Field Hospice nursing to inpatient unit

MissIt · Jul 13, 2011

Like most inpatient units, a 12 hour shift might be longer depending on what's going on (usually admissions and discharges), but never anything like 60 hours. It's similar to the floor-- we start the day with report, then do our morning assessments and meds. The docs round with us every morning and do orders then. Throughout the day, we do treatments, wound care, more meds, feedings, education, etc. Most of the time I try to do wound care when the CNAs are turning the patient anyway (if I have time, right after the morning bath). Then we have admissions and discharges (live discharges or deaths), family members calling with questions. I do my charting whenever I have time.

Ginapixi, BSN, RN · Jul 18, 2011

sounds like you are being abused... the all mighty buck is driving management and if it smells like a possible new pt we are on it, no matter how far we send a nurse.... that part you should not have to deal with working inpatient; the rest is nursing! health care workers are the most abused i think and we let them because we care more for our patients than ourselves.....

give it i try Annie and god bless in your switch! take care of yourself (no one else will - i know it!)

evolvingrn, BSN, RN · Jul 19, 2011

Good luck , i work inpatient and like it! its definately not case mgt, more floor nursing but i would say we get more input in direction of care than traditional floor nursing.......

tewdles, RN · Jul 19, 2011

no matter what, you DO NOT want to work for a hospice which puts profit before people...hospice is too demanding and stressful and will eat you up in that environment.

ws582 · Aug 20, 2011

Hi everyone! I'm very interested in hospice, and wanted to ask a few questions. My only nursing experience is 6 months at a long term/rehab facility and 2 years currently on a med/surg floor. I love nursing, but the floor is soooo hectic with tons of orders, transferring people back and forth for tests, discharges, admissions, etc. I don't get to spend nearly as much time with the patients that I want to and my favorite part of my job is making them comfortable. I'm not considering home hospice at this time, but very interested in inpatient hospice. I know you must have some crazy hectic days, but on a typical day, would you say you have more time to devote to each patient, or are you constantly running like on the med/surg floor? How many patients do you have on day shift? MissIt, what kind of treatments are you refering to (respiratory? or do you have a respiratory tech there?). Also, I'm a nervous about starting IVs on hospice patients. I'm decent, but I'm sure they're so ill, it must be extremely difficult. One last thing: On my med/surg floor, most nurses are so busy they can't help out when you get overwhelmed. Do the nurses you work with typically help each other out if they're drowning? Thanks in advance for your input :)

evolvingrn, BSN, RN · Aug 20, 2011

I work inpatient hospice.......its a lot like med -surg... lots of admissions, discharges or deaths (which takes just as long as a discharge...longer if they are a coroners case) ..but we ususally are good at supporting each other if one of us is drowning....(to a point) I don't feel like i have tons of time to spend with family .....unfortunately but our inpatient support has good support staff chaplain , social worker, volunteers ect....that is a great tool for me . good luck in your decision.

MissIt · Aug 21, 2011

I agree, I think it's better because we have extra support staff there most of the time and volunteers during day shift. We usually have 5 patients, but it can go up to 7 on days. Admissions, discharges, and all of the resulting documentation are the worst time drains, I think. Our nurses and CNAs really do work together as a team. I have never had to move a heavy patient on my own at our facility and most of the time I have help for things like awkward dressing changes too because we understand that not only is it easier on the nurse, it's easier on the patient. We do some respiratory treatments, like nebs. We have a resp. therapist that can be called, but not anyone here all the time. We really don't do that many IVs, most people either have central lines already or we just use subQ medications. I'd recommend finding out if you can volunteer at the inpatient hospice you're thinking about working with because every place is going to be different. Personalities and the culture of the place can make such a huge difference.

ws582 · Aug 21, 2011

Thank you so much for your responses. I have a better understanding now except for one part. I really long to be able to spend more time with the patients. I know you said you don't have "tons" of time, but compared to med/surg, would you say it's considerably more, or does all the paperwork/charting still keep you from the time the patients deserve? I usually end my day thinking they needed more from me, but I couldn't give it because of all the "busy" work. Thanks again in advance :)

MissIt · Aug 21, 2011

I would find out what the usual patient load and staffing is at the inpatient facility you are considering. On days when I have 4 or 5 patients, I get to spend lots of time with patients and families. And that ratio happens a lot more often than it did for me at the hospital. On days when we're short a nurse, we rush around like crazy. Definitely, I feel like this kind of nursing allows me more time to provide excellent nursing care rather than just getting through the day.

ws582 · Aug 22, 2011

I was hoping you'd say that MissIt :) Thank you so much for your input!