Career change from ICU to Hospice

toomuchbaloney · Dec 21, 2015

I prefer professionally challenging and autonomous enviroments. That is why I spent much of my career in the ICU setting and ended up in hospice.

I prefer to work in the patient home rather than in a facility. Mostly because it fits with my philosophy of nursing and with my philosophies about things like birth and death...we should normalize them in our society.

Critical care nursing prepares you for the critical thinking which should serve your patients well. In the early stages we must train ourselves to consider not what will treat their disease best but, rather, what will palliate their symptoms best, what will improve their quality of life in the short run, what makes the patient happy and hopeful. Good luck

coffeetalker · Dec 22, 2015

For about the first three yrs of my nursing career, I worked cardiac stepdown and critical care, I have now been a hospice nurse for about 6 yrs, 5 of that doing homecare and ALF/SNF, a little over one yr now in an inpt facility. One of the biggest challenges that you will probably have will be "letting go of numbers'- ie not having labs drawn on any type of routine basis, not checking o2 sats, and learning that it's okay to not check vital signs. Another challenge you may have will be to just focus on symptom management and getting use to the mentality of it's ok to have a pt on steroids for long periods of time as an adjuvant to pain control and other new ways of thinking about medication. The great thing about hospice is letting the pt tell you what is causing them the most trouble and working with that- you will be amazed what good symptom management can do. At my hospice, the relationship with the SWs, CHPs, cna's and MD's is great- true teamwork instead of catchphrase teamwork. Have you though about if you were leaning more toward home care vs inpt? You may find that an inpt position will be an easier transition than homecare (just because there will be folks around you to ask questions to instead of waiting on your phone -a -friend to call you back.

NurseIndependa · Dec 22, 2015

OP, I find your question very interesting. I work in acute care now but plan to eventually go to hospice too. What type of graduate degree are you thinking about to become a palliative care specialist?

nursecathi · Dec 29, 2015

I worked critical care for 22 years--ICU, PACU, Stepdown, ER. Got tired of all the adrenaline drama. Now in inpatient hospice and love it. There are worse things than dying.

sandygator, BSN, RN · Jan 3, 2016

I was CN in a large University Hospital PICU for 20 years. I am now a CHPN in an 18 bed inpatient Hospice Facility for nearly 5 years. Talk about 180 degrees! I was ready for this change, but even so, it took some adjustment. As one responder said, letting go of the numbers is a biggie. There are few emergencies. Comfort is the basic need of most of our patients. For that I am SO grateful! So many years of futile treatment, causing so much pain. I'm so glad I can now face the reality of death which our society so vehemently wants to deny. And to help my patients and families along that inevitable journey. I will be retiring after 40 years of nursing next July. But I will continue to work with Hospice patients in some capacity. It is very rewarding when you know the facts and can impart them with compassion to patients and their families. I always had people say, when I was a PICU nurse, "How can you do that? I would get too attached." And I would answer "If you don't get attached, you are not being the best nurse you can be." Same exact thing with Hospice. Get attached! Cry with them. Love them. Your life will be better for it. :-) I wish you and your patients all the best!