Day in the life of inpatient hospice RN

westieluv · May 21, 2012

Well, this was my experience working inpatient hospice on the 11p-7a shift:

-Go to work, sit down with the other team members and get report on my patients. The maximum number we ever had was six.

-Count narcotics if it wasn't already done by other team members.

-Go into my patients' rooms and do a quick once over and assessment, either head to toe or focal, depending upon their condition and if they were actively dying or not.

-Chart on all of my patients and update their care plans in the computer in between passing meds and helping the aide with bedside care such as turning or toileting a patient.

-Occasionally (but not every night) having a patient die and having to do all of the duties that that entails, such as calling the doctor, calling the funeral home, etc.

-Very occasionally on the midnight shift get a new GIP admission who was either sent over after the on-call RN paid him a visit at home and determined that his symptoms needed inpatient management or referred on the spur of the moment by a family member or doctor.

-Took a break, which in my experience is easier to do in inpatient hospice than in an inpatient acute care setting.

-Tape report for the oncoming shift.

-Punch Out!!!

MissIt · May 21, 2012

I work inpatient 7a-7p. Our facility is a mix of acute care and EOL. Mostly, we have patients who have been at home or the hospital and who have acute symptom management needs. I like it because you aren't by yourself; there are other nurses there to back you up. Our day also starts with counting narcotics. It seems to take forever-- 20-30 minutes-- because we have to also count patient's own medications, PCA bags etc. I would actually be curious to know how other facilities do this, as it it makes it almost impossible to get out on time.

After med count, we do report. Then, just like westieluv, I go through my room(s) and do a quick assessment of each patient. We usually have 5 or less. Then, we get meds together. Many of our patients are on all their regular meds (BP, dementia, etc. etc.) in addition to their hospice meds. Then we do report/rounds with the docs, social work, and chaplain. The nurse usually has the most knowledge about what has been going on with the patient, so this is a time when we can make suggestions and express concerns. We chart on the computer; it takes me about 10 minutes per patient. Then we just take care of what our patients need during the day-- education, dressing changes, prn meds for symptom management.

We usually have admissions and discharges. I'd say that takes the most time because you have to do an initial assessment, education, get orders, take off orders, order meds.... It can take a few hours, especially if the doctors have already left. Discharges can take a long time, as well.

Inpatient hospice is a great place to work. I do wish the days were shorter, but most days you feel like you have really made a difference for your patients and their families.