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Home Health-The good, The bad, and I'm getting out.

Home Health   (21,682 Views 42 Comments)
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Those of you who ventured to hospice after ICU.... May I ask what about Hospice made it more appealing to you than ICU at the time? Very curious because the company I work for just hired two nurses coming from ICU. I don't hate my job or the company/policies, I'm nervous wanting to leave for the "icu experience" and others are running from it. Would greatly appreciate a different frame of mind than mine.

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Those of you who ventured to hospice after ICU.... May I ask what about Hospice made it more appealing to you than ICU at the time? Very curious because the company I work for just hired two nurses coming from ICU. I don't hate my job or the company/policies, I'm nervous wanting to leave for the "icu experience" and others are running from it. Would greatly appreciate a different frame of mind than mine.

It is difficult to explain but I will try. It becomes an exercise in futility to keep a person alive who is never going to get better, or death is in the immediate future. It is disheartening and feels like you are a torturer at some points.

For example, keeping a 65YO on an oscillator that has terminal advanced lung CA. Intubating 80YO ARDS pts that are not going to get better and face a sure death. Repositioning Q2HR when it obviously causes more pain than relief and you don't have enough pain meds ordered, nor are you likely to get them. Doing CPR on a frail 90 YO and YOU are the one who has to crack the pt's ribs. Explaining to loved ones and family that everyone has to die and watching them sob over beds.

I find it much more pleasant to give patients a good quality of life until they do die a pain-free death in hospice. In other words, death in ICUs are rarely good and are mostly horrible and traumatic for all involved.

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It is difficult to explain but I will try. It becomes an exercise in futility to keep a person alive who is never going to get better, or death is in the immediate future. It is disheartening and feels like you are a torturer at some points.

For example, keeping a 65YO on an oscillator that has terminal advanced lung CA. Intubating 80YO ARDS pts that are not going to get better and face a sure death. Repositioning Q2HR when it obviously causes more pain than relief and you don't have enough pain meds ordered, nor are you likely to get them. Doing CPR on a frail 90 YO and YOU are the one who has to crack the pt's ribs. Explaining to loved ones and family that everyone has to die and watching them sob over beds.

I find it much more pleasant to give patients a good quality of life until they do die a pain-free death in hospice. In other words, death in ICUs are rarely good and are mostly horrible and traumatic for all involved.

Is is exactly why I went from ICU to hospice.

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Thanks to both on your insight. I liked that both agreed to the same thing and that the "things" were not related to: how hard, stressful, unrealistic job demands, the long shifts, the nights, the weekends. I can see how that bothered both of you. I get aggravated when a patient begins to decline, (which is expected on hospice) and the family panics and wishes to change to "aggressive measures" and they transfer to ER. I can get through to most but the few would end up like those patients you guys described and it is a horrible way to die. Invasive treatments are not always life saving for everybody. I also like about hospice that it is not going anywhere. The demand for it will grow as home care becomes more important and more people understand the importance in changing intensity of care as we age or have a debilitating disease with poor prognosis.

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These threads always make me want to go hug my boss.

What is the top 500 agencies? Honestly, that's a lot of agencies and doesn't sound reassuring at all.

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