Hi...I spent 2 years as an on call nurse before I moved into a primary nursing role with hospice. It was also 7 on and 7 off. My hours were 4:30pm to 8a. My coverage area was huge, and I was responsible for symptom/death/admission visits. I was also called to confirm continuation of extended care presence.
It was a difficult transition from med/surg and ltc nursing. The travel, the elements, the critical thinking, emotional support needed while at the same time learning hospice philosophy and resources was very challenging. I learned a tremendous amount, but at the cost of dreading the sound of the ring tone on my cell phone
. We rarely ever had a fully staffed team, but everyone went way beyond what was expected of them.
My advice is to be extremely organized. Make a list of common terminal diagnoses: CHF, COPD, CA, Dementia, ALS, Renal, Liver, etc., and review common symptoms and common symptom management. Become familiar with what is needed to get meds from a particular pharmacy, how to send patient to an inpatient unit (if that is advised and families are willing), how to initiate continuous care. how to provide non-pharmacological interventions, and providing emotional support/education. Review your practical skills: changing dressings, catheter placements, etc. Review caring for an actively dying patient. Much of this you probably already know, but it makes things somewhat smoother if you have some kind of a outline to guide you in your head.
I would often know the name, age, sex, dx, problem, doc, current medcations, and length of stay with hospice on my way to the home/facility. I would use my drive time to consider possible interventions before I walked in. Caution though...be open to nothing being what you necessarily expected when you get there =).
Hope this helps. I know this is just scratching the surface. If you have any specific questions feel free to message me. Following a year in primary nursing for hospice, I spent another 2 years on the Admission team, which is what I am doing now. So, I may be able to help if there is an admission piece to your role afterall.