Can a new graduate be a hospice RN?

Specialties Hospice

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  • Specializes in Telemetry, PCU, Private Duty, Hospice.

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NavySERE

4 Posts

As anurse educator in hospice, I would love to have new graduates coming into theranks. One of the biggest concerns is for the “new” nurse case manager in thefield not just the clinical experience but also, the organizational experiencesto manage a case load of any were from 18-23 patients, seeing any were from 5-7patient’s per day.

Fromreading the posts the new grads that have found jobs in hospice are lucky tojoin “large” organizations that can put forth the education time and moreimportant money to train these nurses. For them I wish them the best of luck.

In onepost the nurse mentioned that the company will allow her up to 6 months to bein orientation. Even for experienced nurses who have no hospice training. Iwould not expect them to be comfortable for at least 6 months to a year workingwith hospice patients. Also for the nurse who is new how many patients will shebe required to follow?

I would recommendnew nurse start out in an “inpatient” hospice setting before doing into homecare hospice. When one is out in the home, you have to project a sense of calm toyour work. Even though what is going on in-front of you may be is anything but calm.

Forexample, if you as a new nurse have not seen what a patient “looks like” priorto going into Resp Distress. How can you educate the family for s/s to lookfor?

Greaterthan 90% of my “assessment” is done before I even take a BP, check a pulse,etc. Those things are important but having the critical thinking and experienceto be able to “hear and see” what the pt/family are saying and come up with aprognosis and then be able to teach the family to care for their love one whenI am not at the bedside is critical.

Bottomline, for new grads, if are looking at hospice organization talk with themfrankly about what their orientation is like, what education is done. An examplewill they pay for you to go to things like ELNEC (End-of-life nursing EduConsortium) in your first 6 months. Then what type of mentoring support do youhave once you are off. Remembering anywhere a nurse starts there is theprogression from novice to advance nurses that needs to and will occur.

I wouldsay most “smaller” hospice just don’t have the educational staff, and resourcesto commit towards that end. Though I so wish it was different!!!

In thatcase, going into areas like, ICU, ER, oncology will give the new nurse the foundationto build on so in a few years to come back into hospice.

Theother thing I hear is from “older” nurses who will say … before I retire Iwould like to do hospice. Having worked at some of the busiest trauma centersand hospitals in the state that I am in I have this insight. I have left workfrom our in-pt hospice equally emotionally and physically drained as I ever didworking at the Trauma center.

If youdo have the experience and what “to do hospice” come on and join the fun. It isa true calling, we call it the “hospice heart”.

Lastlyfor any hospice nurses or any one, I would highly recommend they get theircertification in whatever specialty they work in. Has Hospice nurse it would bethe CHPN, ER CEN, or oncology OCN.

I hopethis helps and look forward to seeing more nurses in hospice. Both new and old,men and women.

Thanks

NavySERE

KMRN81

34 Posts

Specializes in Hospice and Palliative Care.

Hello all,

I know this thread goes back a few years, but I wanted to share my experience with hospice for those who might be interested in going into hospice at some point!

I'm graduating from nursing school this fall and my plan is to become a nurse at my local inpatient hospice center. I, too, feel called into hospice care, and this is a recurring theme I've both read here and heard in the field.

Since I was interested in hospice care before I started nursing school, I decided to first volunteer with the local hospice to see if I was really cut out for this type of nursing. I did this for three years while in school, and then applied for a CNA position at the inpatient unit. I was hired and have gotten tremendous experience doing this. I work part time around my school schedule, and plan to apply for an RN position there following graduation. While many hospices won't hire new grads, it certainly helps to have experience as either a volunteer or CNA, as well as a passion for hospice care. There is no guarantee that I will be hired as a new grad, but the odds are in my favor due to the different roles I have played there and my passion for end-of-life care.

I think it is difficult to begin doing any kind of home care right after graduation due to the level of autonomy that home care nurses demonstrate, as well as the expansive knowledge required to educate patients in the home setting. However, one of the great things about inpatient hospice care or facility-based hospice care (for example, in a long term care facility) is that a new grad may be precepted in these environments much more effectively. Once the new grad has attained enough experience to move into the home care setting, the transition can be more seamless.

I think there is a steep learning curve for a new grad going directly into hospice care, but it's not impossible: I know of new grads who have succeeded and those who haven't. Some "old-school" nurses have told me that oncology and/or med-surg experience is necessary to be a hospice nurse, and other "new-school" nurses who have told me to pursue my passion and the rest will fall into place. Both philosophies carry wisdom - it is up to the new grad to decide what is best for him/her.

