advice young new grad (adn)

[lexi_16]

Hello all,

im turning 23 this year

I recently graduated from adn program May 2014 in albany new york and passed nclex a month later.

I am an average student. No experience in leadership

I am now in california and with no experience in acute setting (my only experience is as a licensed practical nurse in an assisted living in new york for six months), it was very tough to get a job. Fast forward to my first job as an rn, I am orienting in a hospice agency as an RN (family friend connection). I am quite intimidated because Ive got no experience, i feel so small around the other nurses (some have been nurses in other countries) because I feel Im much more comfortable in hospital setting. Right now im auditing charts, doing clerical work because i am waiting for my California license so i can visit patients

anyway in my opinion, i dont think hospice is ideal..? to start nursing career. However, on the other hand, I believe nurses should be able to work in any setting, period.

Any advice? It would be greatly appreciated!

[toomuchbaloney]

Are you working in a hospice facility or will you be visiting patients in the field?

Nurses can work in any nursing setting but not all nurses are competent to work in any or every setting.

Study the policy and procedure manual.

Study the resources they have provided you on symptom management.

Memorize any standing medical orders that they use.

Good luck.

[softrbreeze]

Let your supervisor and fellow RNs know that you will need to "pick their brains" from time to time as you orient to your new job and try to get a sense of who feels most comfortable with that. We have nurses coming from varied backgrounds all the time so even experienced nurses have to get input from others quite often. Most nurses are comfortable with their role of educator. As long as you are able to consult other nurses freely, you should be able to manage. Competency takes time however. Just be patient with yourself. And good luck!

[caliotter3]

Don't be afraid to ask questions of other staff. Even the HHA that you may meet on a case can give you valuable insight.

[caliotter3]

Do an internet search for continuing education providers and look for courses on hospice. There is one out of Mass, that I can't quite recall the name of, that I think might have some courses on end of life and hospice. Get your hands on any reference you can that talks about hospice and start to read. I took a course one time on pain management. Pain management, particularly at end of life, is a good place to start with your self study. Ask to go to cases "behind" another nurse, or actually get some shadow time in. Get an orientation from these nurses and ask questions. When you go out on your own, for say, a continuous care shift, read the charting of the previous nurse. There should be a copy with the chart. That will give you an example of the expected charting, what to say, what not to say. Try to be assigned some continuous care work before you are required to go out on "crisis" type calls. Continuous care shifts will bring you some familiarity with the entire atmosphere of hospice, before you are asked to handle specific problems. It goes without saying that you should have the phone numbers of any of your supervisory staff or other RN's that you can call when things come up.

[PomMom65]

HPNA.org has excellent resources. I was a new nurse in a Hospice unit. I did a few of the online classes with them.

[TammyG]

I agree that hospice is not an ideal first job, but no job is an idea first job if there is not the required orientation and support for the new nurse. If you receive a good orientation and preceptorship, you should do fine. Doing office work on charts is actually a nice, low-pressure introduction that allows you to see what kind of treatment takes place. Take it one day at a time, learn all you can, and see how it goes. Many nurses (with gobs of experience) find that hospice is not for them and leave in a few months. If you need more time or precepting, ask your employer. Hopefully they are doing everything they can to help you succeed, and you will be fine.

[emoraver]

Will you be doing home visits on your own? If so, ask lots and lots of questions of your coworkers. There are many things that can come up when you do home visits. I plan on working in hospice, eventually, but every nurse I spoke to said to get 1-2 years experience in a hospital setting.

Why? You could be changing port lines, doing stage 4 dressing changes, enemas, ... all alone, with no other nursing help. Keep in mind that while some families will be able to help you, and will want to help, and others will want nothing to do with the care and will watch you do everything.

Ask lots of questions! I hope you'll be going out with other nurses for a few weeks before you get your own patients! You'll do great!