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Advice for new hospice admissions RN

Hospice   (124 Views 1 Comments)
by NurseV32 NurseV32 (New) New Nurse

NurseV32 specializes in Ltc/rehab/hospice.

23 Profile Views; 1 Post

Hello Everyone,

I am a new hospice admissions nurse 2 months into orientation. My background is LTC, memory care, rehab. There are parts of this job I find incredibly fulfilling and meaningful such as being able to start providing the help families need when their loved one is facing end of life. I am proud to be part of an organization that can deliver meaningful services at end of life. I find however I am struggling with parts of this role that I did not anticipate and am looking for insight from anyone who has been in this position before.  

I initially thought I would be coming into the lives of families and patients when the decision had already been made to start services and the patient had been deemed eligible for services by medicare standards. Essentially I would be in the position to start actually admitting patients.

I feel very confident and competent in gathering information that goes along with typical admission (physical assessment, signing paperwork, charting, ordering DME, medication input,etc). I am very thorough and detail oriented. I have always done well working with other people.

I am realizing however that my role will also frequently involve informational meetings which is where I am struggling. Often we go into homes with very minimal information (maybe just a name, number, and a diagnosis---no first cert even) and it is my role to assess a lot that is very psychosocial in nature such as is the patient ready? Is the family ready? How much do they know about hospice? Do they qualify for hospice? Are they meeting criteria/can they actually be admitted to hospice? Do they understand that their family member is EOL (that is really hard news to explain to a family if say the doc has not done the best job with it).What do I do if they are in need of help but I can’t provide them services because they don’t qualify? It’s a lot of pressure being alone with a family and not having answers.  I find myself drawing blanks, feeling awkward, and very unprepared for some of these conversations.   

The preceptor I am with is knowledgeable but has been doing this for a long time but is not necessarily a teacher.  There has not really been any structure to these meetings that we go on---perhaps I just have to get more comfortable winging it and it will come with time.  Perhaps I need to start “lesson planning” in a sense to feel like I have some idea of what to say and teach. Anyway I do have a heart for this work and would like to improve. Any insight is appreciated.

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