Day in the life of a hospice nurse

Becky8 · Aug 26, 2008

It really helps to hear about day to day experiences of a hospice nurse. I am entering nursing school and would like to become a hospice nurse. I have taken hospice volunteer training and have an LNA license.

Would you recommend working as a Hospice LNA while in school? I was thinking it would help experience wise.

Thanks for any advice!

Becky8

thekid · Mar 26, 2009

It's been 8 years since I've worked hospice but they took me in as a new grad and I was very fortunate to have worked with an outstanding team. They were very helpful and made me feel comfortable, I loved my job and quit due to geographical/driving problems as we ended up moving too far away for me to continue. It was very rewarding. I do not have any other nursing care to compare it to other than ltc which was very physically demanding.

Becky8 · Mar 26, 2009

Thanks so much for your response. Since I initially wrote, I was able to get a job as a Hospice lna while I am going to school. I am almost done with the first year of an RN program and the organization I work for is very interested in having me be a Hospice Nurse. I am not sure if they will take me as a new grad with no hospital experience, but at least I got a foot in the door. I really love taking care of the residents that I am assigned to and hope that being a Hospice Nurse will be at least as rewarding as being a hospice lna. It is a blessing to be able to join people in this special time of their life. I consider it an honor to be with them.

Pat

thekid · Mar 26, 2009

I'll be willing to place money on you getting hired as an RN because you are working for them now. I was hired as a new grad with only ltc experience as an LPN so sometimes the hospice will take on new grads. Thank you, you make such a difference to people's lives and the passing of their family member. Take care and good luck to you.

grbrico · May 27, 2009

LOL... sure... I can give this a whirl.

Call report line from home.. because I dont have time to sit at the office... because I just a call that my pt has died. jump into my clothes I laid out the night before, my hair is wringing wet... grab the phone, the laptop the portable computer, oh yes... dont forget my meds.

Pop in the car.. plug in the rear jack... the computer in the front jack the GPS system that will not freakin hold a charge. tether blackberry phone to computer upload the pt from the computer data base.. because it wasn't my pt... I forogot.. Im on call.. and it was my partners pt...lol

Call the family.. tell them I am on my way. When I hang up... I call my PCC and tell her that I am headed to a death, but could she pick up the green script from the doctors office for me. Since this death I am heading to is at the same facility that I will be seeing another pt I scan my previous visit notes and get them ready to print because my printer only works in the car with radio going my arm hanging outside the window... chewing bubblegum... and humming... work dammit work... or your roadkill" Afterseveral tries... I get one note printed.

Arrive at the house 1 our later (yes we live out in the boon docks.... our response times sucks... and we can't tell them where we are coming from..LOL but I will be there... the corpse might walk out on his own... but we will be there.

I get there, the family is now half drunk and crying. I locate the body do the assessment and do the pronouncement. There is usually one person at this point who didn't think that the blue color that granny was, was actually death, so she faints while boyfreind catches her. Get the body bathed with the help of NO ONE and dress her in a 4 piece suit.. because they do not understand the process of embalming at this point. We have a conversation about sending pt in pajamas or hospital gown so the facility can access her more easily. Nope... Granny isn't going out of the house without panties, girdle, bra, slip frilly shirt, too tight skirt and buckled shoes that no one thought to do slippers or let her go barefoot since her feet are contractured.. and can't wear the shoes... However... the shoes go anyway...

Get the Funeral Home there... which you have time since Billy BoBo had to go pick up his Auntie Maude and bring her to the dyin. At this time, I gather meds with the family to destroy, and to finish up the death report. There are arguments as to what Granny HaHa will be named on the death certificate, and then an all out brawl breaks out as to who will sign the death certificate as if they were getting the last will and testament read to them.

The funeral home comes, I call the doc, talk with the family some more, decline the ash topped cake Ms. Flo made while I was there and head back to my car to document and move on to my next patient.

Get to next pt, Granny poo poo has been sippin on hubby's Lactolose, and now can't quit pooping and she can't get off the toiliet to help her own hubby to the toliet and he is mad at her cause he had a boo boo with the poopoo in the bed.

