Hello, I am a new Hospice nurse. I just started my new position about and month and a half ago. I really like the company I work for, I love everyone there! They are so encouraging and caring and I feel very supported!
At this time I have one patient of my own, I am admitting another tomorrow and I am covering for another nurse seeing her two patients. I am a little nervous about having 4 patients, even for just 2 weeks. But what I am really struggling with is the feeling of responsibility.
I tend to feel like I am responsible for these people 24 hours a day. I know in my head that this is not true, I have my set days of the week, and after 5 we have an on call person until 8 am and on weekends as well. But when one of my guys is having problems, (a stomach virus) and starting on a new medication I find myself thinking about him all the time. I wonder if he is doing okay, I feel like I am the only one watching out for him. I KNOW this isn't true, he is in an assisted living facility, so he has a med aid and a resident aide, but I am trying to get a feeling for how much of him is MY responsibility. Am I just there to manage the end of life issues and symptoms or am I there to manage the whole thing????
We see our patients twice a week, and manage the medications related to their hospice diagnoses, medical issues etc.
I guess this is just such a change from being on 12 hours and then going home and not thinking about your patients or your day. Does anyone have any advice on how to separate yourself after hours, not feel overwhelmed with responsibility etc.?
Nov 16, '11
I think this is a pretty normal feeling. You are responsible for your pt's during your working time, but not when you are off. However, if your pts are well managed, you will find they have minimal night and weekend needs. Good luck.
Nov 17, '11
one of the hardest challenges a new hospice nurse has, is creating boundaries w/his/her pts.
for many of us, it feels like a privilege to care for dying pts, and sometimes we can even feel a tad possessive.
not saying this is your dilemma, but nevertheless, you have to learn when/how to let go.
otherwise, you'll burn out far too soon...which won't benefit anyone.
you'll be fine.
try to keep it in perspective.
Nov 17, '11
You have to set boundaries out you will burn out. You will be a better nurse to all of your patients for a much longer time if you can find the balance to turn it off and have your down time. I work with a Chaplin that has taught me that "God will put the right person in the right place at the right time... And it may not be you."
Nov 18, '11
I had the same problem when I first started hospice nursing. I was "talked to" several times by both my DON and MSW about setting boundaries. Another poster mentioned burn out if you don't. That's true! I eventually got better about that, but it took some time.
Still today, 12 years later, I get really attached to some pts. Some people just have the ability to reach out and grab your heart strings.
Give it some time and work on your boundary issues. Good luck!
Nov 18, '11
Just remember there will always be crisis. It is how you deal with those crisis. If you believe in a higher power, and being in hospice I am sure you do or you wouldn't pick that challenging field, know that your "ultimate boss" will give you directions. Your patients are in "her" or "his" hands, you are only an instrument of her guidance. Please take care of yourself. You are doing great work.
Nov 22, '11
Thank you all for your encouragement! I am really trying to put it all out of my head at 5 pm! But it is difficult. I find I am feeling a tad overwhelmed with all the needs. The labs to follow up on and doctors to contact re: this med and that med and that antibiotic, and that patient who hasn't pooped for 4 days and the new admission and all the parts of that and coordinating medical equipment and on and on! I am wondering how you all keep these things organized. I am trying to make notes for everything and to do notes, but it is difficult to manage all of this! Does it get better? I just feel so drained right now.....
Nov 26, '11
just remember you are human. you will make mistakes, and you will learn from them. you already know the outcome of this pt and you need to be sure your ok with that. this isnt the ER where they might get up and walk away, it can happen in hospice but it is very very rare. give it some time and see how you feel in 6 months about hospice. sometimes you think its what you want but its more then you can handle. death does strange things to people, even the caregivers. and if you cant handle the caregiving, maybe the paperwork or support staff end of it is for you. and there is nothing wrong with that. add in this is around the holidays and your dealing with people loosing loved ones, its not easy. fallow your heart, if you want to take 5 minutes at the end of the day to check on your pt, do so. just dont quit your life to manage thier end of life. i hope i dont upset you, nov. and dec. are alway hard months for me too.
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