Getting into hospice nursing

ErinS, BSN, RN · Apr 16, 2011

I work in hospice, but I also work closely with our local hospital's palliative care program. Hospice and palliative care are very different, and I do not think I would like palliative nearly as much as hospice care. I am getting my MSN right now and doing hospice full time, but I am not getting an NP degree. I would say if you are unsure, maybe stay in school but get your FNP. You can always specialize down the road, but the broader your degree the more job opportunity.

mlisk589 · Apr 16, 2011

Thanks for your input! What are some of the differences you've seen between palliative care and hospice? The whole palliative care program sounds great on paper, but I'd like to know more about it. And becoming an NP is kind of scary to me, sometimes it seems like a great idea and sometimes I think I'd be much happier just finding my niche and specializing later (without a masters). Just trying to find out more for now

eternalsunshine · Apr 17, 2011

I work in hospice, but I also work closely with our local hospital's palliative care program. Hospice and palliative care are very different, and I do not think I would like palliative nearly as much as hospice care. I am getting my MSN right now and doing hospice full time, but I am not getting an NP degree. I would say if you are unsure, maybe stay in school but get your FNP. You can always specialize down the road, but the broader your degree the more job opportunity.

Erin, I recently went for a job interview and was told that the majority of candidates that apply to do Hospice work have never done it before but have had some form of 'experience' be it through being the other end such as a family member of a patient, or who have maybe cared for someone in hospital until the end.

I think it is far more important to have the right qualities rather than experience, I think that is key. You cannot learn 'qualities' but you can learn nursing experience (if that makes sense!).

My advice would be to see if you could maybe spend a few days shadowing someone to see if you like it. It can be quite emotionally draining but there is no job more humbling and satisfying. You get so much out of it.

You could look at getting your Certification in Hospice and Palliative care down the road, but probably best to have some practical experience first, so you can relate to the theory better.

http://www.nbchpn.org/

All I can say is I couldn't do any other type of nursing.

Best of luck to you!! :)

ErinS, BSN, RN · Apr 17, 2011

There are a few differences between palliative and hospice care. Palliative care in the home is currently funded under home health, although I suspect this will change in the next few years. Home health requirements are very restrictive compared to hospice as far as the number of visits allowed and justification for services. Essentially, more red tape.

Also, in hospice people have generally stopped aggressive treatments. In palliative care, most people are still getting some type of treatment (otherwise they would likely be on hospice). So in addition to palliating disease symptoms, you also are trying to manage side effects from treatment, which are often very difficult to manage. I have a hard time seeing people who are uncomfortable, so this would not be a good fit for me.

In the hospital setting, our palliative care team is directed by a NP, but she has no real ability to oversee care, because there is no MD over her. So she meets with families and discusses the option of hospice vs. aggressive care, or going home on home health palliative care. Then she makes appropriate referrals, and if the family decides they want hospice, we come in and provide the care.

I definitely agree with eternalsunshine, you may want to shadow a hospice nurse (although a few days will only begin to help you grasp the emotional stress the job entails), and consider getting hospice and palliative care certified down the road, although they recommend 2 years experience prior to certification. In the mean time, I would still consider going to school if you are in 'school mode'. Like I said, a FNP will give you a lot of flexibility to specialize throughout your career as the job market changes.

eagle78 · Apr 17, 2011

I am soo glad you opened this thread. I am starting nursing school, and have no hospital experience. I really, really want to work in Hospice. I have been volutneering at Hospice, is that helpful for background to try to get into Hospice?? Also I am a cancer survivor, so I am hoping that my past experiences will help me in the pursuit of caring for Hospice patients. There has always been an inherent desire in me to take care of people, and I love the team work that I see in the Hospice environment.

eternalsunshine · Apr 17, 2011

I am soo glad you opened this thread. I am starting nursing school, and have no hospital experience. I really, really want to work in Hospice. I have been volutneering at Hospice, is that helpful for background to try to get into Hospice?? Also I am a cancer survivor, so I am hoping that my past experiences will help me in the pursuit of caring for Hospice patients. There has always been an inherent desire in me to take care of people, and I love the team work that I see in the Hospice environment.

Eagle, congrats first on being a survivor! :yeah: You will be in a far better position than most nurses when it comes to the empathy, as you have been there yourself, so you can truly and genuinenly empathise :).

My best friend told me that when she was going through her treatment and you meet and talk with other cancer patients, she said there was a kind of unspoken respect and understanding - a special kind of comadery between them. As she said there was nobody else that truly understood what it was like to go through a cancer diagnosis apart from another cancer sufferer. I totally understood what she meant. No matter how much experience I may have had caring for people, I had never actually been there myself. You will be able to share your experiences etc which I think is invaluable :)

Again, as I said below, to have the special qualities needed to be a Hospice nurse I think are far more important than experience. Nursing is a continual learning process no matter how many years you have been nursing, its never ending! :) One thing that is key is impeccable communication skills (both verbal and non verbal). This is very important in palliative and hospice care.

If you are already volunteering at a hospice as well, perfect! You will have hopefully already had a taste of the Hospice environment and the emotional strain.

One piece of advice - I suspect you would be closely monitored by your peers due to your personal battle with Cancer. There is a fine line when it comes to boundaries and you have to be very careful not to blur that boundary. It can be very hard, I myself have become too attached to patients, especially when they are similar to your own age. It can be come very intense when you build a strong bond with a patient, it's like you become a part of the family. So, all I would say, is for your own protection, know your boundaries and recognise when you think you are getting too emotionally attached and involved (it's so easy to do without you knowing it) as otherwise you will hit emotional burnout.

Message for Erin: My apologies!! I addressed my first message to you! sorry! :lol2: It was supposed to be addressed to mlisk589!!

eagle78 · Apr 17, 2011

To eternalsunshine, thank you so very much for your feedback. I had not intended on disclosing my past experience as a patient but now that I see your comments it may be a good idea. There is a special bond between patients, and my one concern is that my empathy not be so strong for the patients that I overlook the expertise of my peers. I had such a wonderful care team, doctors, nurses and the techs, that I know how knowledgeable and caring you all can be.

For people who have not gone through the experience I believe you all do a wonderful job of relating to the needs of the patient as well as the family. It would be an honor to be able to be part of the team and I hope I can make it. Thanks again, your remarks are truely a godsend. Have a blessed day.