Looking for a new specialty

cardiacfreak, ADN · Jul 24, 2017

Well it's not for everybody but I recently left a Progressive Care Unit and now I work for a hospice company. I have time to teach, ease suffering, my annual income is the same, I know I make a difference to the patient and caregiver, my critical thinking skills are inhanced (I don't have monitors anymore), the doctor's support and value my input and rarely tell me no to a change of plan.

The hard thing for me was wrapping my head around not saving them but making the remaining days, weeks, months as pain free and comfortable as I could. I finally realized that these patients were the ones I frequently questioned WHY? When we were coding them.

OnTheSearch · Jul 25, 2017

Thank you cardiacfreak for your reply! I have considered hospice nursing, I like the idea of allowing one to die in peace and in comfort. What made you make that switch? I did apply to a company called VITAS but I needed 2 years experience.

cardiacfreak, ADN · Jul 25, 2017

A lot of things added up to me leaving. My age (50) I was just tired of running up and down the halls chasing bed alarms plus my back ached everyday. I only have an associates degree and for me to stay as the Assistant Nursing Care Manager I was going to have to get my BS degree (hospital had applied for Magnet ). Too much turn over on the unit, I was training brand new nurses every couple of months. And I really hated all of the scripting. I felt like I was a recording, instructed on what to say, when to say it, and how to say it.

Two nurses that I trained already worked for the company and spoke with the PCM and director and Voila, I told them how much I needed to work for them and they accepted. Now, I should add I had 18 years acute care experience and 6 years management to bring to the table.

ChryssyD · Jul 27, 2017

Sad to say, your "dislikes" are going to exist wherever you choose to practice. If you really love teaching and making a difference, OB and peds are good areas; however, the family is your patient, so if you have trouble dealing with hysterical or high-strung families you can't go there. Hospice is a wonderful area for a caring nurse who wants respect from doctors and families, but it is also uniquely stressful and more than a little sad; yes, it can be immensely satisfying to help patients die with dignity, and when they're 75, it's all perfectly OK. When they're 40, 35, 31, and 19, over time it wears on you, because it's so darn sad; this is my experience.

I will say that one great experience I had while working agency was on an in-patient rehab unit: the patients were still sick and hurting, but they were recuperating. They were (for the most part) motivated. The families were motivated, because they could see a light at the end of the tunnel. Goals were fairly well-defined and there was a multi-disciplinary team approach. I really felt I was making a difference. Of course, I also felt that way while working at an in-patient hospice, even though it was a bit draining. I loved working there, but I wasn't able to do it for very long.

At the end of the day, only you know what is best for you. Search your heart, and whatever you find, follow it.

A&OxNone, MSN, RN · Jul 28, 2017

You should for sure look into pediatrics. Its almost none of your "dislikes". I actually didn't like doing adult nursing for most of the same reasons. I do work ICU now and will tell you that the fear of messing up is really high - BUT, those parents are usually so stressed out and shocked that any amount of kindness and teaching you give them is helpful.

Everybody says the parents in pediatrics are terrible but really, that hasn't been my experience. If you take good care of them, tell the parent what/why you are doing what you are doing, and are generally kind. I feel like most people are reasonable. I also think sometimes it takes the personality of somebody that doesn't mind letting mom run the show every now and then (within reason) just to let them have some control.

OnTheSearch · Jul 31, 2017

I haven't thought of pediatrics! Interesting. Some people have also suggested NICU to me, which was my first love, but I am still hesitant.

westieluv · Jul 31, 2017

I second hospice. I have been an RN for 27 years and I cannot tell you how burned out I was on acute care. The constant stress of worrying if that borderline critical care patient on the progessive unit was going to crash, having to deal with drug seeking patients and the physicians who enabled them, dealing with nasty families always looking for something to be unhappy with, dealing with lazy co-workers who walked off the floor to smoke (when the campuses were non-smoking indoors and out), and etc., etc., etc.

I am someone who has always loved the people side of nursing but not so much the technical side. I probably would have made a good social worker. I love hospice because I get to comfort dying people and their families and feel like I really made a difference. I have had grieving families that I'd never met before hug me and cry and thank me over and over. I don't remember getting a lot of thanks for anything in acute care. It is so satisfying to see someone who was suffering with end of life and terminal illness symptoms get relief and fall into a peaceful sleep after I spent time with them and advised the correct medications and you cannot even believe how thankful families are when they see their loved one's suffering stop. You have autonomy in hospice if you work out in the field and you can set up your day how you want to unless you are an after hours nurse who goes out for emergent situations and death visits.

I know a lot of nurses who were so done with nursing and then switched to hospice and can't imagine themselves doing anything else, myself included.