Day in the life of a hospice nurse

ppav01 · May 15, 2010

I would like to add that being a hospice nurse is not all about the assessment and just being a nurse. there are many people that make up the team for hospice and with that, us as nurses have to know when it is time to ask for help. I know this is hard. but as nurses we are the maybe 20% for the patient and 80% for family. Usually it is the patient who is ready at the end of life, but it is the family who does not accept it. Hopsice nursing is a great profession and that is why I will continue. But there are times as all jobs it is trying and you have to be sure it is the nitch for you

sas15 · Jul 8, 2010

Awesome!!!! That sounds like a typical day where I work, too!! Are you from TN? LOL.

eternalsunshine · Feb 9, 2011

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

I would be really interested to hear about this too. Just moved to Florida from the UK where I was a Hospice Nurse but I was based full time in the Hospice Facility.

Can you tell me what the job title is called of RN's who are based solely in the Hospice working?

Thank you in advance :)

Baubo516, RN · Mar 6, 2011

A question for those who wrote about being on call - how often are you on call if you are a visiting hospice nurse?

grdmdb · May 7, 2011

i find the patient care and home visit to be a wonderful experience. it is calling dr's 3 and 4 times , pharmacies, charting that never ends and documentation that is for the jury in mind as well as check off boxes and naratives and 485s and updates and on and on.. i spend a full day in the field and then chart another 2 to 4 hrs a night- not sure if this is typical

tewdles, RN · May 10, 2011

i find the patient care and home visit to be a wonderful experience. it is calling dr's 3 and 4 times , pharmacies, charting that never ends and documentation that is for the jury in mind as well as check off boxes and naratives and 485s and updates and on and on.. i spend a full day in the field and then chart another 2 to 4 hrs a night- not sure if this is typical

We do not use 485s. Documentation should occur during the visit or directly after...if you are charting at home at night something is not right. It is common to have to phone a physician more than once/day if you have multiple patient visits requiring medical collaboration. Most of the time they are VERY responsive to hospice calls...if they are not, call your medical director. Make sure to gather all of your data for a patient first, THEN call the doc, best not to call them more than once during a visit about the same patient. Sometimes I speak with the same doc several times over the course of the day about different people with different issues.

If you are documenting the same information in multiple places your workload is needlessly increased and you are less efficient than you could be. Your employer would benefit from critically examining those forms and processes to find ways to improve them.

meljam · Sep 19, 2011

Wren is exactly right, if you dont have support from your team leader then it makes for a very long unpleasant day. I started working for Hospice in May and unfortunately I feel I have NOT had the proper training or support. I had 2 weeks of riding with another nurse to see how to work with family and pt's. Although I have been a nurse for 5 years, I know how to assess and treat my patient.

We have computer charting and Nobody has taken the time to inservice or train me on several issues that arise.

The other nurses on my team have been wonderful and very helpful in showing me what form or what I need to complete my charting in certain circumstances, but then again they have had to learn on their own as well.

Team leaders should be the backbone of the team, support, assist, and teaching any and all new nurses.

tewdles, RN · Sep 19, 2011

Meljam, take your computer and stop by your team leader's office, ask her/him to help you.

meljam · Sep 19, 2011

Unfortunately that has been tried, and they never seem to have the time when I'm needing questions answered

tewdles, RN · Sep 20, 2011

I am sorry to say that you might want to look for a different employer, one that is more supportive. Field nursing is hard and the absence of clinical support only makes it harder.

Good luck.

TheRootler · Sep 29, 2011

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

I am a RN working at our hospice's hospice house and do not normally do house calls. Our house is split into two units, general inpatient and residential. There are 10 beds on each unit. A typical day for me looks something like this when I work day shift: I get into work around 6:45am and check which unit I am assigned to. If I am on the GIP unit I head over and get a detailed report from the midnight nurse regarding the status of each patient, their disease progress, family issues, and general health. We then go and count each patients' narcotics (kept in their bathroom in a lockbox) and briefly observe the patient. I check their meds with the kardex and do an overview of the meds they will receive that shift. Next, I perform a head to toe assessment with a focus placed on the pain assessment, skin assessment, any signs of anxiety or restlessness, respiratory, and anything related to their diagnosis (lung ca --> lungs and breathing, colon or and GI ca --> bowel sounds, distention, tenderness, etc). Typically, at least one patient has some sort of need or change in medication. I address these issues as best as I can and decide what I need to bring up to the physician or the NP. If the needs are serious (i.e. increased pain that cannot be treated due to frequency of pain medication or lack of medication order) I make a call to the physician to get a one time dose order, medication order change, or whatever they deem necessary. The NP comes to the unit by 9am and the physician arrives shortly after. I give them an update on each patient, and inform them of any changes in status or needs. The rest of my day is composed of passing medications, general care you would see in the hospital, etc. Patient education is a large part of job as it is in the home. Much of what we do on the GIP includes some sort of education. Family education often finds itself to become even more important especially toward the end of a patient's disease progress--educating on pain, medications, anxiety, and the signs of progressing disease and what to expect at the end of life. Emotional and family support becomes a large part of what I do on a daily basis as well. Depending on the patients on the unit there may also be discharges and the RN on the floor takes the lead on the admissions that come in to the unit as well. I also participate as the RN in interdisciplinary team (IDT) meetings once a week when I work days. Each day is different and there are several variations of the day listed above. The residential unit is generally the same but more similar to a "nursing home" without being a nursing home.

Hopefully this helps!

JuiceRN · Feb 13, 2012

Team Leaders are a myth! In my agency, I've seen the Team Secretary provide more support the our TL could ever in her entire Nursing career. Sad, but true.