Discouraged!!!

How about working in Florida Hospital system (you may not be able to start immediately with terminal patients) and they will pay you to obtain your RN and pay you a salary as well while you are attending their school. You must commit to one year employment with them after you graduate. I live in the Orldando area and just read an article in the Orlando Sentinel business section today that had some alternative means of paying for school. It will take some time, but you will be back in the hospice environment before you know it.

I am an LPN who recently moved to FL. Prior to my move, I worked in hospice for 1 1/2 yrs, full-time. I loved my job! I went into nursing with the hopes of working for hospice, and my dream came true. I worked with an RN side by side, and when I left the caseload we had was 33 patients. We then had a new RN on our team, so I was showing her what to do, and teaching about hospice meds, patient care, family situations, etc. I pretty much carried 25 or so patients while she did 7-8 (not bragging, just the facts...) I loved it! I loved going to work every day! In fact, it wasn't even work, I was doing "my heart's calling"

Now my problem is getting a job here in Florida. I was told I would have opportunities beforehand, but when I got here they were nowhere to be found. I've tried a couple of hospices, but they only seem to use LPN's per diem, or not at all. I'm so disappointed, I could cry sometimes....

My reviews were fantastic, references are great, and our Medical Director wrote a wonderful letter of recommendation for me. Now it seems I'm not going to be able to follow what my heart truly wants to do.

I even looked into going back to school, but I have alot of prerequisites first, and since I'm not considered a resident until I've been here a year, the cost per credit is over $200.

Does anyone have any advice on what else I can do to try and break in down here? It makes me so sad when I know I have so much to offer our patients.

Thanks for listening,

mc3

Find out the structure of the hospices near you and talk to the person who can change the way they utilize LPN's (Director of Clinical Services) and convince them to give you a try. You are already a trained and seasoned hospice nurse so it would not be a big gamble for them. Figure out a way to show them that you are great at critical thinking, communication, and maintaining continuity. Don't give up! Keep knocking at the door!

I am an LPN who recently moved to FL. Prior to my move, I worked in hospice for 1 1/2 yrs, full-time. I loved my job! I went into nursing with the hopes of working for hospice, and my dream came true. I worked with an RN side by side, and when I left the caseload we had was 33 patients. We then had a new RN on our team, so I was showing her what to do, and teaching about hospice meds, patient care, family situations, etc. I pretty much carried 25 or so patients while she did 7-8 (not bragging, just the facts...) I loved it! I loved going to work every day! In fact, it wasn't even work, I was doing "my heart's calling"

Now my problem is getting a job here in Florida. I was told I would have opportunities beforehand, but when I got here they were nowhere to be found. I've tried a couple of hospices, but they only seem to use LPN's per diem, or not at all. I'm so disappointed, I could cry sometimes....

My reviews were fantastic, references are great, and our Medical Director wrote a wonderful letter of recommendation for me. Now it seems I'm not going to be able to follow what my heart truly wants to do.

I even looked into going back to school, but I have alot of prerequisites first, and since I'm not considered a resident until I've been here a year, the cost per credit is over $200.

Does anyone have any advice on what else I can do to try and break in down here? It makes me so sad when I know I have so much to offer our patients.

Thanks for listening,

mc3

Maybe a good first step would be to check Florida's Nurse Practice Act and see what restrictions there are on an LPN's practice. Then put together a comprehensive list of the specific job activities you can perform for the hospice you'd like to work for. They may be saying, "We only use LPNs in ____ capacity" because they don't have the vision to see what an asset you could be.

Perhaps you need to market yourself by getting in the door for a per diem interview and then show 'em your stuff. On the other hand, they may be leery of you practicing beyond your scope, so you'd also need to show that you can comfortably work within the limitations of an LPNs scope versus an RNs in that environment; you need to be clear about what you can't do for them, too. I would suspect that the only thing you can't do is the case management/primary nurse piece.

If you apply to a busy hospice, I would think that there is always a need for nurses to do spot visits and all of the job activities you mention above. You may be able to team with an RN as you formerly did and share a caseload, too. It's just not that easy to find good hospice nurses, so I think that you just need to "make it real" for them.

Maybe for the "vision impaired" get creative and show a homemade video of you doing an acted out version of a visit and responding to phone calls? Thirty seconds of you doing med education, a shot of you doing vitals (I'd stay away from "assessment" other than that), explaining s/s of imminent death, educating patient and family on the use of equipment, explaining when they need to call the hospice, changing a dressing, changing a hearing aid battery (and smile! the patient can hear again) etc. Maybe some shots of you updating the "primary nurse" and coordinating with her, and thirty seconds of you "on the phone" taking a call from a patient about a medication that needs to be refilled. End it with a smiling you holding cards saying, "mc3, bringing value, compassion and integrity to her work with YOUR hospice."

I wish you all the best with this. Keep trying!

Kat

Thanks so much for your great suggestions! I'm going to use them all in my job search! In the meantime, I plan to take the CHLPN exam in September. Hopefully, that will help also.

Gratefully,

mc3

Just curious where you were in florida? I just moved from florida, but worked for hospice for 2 yrs there. We used lpn's alot, but primarily for continuous care....which they all loved. When continuous care cases were low, we would then use them to help us with visits as needed...there never seemed to be a shortage of things for them to do. I know the other company in town used the same system you referred to....where the RN and the lpn sorta worked in a team...with the RN more managing the care. You must just be in a weird area....when you say florida it's sorta generic...in the sense that the panhandle and the peninsula are like 2 different worlds.

Kathryn RN CHPN

Just curious where you were in florida? I just moved from florida, but worked for hospice for 2 yrs there. We used lpn's alot, but primarily for continuous care....which they all loved. When continuous care cases were low, we would then use them to help us with visits as needed...there never seemed to be a shortage of things for them to do. I know the other company in town used the same system you referred to....where the RN and the lpn sorta worked in a team...with the RN more managing the care. You must just be in a weird area....when you say florida it's sorta generic...in the sense that the panhandle and the peninsula are like 2 different worlds.

Kathryn RN CHPN

I'm in Lake County...Am I correct in understanding that hospices are by county, and there can only be one hospice covering 1 (or more) counties?

Thanks,

mc3

Hurrah!! Just wanted to let you know I finally did land my hospice job!! I did as you all suggested, basically just kept at it. My interview went fantastic; you know, the type where it doesn't even feel like an interview, it just feels you're having a good chat. They called 2 days later, and I'm in! Now I feel like I'm "going home"... Thanks again for your suggestions and support.

mc3 :

I'm in Lake County...Am I correct in understanding that hospices are by county, and there can only be one hospice covering 1 (or more) counties?

Thanks,

mc3

Not exactly....florida has what they call certificate of need...basically the need is assessed for that area (by AHCA- which is the state). They determine the need and whether or not multiple agencies can open in a given area, for example, larger cities like miami would have more need than small rural areas and would therefore have more agencies. I lived in ft walton beach...our office served okaloosa/walton counties....there was one other hospice in the area. No other hospices were allowed to come in and open b/c the state determines that the 2 existing agencies meet the need of that population. I am from/currently live again in louisiana...they do not have certificate of need....so for instance, there are at least 50 different hospice agencies in the new orleans area alone.

Hope that helps,

Kathryn RN CHPN

The non-profit hospice I work for in Palm Beach County utilizes LPN's in continuos care, under the mangement of an RN case Manager and also offers tuition reimbursement as well as helping with CHPN certification