Different Hospice Roles

lifelearningrn, BSN, RN · Oct 14, 2014

Admissions nurse

I'm still new to hospice but in my company it goes like this-

Case manager- RN leads the IDT team which consists (generally) of a chaplain, volunteer (sometimes), social worker, aide, and LVN (sometimes). The case managers manage all aspects of nursing care.

Hospital liaison- This is basically a marketing job.

Home care- Going into patient's homes to care for them (rather than in-patient). Sometimes their homes are nursing homes or assisted living facilities.

Nursing home- Not sure?

Home care pool- Not sure?

On call RN- The on call RN takes emergency and after hours phone calls, makes visits if necessary.

PomMom65 · Oct 16, 2014

I think the nursing home category refers to a nurse that may be assigned to a particular nursing facility where there are patients on service.

ShesanRN · Oct 29, 2014

Admissions nurse
I'm still new to hospice but in my company it goes like this-
Case manager- RN leads the IDT team which consists (generally) of a chaplain, volunteer (sometimes), social worker, aide, and LVN (sometimes). The case managers manage all aspects of nursing care.
Hospital liaison- This is basically a marketing job.
Home care- Going into patient's homes to care for them (rather than in-patient). Sometimes their homes are nursing homes or assisted living facilities.
Nursing home- Not sure?
Home care pool- Not sure?
On call RN- The on call RN takes emergency and after hours phone calls, makes visits if necessary.

At our hospice, an admissions nurse focuses primarily on admitting new patients, but may visit current patients if the need arises. Otherwise, the roles where I work are similar to what's described above.

toomuchbaloney · Oct 30, 2014

The hospital liaison often is the professional who speaks to hospitalized patients and family members about hospice benefits and elections when they have qualifying medical conditions. That individual often visits hospice patients who are hospitalized for unrelated or related conditions. They collaborate with palliative care teams and hospitalists for end of life support of patients not desiring hospice. They coordinate discharge orders and equipment for folks discharging with hospice services so as to make the transition as palatable as possible.

Case managers manage the hospice care of the patients in collaboration with the other team members which MUST include Patient/family, MD, MSW, CHAPLAIN, and Volunteer Coordinator. Many teams also require the PharmD and HHA to be included in the collaboration. Regardless, the RNCM is responsible for coordinating and insuring that the care is appropriate and timely.

Home Care and Home Care pool imply that the organization has nurses other than CMs visiting the patients in their residences. In many agencies the RNCMs also conduct visits in the home.

Nursing home reflects the practice of assigning one RN or a care team to each facility thereby providing consistency and continuity for both the patients and for the facility staff in delivery of hospice services.

Elle23 · Oct 31, 2014

Thank you for your replies!

Which position dp you think would be best for an experienced nurse but one who is new to hospice?

ShesanRN · Oct 31, 2014

That might depend on the type of nursing you've done. If you were in acute care, I would think wading in as an admissions nurse may be an easier transition than taking on a caseload of patients (and their paperwork), or dealing with the variety of needs that on-call can bring. ER or ICU nursing may translate well to on-call, however.

If you've worked in long-term care, a nursing home case management position seems a good fit. I would say home patients and on-call require the most autonomy, because with home patients there's no underlying facility structure and around-the-clock staff. On-call, you'll be managing symptoms/crises after hours. That being said, you will always have someone in charge of you to refer when on call, and possibly phone triage and backup nurses as well.

I truly think the best position is the one you're most excited about. Whenever we change specialties, there will be a ton of new things to learn. Some positions may require less of a learning curve than others, but your enthusiasm and dedication to a new skill set will shorten that learning curve quite a bit! :) The training offered at the hospice you work with will make a difference as well, so be sure to ask about it ...

Elle23 · Oct 31, 2014

I am actually a former NICU nurse. I have done pediatric home health (private duty) for about a year and a half.

I hope my non-adult care background will not hurt my chances of getting a job. I did do adult med/ surg as a LVN for 2 years, but that was well over 20 years ago.

toomuchbaloney · Oct 31, 2014

In my view it is more important that you possess good critical thinking and patient assessment skills. It is important that you can function autonomously without having a colleague just down the hall. It is important that you can communicate with very emotional and sometimes irrational people in their homes where you are often out numbered and have no authority other than what they allow.

Maybe there is a position for pedi hospice nursing in your community?

ShesanRN · Oct 31, 2014

In my view it is more important that you possess good critical thinking and patient assessment skills. It is important that you can function autonomously without having a colleague just down the hall. It is important that you can communicate with very emotional and sometimes irrational people in their homes where you are often out numbered and have no authority other than what they allow.
Maybe there is a position for pedi hospice nursing in your community?

Well said! Your rock-solid nursing skills - assessment and critical thinking - will take you anywhere you want to go.

Do consider pediatric hospice - it may be a perfect fit!