospice whether they are truly appropriate or not. If you are the nurse doing the admission, it is YOUR name that goes on the initial certification - if the person isn't truly eligible, that is essentially fraud.

I love hospice. However, you need to be careful when looking for an agency, as many places are just out to make money (to be perfectly frank) no matter how they try to present themselves. It can be very frustrating and sad to try to honestly do what is right and good when you are working for an agency like that.

0 Votes

I am a brand new RN, and I was just hired with my local hospice. I will be a case manager...AND I LOVE IT! I am still orienting (only been 2 weeks). I have been so blessed to work with a HUGE organization (7,000 employees) that really take care of their staff...100% paid benefits, massage therapy, 27 days paid vacation (1st year)...list goes on. They told me that, if I need 6 months of orientation that they are willing to put the time into it. I feel so blessed. This hospice works with my school, and we did some clinicals with the hospice houses and with the home health field nurses. I have such an awesome team and preceptor is phenomenal. If anyone decided to move to South west Florida....LOOK INTO THIS ORGANIZATION!

0 Votes
Specializes in PICU, NICU, L&D, Public Health, Hospice.

good for you JaclynRN789 , it is nice to know those organizations exist!

0 Votes
Specializes in SNF, LTC.
I am a brand new RN, and I was just hired with my local hospice. I will be a case manager...AND I LOVE IT! I am still orienting (only been 2 weeks). I have been so blessed to work with a HUGE organization (7,000 employees) that really take care of their staff...100% paid benefits, massage therapy, 27 days paid vacation (1st year)...list goes on. They told me that, if I need 6 months of orientation that they are willing to put the time into it. I feel so blessed. This hospice works with my school, and we did some clinicals with the hospice houses and with the home health field nurses. I have such an awesome team and preceptor is phenomenal. If anyone decided to move to South west Florida....LOOK INTO THIS ORGANIZATION!

Hello JaclynRN789:

I'm happy you are having such a great experience with hospice. I also live in Florida, can you tell me the name of the hospice and the area that they serve?? I'll like to know, I'm a new Rn as well. If it's not in my area the information might help other people reading the thread. I thank you, good luck!!!

0 Votes

I must say it's not a regulated feild. But ANY good agency will require you to have 1-2 years of bedside, nursing home or acute nursing somewhere. There is way to much for a new grad to step into. You are alone, making judgements and often this is too much responsibility as even being an old salty nurse like myself, we pull from our prior experiences on how we act now.

Some hospice agencies will hire new grades and I would sway from them unless, they can provide an actual mentor and clinical support vs. just handing you a nursing bag and assigning patients. Sad but true. Most agencies require at least a year of bedside somewhere.

0 Votes

I'll be starting nursing school in the fall of 2011. I would love to eventually be a hospice nurse and wondered if volunteering for a hospice facility during my schooling would give me some of the practical experience I would need. When I graduate, should I try and find work in any particular field of nursing to prepare me for hospice? I'll graduate at the ripe old age of 56, but have dreamed of going to school for 35 years. I'd apprecialte any suggestions anyone can send my way.

Thanks,

mtsandsky:redbeathe

0 Votes

If you volunteer... you will be able to see the inside of the hospice, how it works and perhaps interact with patients on a volunteer basis. ( volunteers do not give medications, or act in a clinical way at all , but rather provide socialization and support in the area for both the patient and family.

It think it's a good idea!

WHen I was younger. I was planning on going to school for my RN. I didn't wan't to be one of those many students who went all the way through prerequisites and then find i hated it. I took a little 6 month community course for my CNA just to get some idea of what it's like. It worked to my benefit. I couldn't work as a CNA in school, as I made more money serving at a local restaurant. ( thats shameful ) But doing that gave me a HUGE edge over my schooling..

0 Votes
+ Add a Comment