Fireball, I hope you continue to pursue hospice! Perhaps the hospital where you work has a palliative care team that you could join, or you could volunteer at your local hospice. If you want to message me, perhaps we could collaborate and I could help you find an inpatient facility near you or know someone who could help.

Best of luck to all (including myself - haha!)

:-)

fireball78

68 Posts

Specializes in Telemetry, PCU, Private Duty, Hospice.

I FINALLY got a job in hospice!!! I have been working for an agency for almost 2 months now and I absolutely love it....always knew it was the right place for me. I am thriving in the environment and love that I learn new things every single day. My supervisors are supportive to my learning needs and do not push me too far out of my comfort zone without backing me up. It feels so good to finally have a job in nursing that I love. I don't dread going into work. No more digestive issues every day before my shift.

Thank you to all you hospice nurses who have encouraged me and provided support these past few years. I have learned a lot from your posts and I strive to better myself every day from learning from experienced nurses.

Debilpn23

439 Posts

Specializes in long term care Alzheimers Patients.
I FINALLY got a job in hospice!!! I have been working for an agency for almost 2 months now and I absolutely love it....always knew it was the right place for me. I am thriving in the environment and love that I learn new things every single day. My supervisors are supportive to my learning needs and do not push me too far out of my comfort zone without backing me up. It feels so good to finally have a job in nursing that I love. I don't dread going into work. No more digestive issues every day before my shift.

Thank you to all you hospice nurses who have encouraged me and provided support these past few years. I have learned a lot from your posts and I strive to better myself every day from learning from experienced nurses.

Fireball

I know this a little late, I want to congradulate you on getting your dream job in hospise.

I ve always dreamed of doing hospise nursing. Maybe some day

latishal

1 Post

Thank you so much for all this great advise

areensee

73 Posts

I wish you well. Be sure and let your colleagues help you along as you learn hospice nursing. It is very different from other areas and extremely rewarding. Do be sure to give yourself permission to grieve and grow. You have to learn to do this when you work with patients that you know will be dying soon. Be sure and make the most of your time off, vacations take on new meaning. You must have time away. Also, be sure and take advantage of the continuing education, and after you have been doing it for a while, consider taking the CHPN exam. Good luck and welcome to hospice nursing!

silvkapp

1 Post

On 5/25/2010 at 10:44 AM, fireball78 said:

Hi there.

I just finished my 1st year of nursing and will graduate next May. I have pictured myself as a hospice nurse, even before I entered nursing school! I was with my step-dad who battled lung cancer for 7 months before he passed away. His death was the first that I have experienced, and I was surprised by the experience. I was witness to him slowly dying day by day, lose of his independence little by little, pain (which was managed very well), and eventually he lost his hope (which was the worst of all for me to see). When he died, surrounded by his family, I felt relief that he was no longer suffering...no more pain. I am a spiritual person, and I found the experience of being with a human as they transitioned from earth to heaven, very rewarding. I felt honored to have been there...I was also relieved that he didn't die alone! That was my worst fear as his disease progressed. I was very sad at the loss of my step-dad, but never felt anger as I knew where he went...no more pain, no more suffering. From then on, almost 2 years, I have wanted to be a hospice nurse. Even though I am spiritual, I realize that not everyone is, and I am not preachy about my beliefs. I am just explaining my experience.

I would like to hear from hospice nurses, if I can be trained as a hospice nurse right out of college, or if I have to "do my time" in a specialty such as Med-Surg? The thought of working in Med-Surg makes me nauseous! I would not be a good Med-Surg nurse, as having 4 or more patients to focus on at one time will not leave me any time to build a proper rapport with my patients. As I am still a student, having only 1 patient on clinical at a time, I haven't figured out how a nurse priorities care -- medications, wound care, trach treatment, foley insertion, and head-to-toe assessments! During clinical, I tend to spend more time with my patient than my classmates. I love talking to them and getting to know them. Being a hospice (or a home care) nurse appeals to me as well, because I would be with one patient at a time (as least from what I have read/heard). I am 32, never married, no kids, so being on-call, working nights/weekends isn't something that would bother me. I have lots of friends and family, and I do know that having a social life and taking care of myself would be of importance as a hospice nurse, so I don't burn-out. I just don't want to be any other kind of nurse, other than a hospice nurse!

Does anyone know of agencies who hire graduate hospice nurses? I currently live in PA, but will ultimately like to relocate to CA where I am originally from.

There is a hospital in my area that offers a 6-month internship for new home-care nurses. The first 3 months are spent in Med-Surg/Oncology and the next 3 months are spent training as a home-care nurse. I am thinking about applying for that, but there is certainly no guarantee that I would get it!

Any advice you have would be appreciated. Thank you! :redbeathe

 

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