Called??? Scared and energized..

[Nurse SMS, MSN, RN]

So this sounds weird and I am a little wary of typing it out. Here's the basics:

Been an RN 3 years. In school now for RN to MSN but have no idea why. I have zero desire to be a manager. I just know I am supposed to be doing something else. I have worked my whole career thus far in progressive critical care. Far and away my favorite patients are those who are "comfort care"...end of life....I get actually kind of jealous when I hear another nurse has one. I love advocating for the right meds. Keeping the patient comfortable. Protecting the patient's dignity. Educating and supporting the family. Participating in the sacredness of dying.

I lost my oldest son at age 13. He'd been pretty sick and it was time to turn off the machines and let go. He didn't have a violent death or even a particularly "bad" one, but it wasn't all it could have been or all I wish it had been. I decided after he died to become a nurse. At first I thought I would go into oncology, but I learned quickly it was just too much about me. I went home drained and exhausted. But any time I have had a patient dying, I am calm. Peaceful. Incredibly effective at my job. And I go home feeling like I did something really, really good. Like my life matters.

I am currently on a cardiac progressive care unit. I have not been on this unit very long. I love everyone I work with and it is an INCREDIBLE company. But yet I feel dissonant. I don't think I am doing as well as I could or should be. I just feel...off.

I applied today for an inpatient hospice position. They called me within a half hour to come in for an interview. Now I am freaked. I have no idea what inpatient hospice is like. Or maybe I do I guess. Like my comfort care people is what I imagine, but I suspect there is a lot I cannot imagine too.

I want to know the good, the bad and the ugly. I have felt for a while now I am not quite where I am supposed to be. When I think of hospice I feel......drawn in. But I am a bit scared. Will it limit my career? Do I even care if it does? (I know you can't answer that). There is such a high rate of satisfaction among hospice nurses yet so many avoid it like the plague.

Not sure what I am really asking. I guess:

What is the job like?

What are patient ratios?

Does inpatient hospice also have CNAs working with them?

Do you do inpatient or home and why?

Do hospice nurses tend to get along?

How about the managing docs? Is it collegial?

My mind is spinning. I am grateful for any and all info you have to give.

[TammyG]

It sounds like you will love inpatient hospice, which is a very special job. It is like taking care of your comfort care patients -- but 5 or 6 at a time. No IVs, but you will use many of your clinical skills with PCAs and subQ sites. Our patient ratios used to be 3-1 but now are 5-1. Yes, we have wonderful and very excellent CNAs with us who perform all daily care. Yes, the nurses all get along and so do the docs.

When I was doing home care, I had 15. I loved the autonomy of home care. I was on my own all day every day, could make my own schedule, could leave the house and return when I wanted.

Hospice nursing is subject to the same struggles that all other nursing is subject too -- lots of documentation (especially in home care), everyone trying to save money. I have never had any interpersonal issues with colleagues but I have heard of them in other hospices (like these boards). Some smaller hospices are still paper charting, making life more difficult.

But all of those issues pale when you look at the mission. Everyone in hospice (from the HR people to the janitor) are doing it because they love the mission. And that makes the whole experience very special.

Good luck!

[nursecathi]

Same here! Been a nurse over 30 years. Spent most of it in critical care trying to save people. Worked LTC the past several years. Now in an inpatient hospice. Not out of orientation yet but very nervous! I've taken care of people at EOL. That's not a problem. I think it's mostly about being the only RN (with one tech who is usually an LPN) on nights. 5:1 ratio. Will check back here to see how you're doing. And keep my fingers crossed that we're both excelling!