ED to Hospice

[UpinawayRN]

Any former ED adrenaline junkies decide and take a hospice job after the epiphany that helping people die a comfortable death seemed much more rewarding than trying to save anyone and everyone at all costs? The thought of making people comfortable when it is their time weighed against maybe losing hospital technical skills and opportunity for advancement and marketability for other areas has been consumming me. Especially having family members former hospice pts. This would be new to me but I think I am very good at comforting pts and families. Opportunity is on near horizon. Any thoughts? This would be an extended care Hospice. I think I have too much compassion to watch people kept alive at all costs..more gratifying to help grandma die peacefully than shoving tubes in every orifice..Yes I have decided, this is what would give me peace.:redbeathe

[nutella, MSN, RN]

My hope is that I can work per diem in the E.D. and work per diem as a hospice nurse. Would you recommend home care hospice or Admissions hospice? What other options are there when it comes to hospice?

To be honest : You should work fulltime in hospice for some while to learn the business. There is a lot to learn and it can be a steep learning curve. It might not look like it but let me tell you - home hospice and home care in general is a total different story as opposed to hospital nursing.

While a person can probably somewhat learn to do an admission in hospice without having worked as a hospice nurse, it is hard to be successful without prior solid experience. Admissions require diligent assessment, a bit of a care plan and symptom management. Plus you can run into problems with coverage questions and this and that...

You can not be a case manager and work per diem in home hospice, which means that if you do work per diem you usually get the cases nobody wants to see.

[friendlylark]

Cool - thank you for the info. I appreciate the feedback! I think, for now, I am seeking flexibility, so I am planning to work per diem in the ED for a while (its my background). Perhaps in the future I will look at hospice admissions! Tell me, what is the role of a hospice admissions nurse, and is it traveling from site to site?

[friendlylark]

Is there a lot of freedom and flexibility in your day when working as a hospice nurse?

[Jensmom7, BSN, RN]

Is there a lot of freedom and flexibility in your day when working as a hospice nurse?

Not as much as you would think.

You can set up your day for 5 visits, easy peasy...then you have 2 other patients develop symptoms that need to be assessed and acted on, doctors don't get back to you for awhile and on top of all that the office calls you to do 2 evals.

I do have to add that my patients are all in one facility, so I'm not driving all over God's green earth (unless I'm requested to go offsite to do an eval or admit), but sometimes lunch happens while I'm doing the computer chart review of one of those evals.

Hospice isn't a cakewalk. You hear about the flexibility and slower pace, but it's not necessarily so.

[friendlylark]

Thank you for the info Jensmom. I'm not really looking for a cakewalk, but I definitely do want flexibility. I need it right now! All of the info will help me make a good decision, so I appreciate your input. Thank you!

[nutella, MSN, RN]

Is there a lot of freedom and flexibility in your day when working as a hospice nurse?

It depends on your agency and workload.

If you case manage you have a bit flexibility but not as much as a per diem hospice nurse without a case load who just does visits.

As an admission hospice nurse there is productivity attached and the expectation is that paperwork needs to be done the same day - usually on the computer. One admission can account for a total of 4 hours (it is a lot of documentation).

The most flexible job I had was in acute dialysis - no kidding. When I had to accommodate my family I went per diem for some months but was able to pick up treatments throughout the day. One nurse would even come in as early as 5:30 to get a treatment done before her day got busy. There was always opportunity to pick up one 3 or 4 hour case on a Sunday as well. The only thing was that per diem acute dialysis can leave you without enough hours at times.