Considering Hospice Nursing

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I'd love to hear from some hospice nurses about the pros and cons of this field, and your experiences with it.

I have home health and oncology experience, which I think are probably good experiences to help ease the transition to hospice nursing.

I love getting to spend lots of time with patients, listening to them, being a comforting/calming presence to them in times of distress.

I love getting to use my critical thinking skills to help patients feel better. Symptom management is my favorite part of oncology nursing, but in my current job the doctor does it all and I feel like I don't get to do much.

I really feel, and have felt for a long time, that hospice might be my calling. I'm scared to make such a huge jump though, and I'm scared I'll hate it and regret it. I've had 3 jobs in the last 3 years, and I don't want to job hop. I want to make sure it's a good move and wise decision for me long term (more than 1 year), and that I'll be happy doing it, before I move again.

My hesitations about hospice are that I would be totally on my own, and having to be on call. I am used to being on my own in home health, but at times it was very intimidating and I didn't feel very confident on my own, with no one there to help me or back me up. Also, I want to have a life outside of work and be able to make plans without having to worry about getting called into work all the time.

Based on what I've written, do you hospice nurses think I would be a good fit for hospice nursing? I would appreciate any advice!

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Specializes in Hospice.

I'm an on-call nurse, I am never out in the field by myself, I have a backup nurse I have my manager and I have my two Physicians that I can call anytime. I love the fact that I work 1 week and off 1 week. My background consists of Progressive Care and also assistant nursing care manager. It was a big leap to go from acute care to hospice.

It took me a little while to become comfortable with symptom management. I was used to fixing the problem.

Spending time with the patients and educating the family is one of the biggest things I love about this job. Only you can decide if it is a good fit for you or not.

Maybe you should try doing ride-alongs with a hospice nurse, to see how you like it. Good luck to you.

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Specializes in Hospice.

Hours and being on call depend on the agency you work for.

As a home hospice case manager, I work Monday - Friday, 8:00 - 4:30. I work every 6th weekend. I'm never on call. Our hospice has nurses hired specifically to work evenings and over night. Once 4:30 comes, I log off my computer and turn off my phone. They get turned on again the next morning at 7:45. I'm able to complete all of my charting during my actual work day, and never have to work "off the clock" Work life balance is good, at least where I work.

I have a case load of 15 -18 patients at any one time. I see 4-5 a day. I have a HUGE number of resources I can rely on while I'm out in the field, including triage nurses, managers and physicians.

Your experience certainly would be a good fit for hospice. I like the suggestion in the previous reply that you try to shadow a hospice nurse on his / her rounds.

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Specializes in Hospice, Palliative Care.

Good day, RN416:

I'm in a similar situation where I am a currently a Cardiac Telemetry RN who handles mainly cardiac patients as well as their various comorbidities and a flux (can be as high as 40% on our floor) of medsurg patients. I've only dealt with GPI hospice patients and those going home on hospice, but never as a pure hospice nurse. I start orientation as a hospice case manager RN on April 9th.

When I was debating the switch over, I was caught between the love of acute hospital inpatient care having tremendous coworkers (they are just fantastic no matter their "title/degree"), and how everything is nearby (so to speak) to the joy I hope to have with hospice in having more time to educate the entire family unit (if we have unsafe patient ratios, which is common, we often have little time for patient teaching) and be there for the family in need.

Thank you.

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Specializes in CT ,ICU,CCU,Tele,ED,Hospice.
Hours and being on call depend on the agency you work for.

As a home hospice case manager, I work Monday - Friday, 8:00 - 4:30. I work every 6th weekend. I'm never on call. Our hospice has nurses hired specifically to work evenings and over night. Once 4:30 comes, I log off my computer and turn off my phone. They get turned on again the next morning at 7:45. I'm able to complete all of my charting during my actual work day, and never have to work "off the clock" Work life balance is good, at least where I work.

I have a case load of 15 -18 patients at any one time. I see 4-5 a day. I have a HUGE number of resources I can rely on while I'm out in the field, including triage nurses, managers and physicians.

Your experience certainly would be a good fit for hospice. I like the suggestion in the previous reply that you try to shadow a hospice nurse on his / her rounds.

I have been An RN over 30 years.Most in hospitals last 15 years ED.I started as a Hospice Case Manager 2 months ago.I am in a very similar situation as you except .I don't work a scheduled set weekend .About every 6 weeks will have to do a one day Sat or Sunday 8 hour backup on call shift.I am really liking it so far.

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Thank you all for your responses! How were you able to transition from having a curative perspective to having a palliative care outlook? Have you guys been fulfilled as hospice nurses even though you can't help your patients get better?

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Specializes in Hospice.
Thank you all for your responses! How were you able to transition from having a curative perspective to having a palliative care outlook? Have you guys been fulfilled as hospice nurses even though you can't help your patients get better?

I was helped by having experience in long term care, then acute care. Care in LTC is very similar to home hospice in that the focus is on quality of life, not quantity. In both LTC and home hospice, you do what you can to make the best of whatever time people have left.

In hospice, you have to realize that even though you can't fix what's wrong with a patient, your focus is on helping them to live what ever life they have left to the fullest extent possible, and as comfortably as possible. My fulfillment comes from knowing that I help my patients live their final days at home, with their families, and that they were as comfortable as we could make them. I also get fulfillment from helping the families of my patients cope with their loved ones end of life. (You won't just be a nurse for the patient, but for the entire family).

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Specializes in Hospice.
Thank you all for your responses! How were you able to transition from having a curative perspective to having a palliative care outlook? Have you guys been fulfilled as hospice nurses even though you can't help your patients get better?

I transitioned by accepting and BELIEVING that quality is better than quantity.

How many codes have you been in when you think to yourself, "Why are we doing this to this poor human being?"

It is much more satisfying to give someone relief than add to their misery. We will all die one day and I would rather be surrounded by all of my family at home and comfortable than lying in a hospital bed with monitors beeping and strangers poking and prodding me in an attempt to extend my life by only mere days.

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Specializes in CT ,ICU,CCU,Tele,ED,Hospice.

I agree with RNBear and Cardiac Freak for me its a combination of both.Also my recent personal experience with my husband's illness.My husband was a nurse for 35 years dx with stage 4 bone cancer in 2015 .He had radiation and chemo .Fought hard unfortunately he passed away in 2017.Our nurses,oncologist,and hospice nurses were wonderful.They made an impression on me.

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