His pain is fine, but his wife's bootie isn't. I go get her some of her own metamucil to take instead of the pt medication.

Off to the next patient who has just pulled out his foley. Replace it, also replace the nasal cannula he is using like a lasoo to grab things off the kitchen counter when his wife isn't looking. He has a nice stash of little debbie snack cakes hid in the couch and wife wondered why his blood sugar was 442 today. Teach on diabetes and the importance of keeping healthy snacks available for the patient and not having little debbie influence him any more.

Call results into Dr. New Orders, call the pharmacy profile meds, and call other pharmacy to have medications waiting to be picked up. and deliver back out to them.

Receive a call from the PCC, could I go (1 hour away) and see another pt they had fallen and gotten a skin tear and their nurse is tied up in a death right now...

Sure thing... teather up the blackberry pull in the pt drive 1.3 hours yep... skin tear... just enough for one bandaid. Nero's intact no other problems note... but wait.... they needs meds refilled. Call those in and get them filled ask if family can pick them up... but no.. we can't leave poppy.... so off we go pick up meds and take them back. My day is gone... no time to go back to office for paperwork and still didn't get to see two of my patients today.

Call directly to nurse oncall because I have missed my call in report time... tell her about 2 routine visits that need to be made today... because... I wont be able to push them later in the week.. because I am already seeing 8 pts a day. I typcially drive.... 2-300 miles a day I get a whopper of a mileage check but wait... Im still oncall tonight... dear lord... I will never sleep again......

I didn't put in the drug diversion, the name calling, the crying on my partners arms, and falling fast asleep in my husbands arms... oops...

I forgot to see my kids today...

Well... I can push that to tomorrow....

I know... it sounded a bit crazy... and I am not burnt out... honestly most of my days are lke that but we have to throw management into it, and a few staff meetings once a week which is two towns over from where I live... and OH NO....

They are changing the documentation system from PTCT to McKesson.... go live in 5 days... did you get your training in? Well... do the best you can.

OMG.... Renee.... did your brain fall out of your head... but that back in your head... and get back in the car woman.....lol

dcgrrl, ASN, RN · Jun 1, 2009

LOL... sure... I can give this a whirl.
OMG.... Renee.... did your brain fall out of your head... but that back in your head... and get back in the car woman.....lol

Thanks for providing so much insight into a day in the life of a hospice nurse. I'm glad to know you also have a since of humor and love your job!

siouxsieyq, BSN, LPN, RN · Aug 7, 2009

No it is not ok to tape an alcohol pad to the skin tear on the little ladies forearm and call it a dressing. SNF's, please don't order CBC's, CMP's Chest Xrays etc on my actively dying patient who is mottled from her toes to her knees just because her O2 sats have dropped to 89 and she has a cough... No, wound consultant for the SNF's corporate, I do not think it is a good idea to debried an intact heel eschar, nor do I think it is appropriate to attempt to debried dry shriveled gangrenous toes. All this and none of these are the patients I am scheduled to see today, 2 hour long IDT meetings, Clinical staff meetings, computer system upgrades, inservices to keep the Snf's and RCFE's in compliance. But then a family member tells you with tears in their eyes how much they appreciate all you have done, and your favorite patient sings to you when you walk in her room and you realize why you do it

Itshamrtym · Aug 24, 2009

Thank you for sharing!!!!!!!!!

annacnatorn · Apr 12, 2010

the typical day of a Lead CNA, I felt that this needed to be shared, as I too work in Hospice..and love it, I live it.

