To be a Hospice Nurse?

  1. Hello everyone,
    My name is Kelly and at 42 I am just completing my first Med-Surg rotation in Nursing School. I have worked as an Administrative Assistant developing training materials for Sedation Analgesia and served on Committees within my hospital for Pain Management as well as being a Medical Biller for several years before the Admin Asst position. The business end of medicine is not the route that is fulfilling for me, hence going back to school for Nursing.
    I was wondering if some of you would share your experience/reasoning for specializing in Hospice?
    Like many peoplemy age, I have had a couple of experiences with friends and family that have passed and gratefully had the assistance of Hospice to care for them.
    I lost my brother in law last week and Hospice was a godsend. I was able to take care of him the last two months working around my lecture and clinicals. He taught me more in two months than I think I have learned in the last two years, medically and about the human spirit. He had me working along side his Nursing team to learn about caring for patients (He had bone cancer and it was eating away his jaw bone) and I had the privilege to care for him round the clock along with my sister in law. I also ran into the frustrations of MDs who are reluctant to alter treatment options without readmitting him,which he refused to do. We then found the MD that cared for him until his death and WOW, what a difference for Bill. Between his MD and especially his Nurses Bill was able to keep his spirits up until three days before his death. The Nurses would come into the house and Bill was not treated the way I have seen patients treated in hospitals, but like a friend that they cared for and could talk to about anything.
    This is where I think that I want to go with my nursing career. I like to get to know my patients, talk to them. Why is it that the interaction seems to be downplayed? I enjoy the medical science of what I am learning, but really want the interaction that I have seen with the Hospice Nurses. Dying is a part living, and looking to cure people is not the end all and be all of how I see Nursing.
    If I can help someone to know that they have someone outside of their family helping and caring for them so that they may keep as much of their dignity as humanly possible until their time to pass comes, I think I will have accomplished, physically and emotionally what I think Nursing should be about.
    Am I not thinking about this in the right way?
    At 42 (44 when complete Nursing School) I am trying to figure out is this is what I am really looking for.
    I have been working in hospitals in different capacities for the last 20 years. I like to observe the workings and interactions with patients and staff, but it seems to me that we never get a chance to get to know the patient and family well enough to help them beyond the physiology of their disease. I want more......am I looking into the right specialty in Hospice?

    Thanks,
    Kelly
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  2. 6 Comments

  3. by   leslie :-D
    yes, kelly.
    you are definitely in the right specialty.
    home health, long term care, are other specialties where you get to know your patients and their families.
    but if it's the body, mind and spirit, that interests you, hospice is the place to be.
    you will be treating every aspect of your pt's body/pathophys, mind and soul.
    it's a nsg specialty that just doesn't get any more intimate (except perhaps, l/d).
    you will be automatically embraced as a part of the family, yet a lot will also be taken out on you.
    when you can recognize the raw, human emotions for what they are, you take very little personally.

    death is a part of life, and you will find that life is a part of death.
    preparing your pt in transition to the afterlife, is a privilege.
    you will witness events that you will probably never share with another person.
    hospice can and likely will, change your life.

    wishing you only the best.

    leslie
  4. by   RntobeKelly
    Thank you!
    I understand your note about having things taken out on you. The day before Bill passed his neck tumor was pushing on his trach and we were unable to clear the secretions. It seemed he was literally choking to death. We asked the doctors about what could be done to keep him sedated until the end so that he would not be aware of what was going on. They told us there were no other meds that could be given for sedation short of gen anes. Bill was on 60 mg of Dilaudid and 45 mg Ativan hourly IV for the last 48 hours of his life, and while I understand that with the Ativan he was not remembering the episodes, it was very hard to watch. As a result I took out some of my frustration on his MD until the Anesthesiologist came and explained to us that even though he felt the episodes, as soon as they stopped he would forget them, and that it was as good as medicine was able to do for him. I will be writing an apoligy letter to his MD. I know that when the end is near the frustration is high and it is not personal.
    That withstanding, Hospice ensured that Bill received everything he needed to stay at home as long as he could, and if not for the choking episodes, which we could not treat as well at home as in the hospital, he would have received his wish to die in relative comfort at home. Some of his RNs came to the funeral home and being able to talk to them about what they did for him and how much he, and we, appreciated them was a great comfort to us.
    I thank you for your note. What certifications beyond RN school are required for Hospice Nursing?

    Thanks again,
    Kelly
  5. by   leslie :-D
    no certifications are required, unless it's a particular agency/facility that holds this criteria.
    but many hospice nurses, become certified with their CHPN (Certified Hospice & Palliative Nurse).
    one needs to be an RN with a minimum of 2 years in this specialty, before being able to take the test.
    as w/any specialty, certifications and degrees, are always preferable.

    it sounds like you've found your niche.
    wishing you the very best.

    leslie
  6. by   aimeee
    Good Luck, Kelly. It sounds like you are on the right path.
  7. by   KJB_65
    Hi Kelly....I'm also Kelly and 42 and a hospice nurse. Anyway. I was taking care of my mother in law at the end of her life. She had ovarian cancer and she moved in with me the last few months of her life. Hospice came in and I developed a close relationship with her nurse. A few months after she died, that nurse was promoted and she asked me to come work for her full-time. The rest is history. Never want to do anything else. This is my thing...my place. I wish you good luck!
  8. by   RntobeKelly
    Thank you all! Since the initial post I have been doing more research. I am more convinced than ever that this is for me.

    Hope that you all have a safe and happy holiday,
    Kelly and family

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