day in the life of an admissions RN?

aimeee, BSN, RN · Dec 5, 2008

Freedom? That's an interesting word I never would have thought of applying to hospice nursing. Autonomy maybe. It certainly can be stressful, or it can be delightful. It all depends on what comes about. Certainly every day is different as no two admissions are alike. Every patient, every family is unique. I'll tell you what a day is like under our model, but recognize that many hospices use different models for admissions.

The day generally starts with coming to the office and updating the laptop and pulling in information about the days assigned admissions. Usually we do two, but sometimes the plan changes at the last minute as to which ones we will be doing. Lots of times referrals are made at the last minute so there is often shifting of assignments to meet the needs. You learn never to get too mentally attached to any plan for the day.

You head out for the appointment. Spend maybe 20 minutes talking about hospice, showing the patient/family how it will meet their needs, getting papers signed. Then about another hour assessing the patient, making a med list, careplanning and educating the family, ordering equipment, collaborating with other team members etc. Then there is about another hour of charting and phone calls to do getting that all typed out in the computer. If there are medication changes needed to get the person's symptoms under control (and there often are) that can add to the time involved.

If things go smoothly, it will take close to 4 hours all inclusive. If there are a lot of hurdles, it can easily expand to 6. We do A LOT of stuff up front though. Some hospices do less on the admission visit, and may even have a rep who goes in before the nurse and explains about hospice and gets all the consent forms signed. In those situations, the admissions nurses generally do 3 admissions or even 4 in a day.

Ginapixi, BSN, RN · Dec 8, 2008

aimeee pretty much summed it up! I worked as admissions RN for a year - it was a newer hospice to the area; the company expected 6 admissions a day (which we never had! not even in a week) so there is your freedom- never mind; i find myself still doing admissions, now that i work for a different hospice and have second shift (spill over, cover etc); there are evenings i do 2 admissions, 2 visits for problems and a death- and you guessed it it is not all done in 8 hrs. It is not your average 8-5 in a building job; there is flexibility and change, no day is the same and that alone is freedom to me. Overtime, yes, but it is not mandatory - you ge the job done and this is not a perfect world; if you like fighting traffic and getting things done in an ever changing situation: GO FOR IT ! I love it! hope this helps....

bacforgiven · Dec 28, 2008

Personally I think being an admissions nurse in hospice is the best job I have ever had. Autonomy-yes, mundane-no. As previously mentioned, every patient and family are different. You have to be very open minded when you walk in the door because you never know what they are going though. My opinion is a good admissions nurse does everything within their power to "set the patient up". You want them to understand the concept of hospice and how incredible the benefit can be not only to the patient but to the family. Then, you are fortunate enough to order the DME, meds, jump every hurdle imaginable just to make sure they have everything they need until their primary nurse comes usually the following day. Of couse, then you have the difficult to qualify cases. These allow you do use your critical thinking skills over and above anything you could have imagined! Every day is a new day, every patient has a different challenge. If you enjoy hospice but feel it would be too difficult to get so attached to your patients and then they die....then admissions is a great place for you!

Mamanurse62 · Dec 29, 2008

There is no such animal as an "admissions nurse" at my hospice. I am the patient care coordinator, and I have done all but maybe 5 admissions in the 7 months I have been in this position. My full time staff RN refuse to do admissions. I have a great PRN RN and she has been great helping with admissions. I would love to be an "admissions nurse", because I currently do all the admit stuff and the other mundane BS that goes along with being a manager, which I have found is not for me. I have accepetd a staff nurse position at another hospice, for more than I am making as PCC and better call compensation! GO For it!