Wake up 5 am. Out the Door at 6. Drive and eat at the same time..oh crap, forgot the special delivery at home, go back to get it. See 2 patients, then get called by office for emergency IDT or some sort of stupid mandatory meeting. Go to office, Drive 30 miles, to be told that Next Friday is Admin/DON B-day or special inservice (um, you can't tell me this on the phone?) Oh yah, have to wait 30 for meeting to start because so in so is not yet there..but is running late. Start out the door with "Important Info in mind" then get to car, crap need gas, go get gas, Office calls, you need to come back to office to pick up supplies for a patient that called yesterday, urgh, go back and ask them why they did not tell you when you were there, they said sorry I forgot..urgh again.. call next Family, go there, discover patient is actively dying, call office, they say case manager is out of office (its lunch time...Im hungry as well,) call directly on cell, no answer, call another RN who answers, Its not my patient, call so in so...URgh...call them, Pts family is crying because Mommas breathing is stroking, Calm them down, tell them to talk to her, sing to her, love her, Finally get ahold of an RN, the DON and they yell at me for not calling soon enough...um..meeting..just got here, u did not answer your phone. Ok, they are on their way...(get a text, getting coffee, u want some..I reply NO..get here NOW) they arrive, Patient has already expired, I am trying to and manage to calm Family down..Time to do paper work with RN...wait for Funeral home to arrive while getting Patient cleaned, Funeral home arrives, I leave. Ok, now that it 4 pm, I am hungry, grab a snack in my car, call next patient, go there all is well, call next patient, Family says Hurry, somethings wrong, Dads not talking and his lips are Blue...OOY..call office, report family concerns, they say well go there and call us with report, (I ask to speak to supervisor/don, gone for the day, I ask who is on call, oh great the one who does nothing and then get informed that I am back up...WHAT?) Call the one who does nothing, says call me when you get there, it takes me 30 min due to traffice, O2 was disconnected, reconnected tubing to concentrator, call nurse (used lightly) took v/s...pt began doing better. Family at ease but wants me to stay for a few hours, its now 6pm (no lunch, no peepee) ask if I can use restroom, relief finally. Go back to check on patient..OMG..#2 for the day? can't be..can it? take v/s yep...take pulse ox...yep, check concentrator, all good with machine, look at feet..purple, blood pooling, finger nails purple. Pray. Call Nurse to report sudden change, she tells me to monitor patient for 3 hours and report back, Nope, I call Administrator (who loves me) Report Pts condition of course not in direct hearing of family, then receive call from DON, she is on her way, reassures me all is ok, tells me what to do and how, step by step, it takes her 2 hours to get there, freeway closed due to rainy accident, Patient expired 1 hour before her arrival. Take care of Family, and patient. Call Mort when Nurse Arrives, assist with all med disposal.....go home. Its now 10 pm. No dinner, Children in Bed, Hubby in Bed, take a shower, put on sweats, start to cry, head to beach, cry some more, get rained on while at the beach, come back home, 1 am, take another shower. Get called to go out at 3 am......then I realize, I'm hungry, nothing is open. Thankfully I keep meal replacement bars in my car. Shut, I didnt do my paperwork for the day, oh well, I guess another write up is coming, but I dont care. My Families are happy with me, but some people in the office hate it when my paper work is late, (I dont have a 9-5 desk job in one place lady..sorry)

Some days are just run of the mill days, nothing big. work gets done.charting gets done, others are not that simple.

Do I LOVE it, YES, do I live for it, Yes. By the way, I still keep in contact with all my Patients Families, they have become part of my family, I would not trade my job for the world.

A day in the life of a CNA.

Bubbles · Apr 19, 2010

With my best hospice employer my day as an RN case manager usually started with everyone calling in at 8:15 AM to get the morning report from the on call nurse. Usually called before visits to confirm before starting out for the day. This employer provided cell phones so was always just a phone call away from other members of hospice team. When situations arose my PCM (patient care manager) would help from the office. Patient load usually 10 to 13 patients. Finished up paper work after returned home. Charting very important and time consuming. Every day different. Usually went to office once or twice a week to attend meetings, get supplies, and turn in paperwork. Lots of autonomy and lots of rewards.

Suninmyheart · May 2, 2010

I am so excited. I have an interview with a wonderful Hospice Agency in two days. I now have 2 1/2 years experience on a cardiac progressive care unit in a major hospital and I am ready to make a move toward where my heart and passion really lie.

I am interested in either an extended care position working evenings nights weekends which I dont mnd, or working M-F days as a case manager RN. Any thoughts on the different experiences of these 2 roles?

Kind regards, Lisa

ertrek84 · May 13, 2010

What is a typical day for a Hospice RN that works in the Hospice, not doing house calls?