Changing from hospital to home setting hospice

CANRN, MSN, RN · May 16, 2008

I am thinking about switching from a hospital palliative/end of life care setting to home hospice care. I have a little home car experience but not as a case manager. What are some of the obstacles I will bump into in this change? What do you think will be the things I will need to brush up on? Can you give me a time frame that you think I will need to start to feel comfortable in this new area of nursing. I am very comfortable with end of life care where I am. Thank you for any advice you can give me.:)

Being out there on your own and the family has all eyes on YOU to make their loved one comfortable and to answer their questions and calm their fears.

When I first started I would repeat in my head *Don't let them see you sweat, Don't let them see you sweat!* Staying calm and providing a comforting presence are very important.

Good Luck, it's the most rewarding work in nursing, if you ask me!

AtlantaRN, RN · May 18, 2008

I agree with the above poster. All eyes are on you, but I prefer the autonomy of the home setting. The medical director trusts us to do the right thing and keep folks comfortable.

My biggest obstacle is ridiculous company issues. Supplies and such---our office manager has only a CNA background--will order foley start kits, then not order any foleys or bedside bags. I have one patient with heavily oozing heel wounds, and requested Exuderm odorshield 4x4's for twice a week dressing changes--she never ordered them saying they were "too expensive". Not her call. That is the biggest problem in my company--nurses have the RESPONSIBILITY, but not the AUTHORITY.

linda