Is Hospice nursing "easier"?

[mgrenwic]

Hello,

I was recently accepted to nursing school and have turned my focus to where I might want to work after school.

I was wondering if Hospice nursing is "easier" in a sense. I think this b/c you know what to expect in terms of the patients status. I would assume is some way the anxiety/worry that a patient could pass on your shift is cut because it is somewhat expected.

I like the idea of getting to spend "real" time with the patients.

I like the idea of helping someone at that pivotal time in their life and striving to do what you can to make this event as good as it can be.

Thanks.

[RNbellashadow]

I think it is very hard. You have very sick patients with a lot of medical needs. The family issues can be very difficult. In some hospices, you will be transfusing blood, running IVs, drawing labs, sinking NG tubes, etc.... You will be calling docs for orders. There is lots of patient/family education.

[westieluv]

Granted it's going to depend on your company, but some of the posters with out of the norm experiences, not every hospice is run the same. For example for our on call, we would not go to a patient's home after hours for incontinence, the family is the primary caregiver so it's their responsibility of taking care of that patient when we aren't there including cleaning their loved one up if they are incontinent. We do not go out on call for anything other than emergencies which are foley cath issues (however if it's a matter that it came out and pt can still void around it, we instruct to place towels and someone will be out in the morning) for pain and sob we instruct how to use the meds that come in their e kit. If there's no resolution we may go out and then likely admit the pt to one of our in patient units. We go out to pronounce as well. We trouble shoot as much as possible over the phone. We do take turns triaging the calls but we also have a really good system and you're never alone, there's always someone else to call if need be. Even on the weekends we are stacked with others and we're more back up to the regular weekend crew.

It's part of our teaching when we bring someone one to tell the family not to disappear when the aide comes to do the bath etc...that the family needs to learn how to care for them because we are not going to be there when they have that huge BM and they need to know how to handle it. We know we're doing our job when the family is able to handle things (for the most part) on their own on the weekends. The job is very rewarding because you are teaching the family how to care for their loved one at a most intimate time in their lives.

Right, and our case managers did a phenomenal job of teaching patients and their families, so it wasn't like families were calling us just for incontinence issues, which is the impression that I think you are getting from what I said. Our policy was to go whenever a family called and said that they needed help. Of course we would attempt to triage over the phone first, but for those times when families just feel overwhelmed and want a competent, calming presence, I think it is very important for a hospice company to be able to provide that, even if the circumstances don't seem critical to us.

In the example that I cited, that patient was a very old school, European-born lady who had always been the iron glove in her household. She also had very strong ideas about personal dignity and allowing "strangers" to see her out of formal attire. It wasn't that the CM didn't do good teaching, it was that the patient was very stubborn and would not allow herself to be cared for completely by anyone outside of her family until she was essentially dying. It was a cultural thing, and I understood and made the visit because it was the right thing to do.

I apologize for not explaining the entire situation clearly.