Can a new graduate be a hospice RN?

  1. 2
    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 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 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!
    Caligirl96 and abqfavorite like this.

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  2. 53 Comments...

  3. 1
    I would love to see these responses. I am also a new grad and have an interview tomorrow for a case manager position at a hospice facility. I wish you the best!
    ntaylor09 likes this.
  4. 0
    Thank you Nicole! Congratulations and best of luck with your interview!!! You will have to let me (us) know how it goes.

  5. 0
    I know know if it's a federal or a state reg, but in my state you must have at least 2 yrs of M/S experience. The only exception is for RN's who have 2 yrs experience in hospice as an LPN prior to being an RN. Good luck to you both!
  6. 7
    I think it is easier for new grads entering hospice to do so in the facility setting. That environment provides opportunity for greater support and mentoring. Case managers in the field benefit enormously from having a solid foundation of critical thought, assessment, and professional communication skills. Those jobs require a level of autonomy and responsibility that is often unsettling for a new grad.
    hooterhorseRN, OCNRN63, DixieBelle7, and 4 others like this.
  7. 2
    Dear Tewdels and Hospice Nurse LPN -
    Thank you both for your suggestions/feedback. I have a passion to be a hospice nurse, and know that if I do Med-Surg for at least 1 year, I can go anywhere and do anything...but I don't have the confidence to think I can BE a Med-Surg nurse. From what I've seen during clinical, Med-Surg nurses rarely get to spend more than 5 minutes an hour with their patients. They are constantly running from one room to the next, giving medications, charting, talking with doctors, and handling one emergency after another without getting so much as a bathroom break. That is overwhelming to me. I want to spend more than 5 minutes with a patient (a person), and their families! I want to be able to sit with them and hold their hand if they need it. Listen when they need an ear. I don't think any nursing job is easy (hospice or otherwise) and I'm not looking for easy!!! I just finished my med-surg rotation and I'm not feeling the most confident (I still have OB, Peds, Psych, and Critical Care coming next year). I just want to actually get to spend time with patient's and their families without running around like a chicken with my head cut off!! I am fearful of getting thrown into the fire as a new nurse, but I guess that all depends on where I get hired and the training/orientation program for new graduates. I am also applying to volunteer at one of the local hospice agencies. I think that will be a good experience for me, and the only way for me to actually see what hospice nursing is all about. I haven't had any clinical rotations or observations with hospice; I just know from my previous personal experience that hospice nursing is where I would like to be. Thank you all!! This website is a great resource for all nurses and nursing students!!! hug:
    DixieBelle7 and mitral like this.
  8. 6

    I feel your pain...I was never a med/surg nurse, never had the desire. You are correct that hospice is not an easy specialty and that there really are no easy specialties in nursing.

    For me, it is the technical expertise and critical thought that are the biggest stumbling blocks for new grads in field hospice work. Because the job is SO autonomous, because you are SO alone when visiting the patient, and because you are in the patient's home where they are in control...field work can be very demanding and stressful for new grads. It is a different thing to learn about a tube/drain/stoma/fill in the blank in a facility setting under more controlled circumstances, compared to in a patient's living room with Aunt Maggie asking you a gazillion nonstop questions and the family cat trying to get into your nursing bag.

    I have seen too many new grad nurses with a keen desire to work hospice be burnt out by employers who cannot restrain themselves from putting too much too quickly on the new nurse's plate in the field. It can be a stressful and frightening situation to be in the home with an unstable, uncomfortable patient and be unable to get one of your nursing peers to answer their phone... It can be stressful and frightening to be required to take oncall for a large group of patients when you are not feeling all that confident managing your smaller case load... It is stressful and frightening when you are alone with a patient who is dying quickly and badly...

    I wish you well, and hope that you get the hospice experience you deserve.
    RunBabyRN, Nurse_Diane, DixieBelle7, and 3 others like this.
  9. 1
    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)
    RNS5 likes this.
  10. 2
    I am a recent grad and am also very sure that I am interested in hospice. I have been a med tech at an inpatient hospice facility for several years.

    But I decided to spend a year on an oncology ward first. I wanted the experience of managing a patient load and seeing a wide variety of interventions, wounds, etc. I have spoken to nurses who spent 10 years on oncology and did not believe it was enough to prepare them for home hospice -- you are just completely alone on your own out there. But at least with a year of experience in doing assessments, etc. I will feel I have a little bit of a basis to serve that role.

    Also, the nurses at an inpatient hospice facility, in my opinion, actually spend less time with patients than I've seen on many med-surg floors. They have the same documentation requirements, etc. that floor nurses have, and many patients are more demanding and/or need more continuous monitoring. In addition, families often require a lot of the nurse's time away from the patient. I would not automatically assume that hospice nurses have unlimited or even ample time to visit patients.
    RunBabyRN and BryanLVN like this.
  11. 5
    My first job out of school was with Hopsice. I loved it. I don't think it mattered whether I had M/S experience or not because the RN's I worked with taught me what I needed to know anyway. Well.... I left Hospice and now work on a M/S floor (my husband likes the whole union idea), and let me say... I MISS HOSPICE very much. I learned a great deal. New nurses go right inot M/S or ICU or other places without knowledge, why not Hospice. I say go for it, if that's what you feel is your place. Good luck.
    RunBabyRN, Rntr, RNS5, and 2 others like this.

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