Can a new graduate be a hospice RN? - page 5

by fireball78 39,922 Views | 51 Comments

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... Read More


  1. 3
    I finally got an interview with hospice after being a nurse for a year and a half! It's an inpatient hospice unit, not sure of the details yet, but it would be a per diem position. I am excited and nervous. I don't interview well. I just hope my passion and heart for hospice shows through. What makes me a bit nervous is that I am sick of working in a hospital environment...combative patients, restraints, bed alarms. I am going through sensory overload and so stressed that there isn't enough time to give all my patients the proper care they deserve. I believe the inpatient unit will be like a med-surg unit, but I am really really hoping that it is somewhat less stressful and I'll be able to provide more hands-on care to my patients. That is what I am really desiring. My ultimate goal is providing one on one care to patients in a non-hospital setting, but this is definitely a step in the right direction and a step closer to my dream of becoming a hospice nurse!

    Thank you all for your encouragement these past few years. I so hope I get this job!!
    Hoozdo, softrbreeze, and LaRoseRN like this.
  2. 0
    Quote from LoveThisNurse
    It's very possible. I know a friend who graduated with me that is RN Case Manager for a Hospice company here in CA. She got the job as a new grad and LOVES it. So it is possible. Talk about "1-2 years experience is required" from acute care is not always true. That company loves hiring new grads and they stay. I'm actually looking into hospice care because bedside nursing is not for me anymore. Been a peds acute care RN for 7 months and I'm just about done! The hustling around back and forth is a little bit much and you know what... It's OK. I have some experience in home health and when long term care... You don't have to be in acute care if you don't want to. Find out where you are comfortable and be satisfied and love what you do. =o)
    Hi, LoveThisNurse - I would love to know the name of the hospice agency in California where your friend got a job as a new grad. I am also a new grad RN in California, have volunteered at a hospice agency for almost a year, and am very interested in becoming a hospice nurse. I look forward to hearing from you. Thank you!!!
  3. 0
    I wouldn't recommend it, but it is up to each hospice agency to set their own hiring practices. I had 15 years of experience in the hospital before I went to hospice, and believe me that background was extremely helpful when I was suddenly out their "on my own", doing critical assessments of patients in their homes. I was very glad for my extensive background in med-surg nursing and the years of learning concerning pathophysiology. I am very glad that I got out of hospital nursing, but I sure wouldn't want to be a hospice nurse without such a background.

    I have known a couple of new grads that were hired directly into hospice, and both of them went through an extremely difficult time and neither were adequately prepared to dealing with the medical crisis at 2:00 AM. They learned and improved, but I know it wasn't the best situation to be in.

    Good luck whatever you decide.
  4. 0
    fireball78

    Im located in the philly area. I really would like to do inpatient hospice. I have about 6 month experience in a fast paced medsurg unit. I've been apply all over the place for inpatient, but have had no luck at all. I haven't heard back from anyone. How are you liking your job? What does you day look like? What is you patient ratio? Any suggestions on getting my foot in the door at an inpatient hospice unit?
  5. 0
    Well, I'll be starting as a new RN Case Manager on March 4th in the Bay area (San jose,ca). I'm a new grad, I graduated in May 2012 with my BSN, BUT before becoming an RN, I have 4 1/2 years of LVN experience under my belt. I was a charge/floor nurse in the LTC....and the last 2 1/2 years I was working as a hospice LVN. As a hospice LVN, I would just get one patient for "continuous care" and would have to monitor symptoms that were unmanaged (i.e: SOB, PAIN, ANXIETY, N/V, etc). Anyways, I'm SUPER excited and nervous at the same time to start being an RN case manager for hospice. I absolutely LOVEEEEEEEEEEEEEEEEEEEE the hospice environment, but I'm also nervous that I'll look like an idiot even though I do have somewhat of the hospice background.......such an exciting and nervous time.
    Last edit by LVN2145 on Feb 23, '13 : Reason: missed a word
  6. 0
    It is difficult to get an inpatient position. I had hospice experience and still couldn't get an interview in an inpatient unit. I would encourage you to keep trying, and if you can take some CE in palliative care, that would look good on your resume. Also, get to know the people on your hospital's palliative care team (assuming your hospital has one). Your med-surg background is the very best preparation for hospice work. Keep trying and bolster your skills with an emphasis in palliative/hospice learning.
  7. 0
    Quote from Angels91084
    fireball78

    Im located in the philly area. I really would like to do inpatient hospice. I have about 6 month experience in a fast paced medsurg unit. I've been apply all over the place for inpatient, but have had no luck at all. I haven't heard back from anyone. How are you liking your job? What does you day look like? What is you patient ratio? Any suggestions on getting my foot in the door at an inpatient hospice unit?
    Angels91084 ~

    I did not get the job on the inpatient hospice unit, so I cannot answer any of your questions. I can't give you any advice on getting your foot in the door as I haven't been able to get one myself.

