I'm a RN who has worked in hospitals and acute-care settings for years. It was always too many patients, not enough help/support. I began to feel anxious about going in each evening feeling that the license for which I worked so hard to achieve was on the line. I would leave in the a.m. (usually well after my shift end time to catch up on all of the charting, reporting, etc) and feel that I did what I could but it did not meet my goals for optimal patient comfort - actually it barely met my minimum. My prayer used to be simply that I did nothing unknowingly to hurt anyone during my shift and that no one would die on 'my watch'. Although I was well liked and my reviews strong, I still felt that I was being held back as a nurse and as a person wanting to give my loving care to others and not being given the possibility of doing so. The acuity of the patients gaining admission to hospitals was higher - much higher - and the staffing was unsafe and unrealistic. I went into nursing so I could make a difference and this did not feel like making a difference...it felt like shift-to-shift survival.
As I was losing my 'sparkle' as a nurse, friends and family began to notice. One of my friends was a nurse working in a completely different field than hospital nursing...it was Hospice/Palliative Care. I had some exposure to this field during a clinical orientation 10 years or so previously. I remembered that experience as being one of the most loving nursing environments I had ever witnessed. When my friend told me about a position with a Palliative Care, I thought I'd look into it. What I found amazed me and disintegrated all of the hospice 'myths' that I'd heard. Hospice was not about giving up hope - it was about regaining hope for a better quality of life for however long that was. It was not about speeding the dying process along...in fact, we 'graduate' patients from hospice when they do not meet the requirements for this specialized level of care (and most times it is due to our skilled interventions and PT/OT, Registered Dietician interventions). Hospice is not a place, it is a philosophy of care. Hospice and Palliative care teams go to hospital ICUs, SNFs, ALRs, and most times to our patient's homes.
Once I glimpsed the difference of how nurses were viewed in this discipline I was ready to begin my journey. I was given extensive orientation to this field while working on the Inpatient Care Center (kind of like the ICU in a hospital. Available for high level/acute issues until effectively managed). The Medical Director was one of the finest and most patient instructors I've ever had. He appreciated my strong clinical skills, explained to me how to approach specific symptoms and educated me on the pathophysiology of many disease processes. He championed all nurses in our organization to be honest with our patients in our assessments, to be prepared to consult with the Physicians as an equal member of our team and to always advocate for our patients who many times could not advocate for themselves. I was blown-away! I had time to sit with a distressed patient and really assess what was going on but not just from a physical standpoint...from an emotional, spiritual, and relationship point of view as well. I had Counselors, Chaplains, C.N.A.s, dieticians, PT/OTs/RTs - all which were available to me and my patients around the clock and which were just as involved in the care of the patient and familiy. It was a loving, caring, compassionate embrace of the care team, by the care team (which includes MD, RN, MSW, Chaplain, C.N.A., Volunteers and ancillary staff i.e., pharmacy, DME supplier, dietician, massage therapy, etc). I worked on the Care Center for a while and loved it. Then I decided to move to having my own patient load in Home Care settings and I really loved it! My kids got busier as they got closer to their teens and I went to After Hours (Nights).
Our family moved a few years ago and I asked my Nursing Educator which was the best hospice to work for (there were about 18 small and larger hospices at the time). Without missing a beat, she told me that XXX Hospice was strongest in their care commitment and support of patients and employees as she had worked with them on several hospice-improvement projects. I visited their website and filled out an application. Within a few weeks, I was hired on as an After Hours RN. Even with a fair amount of hospice nurse experience under my belt, XXX Hospice provided me with more than ample orientation (it was really the paperwork/processes I needed a leg-up on and by the beginning of month TWO of orientation, I was antsy to get out on my own...never had THAT experience in the hospitals when orienting to a new unit, I'll tell you!). I've been working at there for over 2 years and I've never been happier in my nursing career. I am treated very well, with benefits and compensation that are well above anything the hospitals could offer. But most importantly, I am supported. Everyone looks out for one another. I know that sounds corny, but it is true and it makes my heart sing. I know now that death is not failure, that it is a part of life part and a journey each of us will eventually make. I know that relationships define us and are all that matter when life is winding down. And I've learned that it's OK to care about patients and their families and sometimes that's the price of being human and being a nurse and that I'm willing to pay that price in exchange for the uncountable blessings I receive each day I work in this field.
Thank you for reading my thread. I hope to hear from those who felt a tug at their own nurse-heart strings.
