A good place to start is by making a list of the things you think you could actually give to the hospice profession---and be honest. Can you work late if needed, can you get up in the middle of the night to go see patients if you are on call? Do you have small children that you would have to drag out to a sitter in the middle of the night if the company requires on-call?
Do you have a flexible schedule? Are you willing to work your day until it is completely finished? Do you adapt easily to change? (the age old saying.....being a hospice nurse is waking up each day with the knowledge that your schedule IS GOING to change). Do you have a good faith base? A good support network? Excellent clinical skills?
Ask questions like:
1. What is the average caseload for a case manager ( DO NOT be fooled by a company report of "nursing" to patient ratios as some companies report their supervisory staff in the ratios) Find out what the average is for daily visits (4 is average). Ask if you can interview a current case manager. ( a good company is usually proud of the staff they have built and their sense of "team" and they are okay with you talking to staff.)
2 What type of training will I get? How long before I get a full-caseload? Will I have a mentor? What types of ongoing training does the company provide to it's case managers?
3. What types of program is there for stress relief? Does the company allow respite time after difficult cases? Does the company allot paperwork time into nursing schedules?
4. How much on-call would I be required to do in a typical month. What does the company do if they lose staff and more on-call is required. What is the on-call compensation? Does the hospice have a designated on-call staff--what happens if this changes? Does the management team assist with on-call--how available are they if I need hands-on help (DURING THE DAY AND IN THE MIDDLE OF THE NIGHT).
5. Is the company on paper charting or computer charting (this really does make a difference if you have come from one setting or the other--I know some seasoned nurses who will absolutely not do computer charting)
6. Ask about benefits BEWARE of the company that provides excessive time or too little time, hospitals in the area usually have a competitive vacation package---how does the hospice compare? A ton of PTO may seem like a great option up front (I can say this as my first job offered 30 PTO days a year--problem was, you either were so short staffed that you couldn't go on vacation or you were using your PTO time to take off to sleep after grueling nites of on-call and being out all night--when you couldn't get any time for PTO they paid you out at half time). An important question---what type of personal bereavement do they offer their employees in times of personal loss (one of my nurses was actually fired from one of the older national companies for not having the foresight to predict that her husband would die suddenly in December and she hadn't saved any PTO time for the event!!! --even though they were required to use their PTO time by the end of the year and didn't allow any PTO time during the holiday season---DUH-everyone had used all of their time as required)
This is long---and I apologize for that, but the problem is, there are some very good companies and some very very bad companies--sometimes it is just bad management in the local company but the nationwide company is okay.
Hospice nursing is an art, and a calling and we all deserve to be treated with dignity and respect---choose your company carefully.