Advice, Applying for Home Hospice RN

[RNstat123, RN]

For those who have extensive experience as a hospice/palliative nurse, any advice, experiences, you would like to share?

I am about to apply to a Hospice/Palliative Center that also does Home Care Hospice services. I recently moved from another State, and have 3 years of med surg experience, but my unit also dealt with inpatient hospice.

I had home health experience before but I was more of a patient assistant prior to getting my RN license.

Are there any good free online resources I could look into and just read up on or any videos/books, etc?

What usually do hiring managers ask when looking to hire a hospice RN?

What questions should I be asking before I say "yes" to the job?

Thanks so much in advance for all your replies!

[pmabraham, BSN, RN]

Hi:

Join https://www.facebook.com/groups/HospiceNursing/

You will learn as you go. Remember, in hospice, we don't chase any numbers (i.e. abnormal vitals, abnormal labs, etc.). We work with the patient and team on symptom management to help the patient have the highest quality of whatever life remains.

Thank you.

[NRSKarenRN, BSN, RN]

One of the most helpful books "my bible" hospice program I previously worked in provided clients was

Gone From My Sight: The Dying Experience by Barbara Karnes

Barbara has several other books, blog posts that are helpful for nurses and the public.

End-of-Life-Care (ELNEC)

Quote

The End-of-Life Nursing Education Consortium (ELNEC) project is a national education initiative whose mission is to improve palliative care both within the United States and internationally. ELNEC is a partnership between the American Association of Colleges of Nursing (AACN), Washington, DC and the City of Hope, Duarte, CA. The project provides undergraduate and graduate nursing faculty, CE providers, staff development educators, specialty nurses in pediatrics, oncology, critical care, and geriatrics, and other nurses with palliative care training.

They offer regional and national training sessions to improve nursing care provided to palliative care and hospice patients.: https://www.aacnnursing.org/ELNEC/Courses

National Hospice and Palliative Care Organization provides multiple resources, CE, webinars along with membership.

CMS: Medicare Hospice Benefits.

Understanding Medicare's Hospice Benefit

[anashenwrath, ASN, RN]

Ask about census, how many patients you'll be expected to see a day, mileage, etc. Investigate the turnover... see if you can talk to the nurses/aides and get the real-deal scoop.

Is there an on-call/weekend nurse, or do case managers rotate?

I have found historically hospices have pretty terrible onboarding/training. Not just the EOL care stuff, but understanding recert periods, eligibility criteria, etc. I'm guessing you're applying for a case manager position, so it's more than just your bedside knowledge. Honestly, I just got my CHPN, and the study guide I used had really good basic info of hospice/medicare legislation that I wish I had had access to as a new hospice RN. I also like The Hospice Companion for symptom management and The Field Staff Crash Course for Hospice for just basic, "what to expect when you're on the road" kind of stuff. Hospice Quickflips will give you eligibility criteria.

As far as interviews, nothing stands out as different from any other nursing interview in my memory. Maybe be prepared to explain why hospice (and obviously don't say, "Oh, I just needed a change" or "I heard you get to make your own hours" lol!) Hospice has high turnover, in no small part due to compassion fatigue, so you need to demonstrate that you're committed and caring, but also that you're not the type of nurse who is going to burn out by giving their cell phone number to every patient.

It also helps if you're involved/aware of death and dying rights in your state. There are a lot of ethical issues that come up in hospice, and I think interviewers are impressed when you can kind of speak to those issues and demonstrate that you stay up-to-date on legislation.

Don't hesitate to message me if you want more info. Good luck!