I've just accepted a home hospice RN position with my current health system. Hospice has always been something I've been interested in, even when I was an LPN. (RN now for 1 year, just finished a year of Med/Surg)
I have a fairly good idea what the job entails (case management etc.) but was wondering:
What, in your mind, makes a great hospice nurse, and separates the great ones from the simply adequate ones?
There are a few things that help your patients and their families to have positive experience. First, don't promise anything that you can't personally deliver on. If it's not up to you, don't promise. Be honest about what you and hospice can and cannot do. Second, check meds at every visit and order any refills needed. If you wait for them to tell you, they will be calling after hours and on the weekend. Third, educate. The patient and family need to know what's coming. They need to know what changes will occur. When they don't know what's coming, they panic needlessly. That doesn't do anyone any good. They need to know which things they can and should do something about (and what to do) and which are natural and do not cause discomfort. Don't make the mistake of educating once and figuring they'll remember. They won't. Educate again, and again, and again. Finally, don't rush. Things will come more naturally and will take less time as you gain experience. That being said, don't rush a visit. Even when you feel rushed and are trying to get out as quickly as possible, take a breath and focus on what's in front of you. The patient and their family deserve your best.
In my opinion what seperates great hospice nurses from adequate (and sometimes not even that) are empathy, boundaries, self-care and desire to work with patients and families (families-as defined by the patient are part of the care in hospice) who are facing a life limiting illness knowing you will not be "fixing" them. Empathy is key, it seems obvious to say this but I have worked with many nurses who lack this or lost it and it is needed for this very difficult type of nursing care. Boundaries are important b/c families become attached, sometimes dependant and you need to learn to manage that. Self-care is one of the most important items for any nurse and especially a hospice nurse. You need to process the situations you see, the loss you experience. Again most of this sounds obvious but you'd be surprised...good luck and welcome to an amazing profession!