A few questions for hospice nurses..........

Hospice case manager - yep, it's a good place to start as you'll learn all of the Medicare hospice benefit do's and don'ts. I don't wear scrubs I wear casual dress clothes (blouse/sweater and slacks...no jeans, no tennis shoes, sleeves that you can roll UP and which will STAY UP!!) The reason why you may hear that hospice work is 'stressful' is not so much the physical aspects of the job (I don't do a whole lot of lifting as a hospice nurse - not nearly as much as when I worked in hospital settings) it's the emotional component that can weigh heavy on your heart. For me it's the pediatric patients that are around the same age as my own angels, or the infants who we care for from time to time. That's the part that can be tough to move past. That is also the reason why Hospice work really emphasizes that nurses have a plan for taking care of themselves so they stay healthy, emotionally and physically. It's not the dream nursing career for everyone and you'll know within the first year if this is where you are meant to be or not. It's OK if it's not...nurses are needed in so many different care environments. But it just might be your calling and if it is - well, you'll know.

It is a very rewarding job for those who love itand as said can be emotionally difficult. Some nurses burn out quickly when they become too close to a patient and give so much of themselves. I wear scrubs because they wear well, are loose and comfortable and I don't wear out my clothes. Also if body fluids touch them they can be washed more aggressively. Sometimes it can be physically challenging if the patient has a difficult wound or many wounds to dress or is very large. One great aspect is that you spend one on one time with one patient at a time, and care for the whole patient. It is the type of work that you either love or don't like to do and I think we are special people.

Good luck. Some hospices have a pediatric component, many do not. My hospice does have a team that cares for peds patients only. The rest of us provide the adult care which is primarily but not exclusively the medicare hospice benefit. You can do hospice for an agency...there are hospices that need to hire temp nurses for a variety of reasons (sometimes because they are just bad employers and can't keep staff)...the hospice professionals working in that way love it, but all of them I have met have been working in hospice for some time so the organizational differences are not problematic for them. The question of scrubs vs street clothes is generally a personal choice although I did work for a hospice that required ALL field nurses and the HHA to wear navy blue scrubs, the therapies, MSW, and clergy wore street clothes. I personally use a combination...dependent upon my anticipated day. It is a good idea to keep a change of clothes in your trunk regardless of your choice of attire. You just never know what kind of stuff is going to get on your clothes!
Case management and staff management are two completely different animals! If you opt for the staff management job make sure that your organization supports you with management seminars and resources. You may well be a "born leader" but there are tricks to the trade that will help you to be more successful. Regarding the stress...it really comes from a variety of places...of course some will find it very sad that all of their patients die and this can be stressful, demanding and grieving families can be very stressful, demanding and reactive management can be stressful. the very nature of the job is stressful. Driving, visiting sad and hurting people, driving, visiting angry family members, driving, providing postmortem care, driving. There is an acronym for our experience...HALT...Hungry, Angry, Lonely, Tired. Trust me, if you work for a hospice agency that requires significant oncall time for the case nurses you WILL be tired. I have not shared these things with you to scare you...rather, I want you to be informed, so that you can be successful. We need more excellent, committed nursing professionals in hospice...in all capacities.