Does it matter where I start?

Hello! Hospice is a steep learning curve, no matter where you start I believe. I had 8 months of med-surg and went into home hospice care after that. I never did inpatient, so I don't know what the difference is, but with home hospice I think some solid background in the basics prepared me well enough to attack the learning curve. If your heart calls you to hospice, do it! I loved it and hope to get back to it once my kids are grown further. So to answer your question, I don't think you would need to do critical care first to do hospice.

I came from a LTC facility and jumped into Hospice with no problems. It's definitely never bad to have patient care experience, as we encounter many different things like trachs, drains, tubes, etc. but overall you definitely don't need CCU experience. It's such a shift in mindset from "Let's get in there and fix it!" to "Let's treat the symptoms and keep them comfortable!" that it might actually be beneficial to not have critical care experience IMO. Regardless, just like any job you will learn and be trained on the job, so as long as you're willing to learn you will be fine. I agree with the last post, if you have the heart for it then do it! Hospice is such a wonderful and fulfilling realm of nursing and I can't imagine doing anything else!

I went from ICU to Hospice and it certainly helped me. I don't think it's necessary, I think you can get that knowledge base elsewhere, but you become familiar with vented patients, pain management, dosages, etc and you are forced to know your disease processes well. A lot of times you have to have hard discussions about benefit versus burden of certain treatments and if its a treatment you haven't experienced first hand (weaning from vent, discontinuing vasopressors, etc), it can be hard to speak about it in an informed way. Many of my colleagues started in an inpatient hospice setting then branched out in other arenas of hospice and are thriving.