Hospice for New Grad?

[omavirgie]

I am soon to be a 51 year old new graduate with an associates degree in nursing. After homeschooling my children and sending them out to be productive citizens I was faced with a decision of what I wanted to be when I grew up. haha. I tried architecural drafting and loved the creative part of it but hated the lack of personal interactions. I love people! I started contemplating what I really wanted to do with my life and I decided that I needed to find a job that I would do for free if I could. On my way to work I saw a Hospice center for our state. I remembered the kind nurse who assisted my sister-in-law's mother in her final days on this earth. I wanted to do that, was my thought. So that is what I set out to do and be.

I am now finishing my last semester. I know my strengths and weeknesses well and floor nursing is definately not my strength. I am not a great delegator and I want to spend time with my patients - giving them comfort.

My question is this: Do I need to spend time getting experience as a floor nurse when I know that is not what I want to do? Can I get my orientation as a new nurse in Hospice and Home Health?

[amarilla, RN]

I am a new grad also, working since June on a surgical floor. On the 'do I need to start on the floor' question, I'm of two minds: first, that yes, we can start anywhere and learn to adapt to that specialty, particularly if that's what you plan on doing long-term. Having said that, especially because you mention home health, I'm hesitant to recommend a new grad begin in the field without any foundation of skills and knowledge.

Does it happen? Sure. Is it safe? Not as sure.

In home health, you do really need strong assessment skills and intuition to see what's happening with your patient without any second pair of eyes or ears. You'll be responsible for administering drugs, setting up vacs, treating wounds and providing teaching in the home environment, sometimes for conditions, meds and equipment you've never heard of or set eyes on. You're going to have to problem solve complications and equipment follies without another pair of hands, with your patient there waiting and watching, needing you to resolve the issue now. If that's not pressure, I'm not sure what is. Your agency should provide a preceptorship and backup by phone, but it's an awful fine line to walk to take that much responsibility without the experience to back it up.

If it's what you want to do, go for it, but I'd personally be wary of jumping in unless the opportunity really provided a supportive environment and extended orientation. Just my

Best of luck!

[omavirgie]

You make a very good point! Thank you for your input!

[HouTx, BSN, MSN, EdD]

Have you considered looking for a job with an inpatient hospice program? This would be a much better option for an inexperienced nurse. I haven't worked in this specialty, but have developed education programs for hospice training & have been the very greatful recipient of their services for close family members.

Hospice is a very demanding specialty. Of course, the emotional demands are obvious, but hospice nurses are also expected to effectively deal with very heavy family dynamics, and unexpected patient complications - many times coming up with creative solutions. It requires a very deep knowledge of pain management, wound care, etc. I have nothing but admiration for these talented & dedicated nurses.

[omavirgie]

Thank you very much! If I am to be a Hospice nurse, I want to be a good one. I, too, admire them. You have given sound advice!