    Good luck in your search though!!
  8. 0
    Quote from areensee
    It is difficult to get an inpatient position. I had hospice experience and still couldn't get an interview in an inpatient unit. I would encourage you to keep trying, and if you can take some CE in palliative care, that would look good on your resume. Also, get to know the people on your hospital's palliative care team (assuming your hospital has one). Your med-surg background is the very best preparation for hospice work. Keep trying and bolster your skills with an emphasis in palliative/hospice learning.
    Thank you for your advice Areensee!
  9. 0
    As anurse educator in hospice, I would love to have new graduates coming into theranks. One of the biggest concerns is for the “new” nurse case manager in thefield not just the clinical experience but also, the organizational experiencesto manage a case load of any were from 18-23 patients, seeing any were from 5-7patient’s per day.

    Fromreading the posts the new grads that have found jobs in hospice are lucky tojoin “large” organizations that can put forth the education time and moreimportant money to train these nurses. For them I wish them the best of luck.

    In onepost the nurse mentioned that the company will allow her up to 6 months to bein orientation. Even for experienced nurses who have no hospice training. Iwould not expect them to be comfortable for at least 6 months to a year workingwith hospice patients. Also for the nurse who is new how many patients will shebe required to follow?

    I would recommendnew nurse start out in an “inpatient” hospice setting before doing into homecare hospice. When one is out in the home, you have to project a sense of calm toyour work. Even though what is going on in-front of you may be is anything but calm.

    Forexample, if you as a new nurse have not seen what a patient “looks like” priorto going into Resp Distress. How can you educate the family for s/s to lookfor?

    Greaterthan 90% of my “assessment” is done before I even take a BP, check a pulse,etc. Those things are important but having the critical thinking and experienceto be able to “hear and see” what the pt/family are saying and come up with aprognosis and then be able to teach the family to care for their love one whenI am not at the bedside is critical.

    Bottomline, for new grads, if are looking at hospice organization talk with themfrankly about what their orientation is like, what education is done. An examplewill they pay for you to go to things like ELNEC (End-of-life nursing EduConsortium) in your first 6 months. Then what type of mentoring support do youhave once you are off. Remembering anywhere a nurse starts there is theprogression from novice to advance nurses that needs to and will occur.

    I wouldsay most “smaller” hospice just don’t have the educational staff, and resourcesto commit towards that end. Though I so wish it was different!!!

    In thatcase, going into areas like, ICU, ER, oncology will give the new nurse the foundationto build on so in a few years to come back into hospice.

    Theother thing I hear is from “older” nurses who will say … before I retire Iwould like to do hospice. Having worked at some of the busiest trauma centersand hospitals in the state that I am in I have this insight. I have left workfrom our in-pt hospice equally emotionally and physically drained as I ever didworking at the Trauma center.

    If youdo have the experience and what “to do hospice” come on and join the fun. It isa true calling, we call it the “hospice heart”.

    Lastlyfor any hospice nurses or any one, I would highly recommend they get theircertification in whatever specialty they work in. Has Hospice nurse it would bethe CHPN, ER CEN, or oncology OCN.

    I hopethis helps and look forward to seeing more nurses in hospice. Both new and old,men and women.
    Thanks

    NavySERE
  10. 1
    Hello all,

    I know this thread goes back a few years, but I wanted to share my experience with hospice for those who might be interested in going into hospice at some point!

    I'm graduating from nursing school this fall and my plan is to become a nurse at my local inpatient hospice center. I, too, feel called into hospice care, and this is a recurring theme I've both read here and heard in the field.

    Since I was interested in hospice care before I started nursing school, I decided to first volunteer with the local hospice to see if I was really cut out for this type of nursing. I did this for three years while in school, and then applied for a CNA position at the inpatient unit. I was hired and have gotten tremendous experience doing this. I work part time around my school schedule, and plan to apply for an RN position there following graduation. While many hospices won't hire new grads, it certainly helps to have experience as either a volunteer or CNA, as well as a passion for hospice care. There is no guarantee that I will be hired as a new grad, but the odds are in my favor due to the different roles I have played there and my passion for end-of-life care.

    I think it is difficult to begin doing any kind of home care right after graduation due to the level of autonomy that home care nurses demonstrate, as well as the expansive knowledge required to educate patients in the home setting. However, one of the great things about inpatient hospice care or facility-based hospice care (for example, in a long term care facility) is that a new grad may be precepted in these environments much more effectively. Once the new grad has attained enough experience to move into the home care setting, the transition can be more seamless.

    I think there is a steep learning curve for a new grad going directly into hospice care, but it's not impossible: I know of new grads who have succeeded and those who haven't. Some "old-school" nurses have told me that oncology and/or med-surg experience is necessary to be a hospice nurse, and other "new-school" nurses who have told me to pursue my passion and the rest will fall into place. Both philosophies carry wisdom - it is up to the new grad to decide what is best for him/her.

    Fireball, I hope you continue to pursue hospice! Perhaps the hospital where you work has a palliative care team that you could join, or you could volunteer at your local hospice. If you want to message me, perhaps we could collaborate and I could help you find an inpatient facility near you or know someone who could help.

    Best of luck to all (including myself - haha!)

    :-)
    fireball78 likes this.


Top