Any Hospice nurses out there that provide care in nursing homes

[crb613, BSN, RN]

I just interviewed x2 for an RN position and now am being scheduled for a peer interview. I have never done Hopsice nursing before and have some questions. I am being interview for nursing home care. I would go to several different facilities in a three county area. If you do this type of nursing I would love to hear how you spend your day/week. I am wondering about the documentation & care provided. If you have done inpatient as well as home visits how do they differ? Any tips or info you want to provide would be most appreciated. Thanks!

[lesrn2005]

I did hospice nursing home and alf care for 4.5 years and have switched to inpatient care for the same company. Loved the nursing home care portion and developed a wonderful repoir with the staff. It was good because I knew that when I was off, the staff was taking care of the patient around the clock. That is the advantage of hospice nursing in the ecf arena verses the private homes. I transferred to inpatient unit with hospice to meet my school needs. Inpatient is extremely busy 4p to midnight shift, I never stop running. Best thing about working inpatient is I don't have the paper work following me around like it did when I worked nursing homes as a case manager. When I'm off, I'm off! How I spent my day in nursing homes? I did an assessment on the patient, provided wound care if it was the right scheduled time, called doctors, spoke with family, updated care plans, etc.. The staff passed the meds and medicated the patient with prn's if I asked them to. Great working relationship. The facilities were usually very pro-Hospice and loved my visits because they knew I would put out the "fires".

[crb613, BSN, RN]

Thank you so much for your response! What time frame do you think would be appropriate for orientation? I am an ER nurse now, with MS & tele experience. Some background on the Hospice I interviewed with. They are non-profit, paying .42 a mile, work 2 holidays a year, Mon-Fri 0830-1700, have on call nurses & I was told there would be no on call.....except when they were on vacation/sick. I would visit the nsg homes x2 weekly with a cna.

I just don't want to get in over my head in and not be able to provide the care that this patients deserve. There are two facilities in my home county,two-three in the surrounding two counties. One RN is currently taking care of this area with eighteen pts.. We would both eventually split these facilities. Does this sound about right? Thank you for taking the time to answer my questions.

[Hospice Nurse LPN, BSN, RN]

I visit my nsg home pts 2 X week and prn. Head to toe assessment, write note, check meds, teach, speak to family (if they are there)---just like in private homes. I call family members once a week for an update if they live out of town. I also check the chart at the facility EVERY visit to look for new orders, etc. The nurses in the facilities are really good, but sometimes forget to let us know about new orders.

Like Lesrn said, the nurses and I have a good relationship. I try to do teaching with them as well. Many of them like it, but a couple have been resistant. The main thing is, let them know you are there to supplement care---not take over.

Good luck!

[crb613, BSN, RN]

Thank you so much lesrn2005.