Bartender...hospice...next?

[pizzaanddisney]

Hi all...got a lot going on inside my noggin' and would love some help. I have been an RN for almost 4 years, have had a few jobs I've enjoyed, a lot I've not enjoyed. I've done a lot from clinical research, to psych, to med-surg, infusion centers, etc. Done a lot of staffing/temp work, had full-time gigs, been laid off, it seems like everything has happened in 4 years. I relocated last year, got a job on an oncology floor at a teaching hospital and quit after 6 months, after confirming my opinion that teaching hospitals are some of the worst places in the world (not my cup of tea). My jobs I have thrived at thus far have been in small settings, included getting to know my patients, and lots of education and emotional intelligence as opposed to technical skills. I took a six month hiatus from nursing and went back to bartending just to get a break. I had always considered hospice and after finding what I considered a great fit of a small, local company, I took the plunge. I love it so far, although I did not receive much training so stuff that is more technical is complicated. Most of my patients so far are more emotionally demanding, so it has suited me perfectly. The issue is that my company may be going bankrupt, so I may again have to decide what's next. Some days I think of leaving nursing completely, but of course I have debt to pay off. I sometimes love nursing and sometimes hate it (sounds common though). Really, I can't stand the whole healthcare system. The charting is ridiculous, and all the technical crap is nuts. I'm a bit of a rebel nurse, as I spend a lot of time with patients, and do the bare minimum sometimes of charting and such (remember when things like sleep, and joy and laughter and hand-holding actually helped make people feel better?). I've been told to go into sales my whole life, and while I do have personality, I think that'd make me feel hollow. I've considered maybe being a hospice admissions nurse? Hands-off nursing sounds great. My empathy and compassion is my biggest skill set, sometimes I think I should have been a social worker or counselor :/. I'll stop fluffing my gums and take any advice I can get! I need HELP!

[FieryPsychRN, BSN]

There are many avenues in nursing, which is fortunate. You probably need to explore your options. If you like the smaller settings, maybe you could continue hospice nursing, or a doctor's office. If your company is going bankrupt, I am sure there is a competitor right around the corner who would love to have you. I think with nursing, you either love it or you hate it,and you will become burnt out if you do not love what you do. Explore until you've found your niche. Good luck!

[SubSippi]

Look into community health nursing, they do a lot of education and talking.

Or if you thought you could be a social worker, you can always look into care management, which is something lots of people with social work degrees do.

[jdub6]

From what you said about your talent for sales and wanting hands off nursing with more emotional support needed by pt/family and less charting, hospice admissions may work well for you. You do have to be able to look at records (sometimes huge charts, sometimes a couple notes from the md or home care nurse, sometimes one visit note from md) and take history from pt and fam and synthesize it into a solid diagnosis for hospice if you determine the pt meets criteria.

You may face pressure to "find a way to admit this one" from administrators and will definitely deal with a wide range of expectations from pt and family and have to find a way to compassionately explain what is and is not provided (no, we do not provide full-time aids, and we do not have people on call 24/7 to change mom's diaper, perhaps you may wish to look into private care? No, hospice does not pay for that either. No, incontinence does not qualify a dementia patient for inpatient hospice.) You may also face "well, we don't want Dadt [a/o x4] to know you are hospice, he wants full treatment but we agree with the doc that cmo is better so when you see him can you tell him you are home oncology nurses and let us sign the paperwork and dnr?" from families.

If you think it may be a good fit, go for it! Should be an easy move from your hospice position and some people love it. If not, or if it doesn't work out, others have mentioned great alternatives.