Again, would someone please give me some input on hospice?

doodlemom · Aug 26, 2007

I have an interview monday, and they say I will be going to LTC and homes, what all is entailed in this job? I'm a LPN in Illinois, so my scope is limited. Do I sit with the patients all day or do I just do follow ups for changes in conditions, new orders, and family concerns? Help!!! I think it will be a sad job to a point, but also beautiful in the fact that I will be able to help each patient in a small way transition from life on earth to heaven where there is no more suffering. Any advice or information would be greatly appreciated. What are the common treatments, diagnosis, medications used, helpful hints for the transition, etc.

It's all depending on what they are hiring you for. Are they hiring for continuous care or to work with their home care program? For continuous care, you'll be with patient's that are having symptoms that need someone to be attending to one on one and you will be with the patient continuously throughout your shift. If you are being hired into their routine home care program then you would more than likely be paired up with an RN and you would be making visits. If you are seeing mostly nursing home patients, then the majority of your patients will be dementia. Pt's in their home can have any number of end stage illnesses - cancer, heart, pulmonary, stroke, renal, failure to thrive, AIDs, etc...

The most common medications that you will be using are for symptom management...morphine for pain and sob, ativan for agitation/anxiety, compazine or phenergan for nausea, haldol for terminal agitation, etc...though there are a variety of other palliative drugs that you will use depending on the symptoms and that you will learn over time and experience. Good luck with your interview.

rmw44 · Aug 27, 2007

Every hospice has a different need from their LPN's and I don't think your questions will be answered here. I know it's late, but just ask lots of questions on your interview and be prepared to request more information before you leave (i.e., Do you have any reading material that I can take with me? )

I wish I had read your post earlier, but since I didn't I can't recommend all the great resource sites online.

Good luck anyway.

kstec, LPN · Aug 28, 2007

I had my interview today and the job sounds sad but very interesting. I would be going to either the patients homes or nursing homes to monitor them. I would work with a RN as a case manager but yet have a lot of autonomy. I did some research on the whole hospice thing prior to the interview and came to the conclusion that you definitely have to have a certain type of personality and mind set in order to do this job. I think I can handle it. I did ask if I could cry and they reassured me that if I didn't with some of the cases that they would think something was wrong with me. All of the information they gave me really interested me. Death is something that none of us understand or want but is inevitable, but I would love to contribute to helping the family and patient go through the transition. Whether or not it will be to hard on me is yet to be seen. I won't give up right away because I love to nurture and listen, so I think this will be a perfect fit for me. Wish me luck.

rmw44 · Aug 29, 2007

The best thing about hospice is having someone say, "I don't know how you can do that kind of work" and realizing that you don't know how you could do anything else.

Wise advice I received in the beginning of my hospice life was to always meet families where they are. Sounds simple but you begin to understand being non-judgmental in ways that you never thought about before.

It is quite a challenge to develop into someone who can listen and identify needs without judgment using your own value system. Each person has their own set of values and you are assisting them on their journey and not leading them on yours.

I guess people wonder what world I am living in by making philosophical rants about end of life care. I love what I do and the great lesson is that I learn more about me after every visit with a family.

Dr. Byock's site DyingWell.org is a great resource. I use one of his books "Dying Well - Peace and Possibilites at the End of Life" as a weekly discussion group talk cast called "The Spirituality of Dying Well". If you ever want to listen to it, let me know and I will send you the link.

kstec, LPN · Aug 31, 2007

I got the job and start orientation the second week in sept. I went and did my drug screen today and tomorrow I get my physical. I'm so nervous, I want to vomit. I'm also excited to start such a unique form of nursing. The DON said I'll be fine, but as I told her what do you say to a patient when they are dying and to the family who is losing a loved one without sticking your foot in your mouth. My biggest fear is not having the answers they seek and not being able to comfort them appropriately. Well I'll keep you posted for the ones that are interested. In the mean time I'm going to do as much research on hospice nursing and atleast get familiarized with what to expect and what the job might possibly entail.

aimeee, BSN, RN · Aug 31, 2007

Congratulations! How exciting!

rmw44 · Aug 31, 2007

I hope this will help you. If you can find a few minutes here and there, go to:

http://spiritualityofdyingwell.blogspot.com/

and listen to the weekly discussion group about the book, "Dying Well - Peace and Possibilities at the End of Life". It doesn't cost anything to listen and this is a great book to learn the good stuff about hospice.

My best advice (today) is to turn off your cell phone if possible in the patient's home. A friend told me today that her daughter, a social worker, was attending a pt's death and as the body was being carried out of the home, her cell phone rang. Unfortunately the tune that played was, "Gone, Gone, Gone Like A Freight Train". It turns out that even the grieving family could not help but laugh. Good luck in your new life.