Anyone do INPATIENT Hospice nursing?

[ShayRN]

My hospital is opening up a new inpatient hospice facility in September. They are hiring now, orienting from the end of July through the end of August. I really, really feel like I have a calling to Hospice. But, I don't like LTC, I did that after college and just wasn't my niche. So, my question is, how is inpatient Hospice nursing different from an ECF? I will not be able to return to my currant position if I leave, although I will be able to go somewhere else in the hospital. The interview I had last week went well. The director of the new place told me that there will be 1 RN and 1 aide per 8 patients. He is also planning on pet therapy and ofcourse, unlimited visitation. I have always been an advocate for end of life care, just a few months ago went toe to toe with a doctor to allow an endstage ca patient die without further surgery. (He actually asked the wife, Do you want your husband to die sooner? ) I told him he had NO RIGHT, that the man was going to die with or without the surgery, and he had a right to die the way HE wanted. Grrrr, what a jerk. Anyway, the wife just sent me a thank you note for being an advocate for her husband, who died the day he went home from the hospital. So anyway, I guess my question is, what can I expect working at an inpatient facility vrs home care Hospice?

[leslie :-D]

i worked inpt for sev'l yrs.

my pts' acuity levels were high, and required intensive nsg mgmt.

my ratio was 1:2, sometimes 1:3.

so i can't expound on a 1:8 ratio.

i need to think that these 8 hospice pts have their symptoms fully controlled, need little intervention and don't have family w/many needs.

it sounds like a lg pt load.

i would ask alot of questions.

much luck to you.

leslie

[aimeee, BSN, RN]

One thing that isn't clear here is whether this is a hospice house or an "Inpatient General" unit. "Inpatient General" is a level of hospice care provided for those who have very high acuity. A hospice house however might have a much broader mix of acuity.

[ShayRN]

Sorry, I didn't know there was a difference. It is a Hospice House, with the possibility in the future for residential patients.

[doodlemom]

Sorry, I didn't know there was a difference. It is a Hospice House, with the possibility in the future for residential patients.

Definitely if the patients are general inpatient 1:8 is way too high. Do you know how many of the beds will be residential?

[DLDoyle]

I work for a company that does hospice care to LTC patients. we also take care of some home patients. Our care, (RN case manager, CENA, MSW and Chaplain) is in addition to the care provided by the LTC staff. RN case load is about 15 patients each and we try to make at least 2 visits a week to each client. We are supported by a set of standing orders that try to anticipate what each client will need at they progress. I feel like I make a difference in the lives of the patients and families, and don't just do "drive by" nursing where we take a fast assessment and drop off meds.

[nurselearner]

I would love to hear more about what you do for your long term care patients on a visit. We also see pt's - and I feel good that we supplement all their care from the LTC facility - adding home health aides and visitors etc but sometimes it seems bleak. Many are in rooms that are not personally decorated or they are in their geri chairs or wc and dozing in the dayroom or hallway. Activities are provided byut many of our patients are bed bound. I do put a communication in each room so the family knows when I've been there. I also encourage the staff to write - I feel like it gives the family something to talk about with the patient. Any other tips for TLC from the Rn would be appreciated.

[mschelee, MSN, RN]

I work as a NAP [nurse apprentice] in a inpatient hospice facility here in las vegas. or ratio is 1:4, and i absolutely love it. I am thinking of doing hospice when i graduate. I have a CNA assigned to me and could not imagine 1:8 ratios. I wouldnt even try it personally, most hospice patients have meds around the clock, and unless you have a med nurse and a cna both, i dont know how you could provide adaquate care [with 2 hours checks and meds and wound care?] good luck to you.