question while studying....

Specialties Hospice

Published

Hi...Taking the exam in two weeks. Not really stressing out about it because I have been very ill for several months, and had forgotten I signed up for this exam before I could no longer work due to this illness. I am feeling a tad better, enough to sit through the exam, and since I paid for it, I am going to give it a shot, no worries. I've had a bit of experience, certainly not enough to say I can pass, but I will take it, combine my EOL and hospice experience with my general nursing experience and we will see how it goes. I won't drive off a bridge if I don't pass, that is for sure, It is an achievement for me to be able to sit up long enough to take it, so hurray for me!!! I've already won.

Anyway, since I am not hitting the books hard, I find myself going off on tangents a bit while looking at the material. I was wondering about Hospice nursing in the various care settings. Home care, of course, that was where I had most of my hospice experience, and long term care as well. In these settings, the hospice nurse manages the plan of care for the most part. Any conflicts between facility nursing and the hospice set plan of care are resolved in favor of the hospice nurse, she more or less "runs the show" so to speak, and is considered the primary nurse, and delivers care along with pt/familly and others of the IDT.

My question is in hospitals...acute care facilities. How is this different from a hospice agency going into an LTC and setting protocols? I can imagine they aren't as "warmly accepted" as in LTCs, when they waltz into an ICU and declare that a family of 20 can most certainly come into this patients room because that's their wishes? how is conflict resolved between staffing in this case? I guess if an agency has worked with a particular ICU and good rapport has been developed it can work. But ICU nurses and hospice nurses are both rather strong willed. I know we don't claim to own our patients but giving up control/responsibility like that? that has to cause some bad juju along the line?

thanks for the replies, just musing....

Specializes in Currently: Certified School Nurse.

Hope you feel better and ace your exam! Very best of luck to you!

OT a bit....Which certification is this for? New to this but aren't there two diff ones for hospice nurses? Which one is the 'gold standard'? What book are you studying from?

thank you very much!

oh sorry...thought I was in a particular thread for it...I am taking the CHPN exam, using the book from the HPNA...thanks!

I've never seen a hospice patient in an ICU. One the decision is made to place the patient on hospice, those interventions are no longer needed and the patient is moved to a general floor where he receives comfort care only. My hospice does have some GIP beds in local hospitals. I have never seen a disagreement as to care for these patients with hospital staff however.

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