Considering Hospice

buddiage · Dec 2, 2008

I want to know too.

Ginger's Mom, MSN, RN · Dec 2, 2008

I worked for many years as a hospice nurse. One agency I worked for asked all nurses considering hospice to spend part of a day with a hospice nurse. Many did and many did not come on full time. Many people think they know what hospice nurses do, but when faced with reality they didn't what to do full time.

It was one of the most rewarding position I have had.

Melinurse · Dec 2, 2008

I worked for many years as a hospice nurse. One agency I worked for asked all nurses considering hospice to spend part of a day with a hospice nurse. Many did and many did not come on full time. Many people think they know what hospice nurses do, but when faced with reality they didn't what to do full time.
It was one of the most rewarding position I have had.

What does a typical day look like? I know there will be alot of driving. Do most places compensate for milage? What is the worst part of being involved in hospice? What is the best? :rolleyes: Would you recommend it as a good place for a new grad RN or would it be more benficial to start somewhere else?

Whispera, MSN, RN · Dec 3, 2008

I think you should have some general med-surg experience before becoming a hospice nurse if you're going into people's homes, on your own. Community hospice nurses have to know alot, because they run into alot and there might not be someone easily available to help them.

There ARE inpatient hospice units.

Agencies do pay mileage.

The best part is giving comfort to the patients and their family members.

The worst is when several take a downturn at once and you have too much to do all at once.

Marshall1 · Dec 5, 2009

I applied several weeks ago at several local agencies. I have heard nothing back. The application is online. Would I or should I go by the offices? I really want to get out of the 12 hr hospital deal and get into a field of nursing I think would be much more rewarding.

AddieRN · Dec 12, 2009

I'm also an RN wanting to specialize in hospice. I've only been a nurse for a year and a half though. I'm currently working in LTC, gaining some geriatic experience before I transition.

tewdles, RN · Dec 13, 2009

Good luck to you...your experience in LTC will be helpful, but keep in mind many hospice patients are not geriatric. Many are in their 40's and 50's and insurance payment is a HUGE issue for them as the best hospice benefit is generally found in medicare.

RN CHPN · Jan 24, 2010

Hospice can be a wonderful and meaningful career if you make a good decision about who to work for. Here are some tips that I can offer you as a CHPN (Certified Hospice and Palliative Nurse):

Hospice is not a lifestyle.

If there's no such thing as "work-life balance", no boundaries (and if you're "shamed" for having boundaries), look elsewhere! What these kind of hospices want are "co-dependent" nurses, meaning nurses that are looking for an identity and a life purpose in addition to a rewarding career, and all for a small salary (with no pay for OT or on-call visits in the middle of the night) who are willing to make hospice their "lifestyle". Any hospices that demands these things of their nurses is exploiting nurses, plain and simple.

Hospice is not a religious calling.

You will hear some nurses talking about hospice as if it were a call to sainthood. It's not. It requires deep compassion, excellent and sensitive communication skills, and staying up-to-date with cutting-edge knowledge and skills related to topics such as pain management, etc. Every hospice has a chaplain for spiritual needs. Utilize them.

Hospice is a profession.

A professional job provides appropriate compensation and consideration of their workers as human beings that have a life outside of work (I know those ideas may be somewhat blurry in the current recession).Those of us working in hospice are very dedicated to what we do; but no job, especially one that requires working with the terminally ill and their families, should require endless hours of work. No job should require working until 11 PM to complete an unplanned admission, and then going out alone to attend a few deaths in the middle of the night (for zero pay), and then having to show up for work at 8 AM for another over-full day. That guarantees burnout. A hospice nurse job should require 40 hours, case closed (no pun intended!). Hospices need nurses around the clock, so let them hire nurses for different shifts, like facilities do. And for different positions. Case managers should not be doing admissions. Being called in the middle of a workday (or, heaven forbid, at the end of one!) to go and "do an admission" -- a process that takes at least 4 hours, if all the planets and traffic patterns are aligned, but usually 6 by the time all is said and done -- can require working well into the night!

There ARE hospices that do not exploit nurses; they have case managers / on-call nurses / admissions nurses.

That is the only kind of hospice your should work for. And until that's the only kind of hospice any nurse will work for, we'll have exploitation, burnt-out nurses, and high turnover.

Hospice nurse managers keep their jobs by containing costs, so as long as they have a supply of nurses willing to work innumerable hours (and for an unfair salary), they'll perpetuate it.

Good Luck. By all means, work for hospice; it is a more-than-worthwhile cause; but remember, you're a healthcare professional, not a martyr. Don't sacrifice your health and peace of mind like I and many others have done!

DLS_PMHNP, MSN, RN, NP · Jan 31, 2010

Hospice can be a wonderful and meaningful career if you make a good decision about who to work for. Here are some tips that I can offer you as a CHPN (Certified Hospice and Palliative Nurse):
Hospice is not a lifestyle.
If there's no such thing as "work-life balance", no boundaries (and if you're "shamed" for having boundaries), look elsewhere! What these kind of hospices want are "co-dependent" nurses, meaning nurses that are looking for an identity and a life purpose in addition to a rewarding career, and all for a small salary (with no pay for OT or on-call visits in the middle of the night) who are willing to make hospice their "lifestyle". Any hospices that demands these things of their nurses is exploiting nurses, plain and simple.
Hospice is not a religious calling.
You will hear some nurses talking about hospice as if it were a call to sainthood. It's not. It requires deep compassion, excellent and sensitive communication skills, and staying up-to-date with cutting-edge knowledge and skills related to topics such as pain management, etc. Every hospice has a chaplain for spiritual needs. Utilize them.
Hospice is a profession.
A professional job provides appropriate compensation and consideration of their workers as human beings that have a life outside of work (I know those ideas may be somewhat blurry in the current recession).Those of us working in hospice are very dedicated to what we do; but no job, especially one that requires working with the terminally ill and their families, should require endless hours of work. No job should require working until 11 PM to complete an unplanned admission, and then going out alone to attend a few deaths in the middle of the night (for zero pay), and then having to show up for work at 8 AM for another over-full day. That guarantees burnout. A hospice nurse job should require 40 hours, case closed (no pun intended!). Hospices need nurses around the clock, so let them hire nurses for different shifts, like facilities do. And for different positions. Case managers should not be doing admissions. Being called in the middle of a workday (or, heaven forbid, at the end of one!) to go and "do an admission" -- a process that takes at least 4 hours, if all the planets and traffic patterns are aligned, but usually 6 by the time all is said and done -- can require working well into the night!
There ARE hospices that do not exploit nurses; they have case managers / on-call nurses / admissions nurses.
That is the only kind of hospice your should work for. And until that's the only kind of hospice any nurse will work for, we'll have exploitation, burnt-out nurses, and high turnover.

Hospice nurse managers keep their jobs by containing costs, so as long as they have a supply of nurses willing to work innumerable hours (and for an unfair salary), they'll perpetuate it.

Good Luck. By all means, work for hospice; it is a more-than-worthwhile cause; but remember, you're a healthcare professional, not a martyr. Don't sacrifice your health and peace of mind like I and many others have done!

Thank you for that.

txspadequeenRN, BSN, RN · Jan 31, 2010

i am a inpatient hospice rn...hospice is the only are where i have ever truly felt that i have made a difference.....i help people die with dignity , respect and pain free.....you go home at the end of a day knowing that you have made a impact and your work means something.....

RN CHPN · Jan 31, 2010

You're welcome. And having said all that, I'd like to add that I hope that you'll find a great hospice job. It is a truly rewarding practice, one where a nurse can really make a difference. Good luck.