inpatient hospice/ advice

  1. 0
    Hello,

    I was offered an inpatient hospice position today. It seems like a nice place and they have a decent amount of acuity. They do have an occasional pt that receives the occasional blood tranfusion ect.. but not a lot of iv's , antibiotics...ect....

    My question is I would like to accept this job and work there for a few years but eventually i would like to 'experience' acute care as well. do you think that working here would 'lock me out' of getting a job in acute care in the future. also what is the classification of inpatient hospice... can i try and sell that acute care experience? I got to spend a shift there and it seemed like the patients had similar needs to my med-surgical pts if not more minus the continuous antibiotics most had on med surg. Im a new grad. thx.

    Sarah

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  2. 8 Comments...

  3. 1
    I really don't know if your hospice experience would be considered as "acute " care experience for future hospital positions or not,
    I would however, advise you to consider VERY seriously your feelings about providing palliative / terminal care as opposed to "curative" care. Even if one is 100% committed to hospice care and philosophy, working with the terminally ill can be very draining. And if your heart is really still connected to curative care; it can be totally debilitating.
    I have been doing hospice for almost 7 years and can't see myself doing anything else; but at the beginning of my career I could not have done it.
    I wish you the best in whatever path you choose.
    tewdles likes this.
  4. 1
    In most cases, inpatient hospice centers are considered acute inpatient facilities. You may or may not get experience starting IV's, but in the inpatient facility I work in I do IV push medications, central line care, wound care, catheters and a lot of subcutaneous and IM injections. I've known lots of nurses that have successfully gone to med-surg hospital floors after working in hospice. A lot of hospice centers work with the local hospitals, so the nurses are familiar with each other adn the nurse managers are familiar with what hospice nurses do. Good luck. I love working at the hospice care center, it gives me wonderful satisfaction and joy.
    tewdles likes this.
  5. 0
    Thanks for this post! I have always had my heart set on hospice work...

    I am almost done with my Associates Degree. I accepted a PCA spot on a cardiac/tele unit recently, hoping it would help get me in the door to be hired as a new grad. (I am not sure- but my thinking may be very flawed in that regard)..

    I have not looked into hospice right now- for the lone fact that I was afraid that I would be short changing my knowledge and learning experiences by not having some type of acute or med surg experience as a foundation.

    Is this true? I know that no one can tell me the right thing for me, but was wondering just how necessary it is for me to spend time on a 'traditional' unit.

    Also- what are patient loads like in hospice? And are nurse managers nicer? 99% of them seem so unapproachable and a little scary, to be honest!

    Thanks for this thread, sorry if I hijacked it!!!
  6. 0
    Thanks all! nervousnelly, I think your plan is brilliant and will be a great assest in landing you a job. good luck!
  7. 0
    I can only tell you about what my care center is like, I'm not sure if it is typical or not. We are a 12 bed facility. There is always an RN on duty and if census is above 5, either an RN or an LPN. We basically have 2 6-bed "wings". On night shift, there is one CNA working for both nurses, On day's and evenings there is 1 CNA (census allowable) per wing. I love it, at most I take care of 6 patients with a CNA to help me. You really have the time to spend comforting patients and family, occassionally it gets crazy, but rarely do I have to work over to get my charting or paperwork done. I really, really, love the type of care I do there. It is my "weekend" job. I also work M-F as a nurse in a correctional facility. I went back to hospice for PRN work so I can do the type of care that I love.

    Oh- I love my nurse manager. I really like everyone I work with. We are truly a team.
  8. 0
    Rnis- thank you for your words!! I will keep them in my head as good luck!! And I wish the same for you! What is in your heart to do? It's like being pulled in 2 directions...

    Marie has 4 kids-

    Thank you for your description. I am glad to hear that things are nice with the hospice- I really do miss that patient time, and I do not for-see having an increased amount of patient time once I am licensed, either!

    I am also glad your nurse manager is nice!! I am convinced mine is a robot- clenched jaw, flawless appearance, perfect figure, and that clipboard she is always marking on.

    I recently learned that I have MUCH thinner skin than I ever thought, and that's Ok- because at least I can work on it before the pressure is turned all the way up!

    but in the meantime, she scared the cr@p out of me, and I am an extroverted person!!

    Any other hospice advice is appreciated! Thanks - even just for reading! :redpinkhe
  9. 0
    The job market for new grads are not great these days. Working on an inpatient palliative care unit will not be "short changing" your knowledge. I work on an inpatient palliative care unit and we have a variety of acute patients who are either recieving end of life care that has PICCs, IVs, Subq lines, mediports and is receiving tons of IV pain meds, IV antibiotics, and IV fluids, blood transfusions; Patients that are there temporarily for chemotherapy or radiation, most of them are still full codes and is receiving the same treatment: transfusions, IV fluids, various IV, IM, SQ, po pain meds, IV antibiotics via PICCs, IVs, Subq lines, and mediports. The RNs on this unit is responsible for maintaining all of the IV sites and starting IV and subq lines.

    I learned alot on the palliative care unit, and is very grateful with the knowledge and experience I've gained so far. So again, you won't be short changing yourself. New grads have to keep an open mind and know that in this job market today, it's not always possible to start on your "dream job" cardiac, ER, or ICU unit without the "1 year experience" most hospitals are requiring.

    Quote from NervousNelly,RN 2B
    Thanks for this post! I have always had my heart set on hospice work...

    I am almost done with my Associates Degree. I accepted a PCA spot on a cardiac/tele unit recently, hoping it would help get me in the door to be hired as a new grad. (I am not sure- but my thinking may be very flawed in that regard)..

    I have not looked into hospice right now- for the lone fact that I was afraid that I would be short changing my knowledge and learning experiences by not having some type of acute or med surg experience as a foundation.

    Is this true? I know that no one can tell me the right thing for me, but was wondering just how necessary it is for me to spend time on a 'traditional' unit.

    Also- what are patient loads like in hospice? And are nurse managers nicer? 99% of them seem so unapproachable and a little scary, to be honest!

    Thanks for this thread, sorry if I hijacked it!!!
  10. 0
    Hi LPN_2005/RN_10, Mariahas4kids, and Rnis:

    I know this thread was started a few years ago, but I am hoping that at least one of you will respond. I have an interview coming up for an inpatient hospice unit at a local hospital. My "dream" job has always been hospice ever since taking care of my step father in 2007-2008 before he passed from lung cancer. I've been working in a hospital for 15 months and I also worked in LTC for 1 month. I absolutely hate the hospital environment....not enough time to give proper care to patients, short staffing (sometimes we only have 2 PCA's for 45 patients), and I have a lot of combative demented patients and I am feeling very drained. I am a very compassionate person, but am currently going through sensory overload on my med-surg unit with call bells, bed alarms, and IV pumps constantly beeping. Just wondering if things will be the same on an inpatient hospice unit? I feel that a patient load of 6 patients is not too high, depending on how large the unit is and if there is adequate staffing. I am not afraid of hospice and death is not something that scares me. I felt privileged and honored that I was able to be with my step father when he passed and it is an experience I won't ever forget. I've also had a patient of mine die in the hospital. I am just trying to state that I am emotionally capable of dealing with death on a somewhat frequent basis.

    Any information or advice you could give would be appreciated!


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