Hospice Admissions nurse

tewdles, RN · Dec 15, 2009

These nurses generally go to the residence of the patient, explain the hospice benefit to them and their families, obtain consent for hospice and then complete an initial comprehensive nursing assessment and an initial plan of care. The physician, social worker, and pastoral care must be contacted for collaboration. The visits often take between 2-4 hours with substantial documentation. Most SOC nurses can comfortably complete 2 cases per day...experienced and efficient RNs can often complete 3.

AtlantaRN, RN · Dec 15, 2009

the only drawback to an admissions nurse position, is that if you don't have any admissions scheduled, you are required to go out in the field and do nursing visits, or chart check in the office,etc. i've found that most small hospices don't have the referral sources to completely support a full time admissions nurse, and a larger one, you will do alot of driving.

tewdles, RN · Dec 17, 2009

So true AtlantaRN.

I currently work for a larger nonprofit in Michigan that has an admission team. They are busy enough that the case nurses have to take turns helping them with after hours and weekend SOCs! Another hospice in the same area has 100+ avg daily census and they depend upon their case nurses to do ALL admissions and all afterhour and weekend visits. They have avg a complete replacement of RN staff about every 24 months...they just burn them out and many leave hospice permanently!

AtlantaRN, RN · Dec 17, 2009

I went into our ipu unit last evening to do 4 admission, took me 10.5 hours, and that was in the facility with family members present. I got home at midnight, and slept til 10am. Each family was at a different level of acceptance-One man was Cheyne-Stokes breathing, and family is asking when nutrition was starting through his dobhoff-no bowel sounds....he was already wet in the lungs on a 40% mask.... I was tired!

tewdles, RN · Dec 17, 2009

holy cow patties! I am pretty sure I would not be able to do 4 admissions in one day...what a brain drain!!!

~MIA~, ASN, RN · Jan 8, 2010

Someone should have stepped up to help you with 4 admissions!!!!! That's crazy! Kudos to you and hope you don't get burned out.

txspadequeenRN, BSN, RN · Jan 8, 2010

i was doing a admit to the inpatient unit yesterday and because i am new to this hospice the paper work is different...i about wore myself out in the middle of it..i cant imagine doing 4...

KDMFLRN · Sep 13, 2015

I live in Florida and am making the transition form ED to Hospice, any suggestions on preparing for my new role? reading material, etc.

CaptKris · Sep 16, 2015

I work at a big hospice in floria. Our's is divided up among different divisions such as LTC, Home, Hospital. We staff every hospital in the area and on a good day I do one admit and 2 info visits. Hospice is like med-surg in reverse but you've got to focus on what's going to be their demise. You'll learn great catch all admitting dx's. Late effect CVA. Cerebral Atherosclerosis. etc. You'll start looking in the medical history for something you can use and what's pressing them. There's a lot of "kittens and rainbows" and hand holding. Being productive in hospice doesn't mean you have to be curt and not sensitive but you can't let the family get sidetracked off on that funny story with the brother at the family reunion a year ago. It has been my experience that a lot of home team nurses love to hear the stories and see the travel pictures and hospital team nurses are about clinical nature.

toomuchbaloney · Sep 17, 2015

I work at a big hospice in floria. Our's is divided up among different divisions such as LTC, Home, Hospital. We staff every hospital in the area and on a good day I do one admit and 2 info visits. Hospice is like med-surg in reverse but you've got to focus on what's going to be their demise. You'll learn great catch all admitting dx's. Late effect CVA. Cerebral Atherosclerosis. etc. You'll start looking in the medical history for something you can use and what's pressing them. There's a lot of "kittens and rainbows" and hand holding. Being productive in hospice doesn't mean you have to be curt and not sensitive but you can't let the family get sidetracked off on that funny story with the brother at the family reunion a year ago. It has been my experience that a lot of home team nurses love to hear the stories and see the travel pictures and hospital team nurses are about clinical nature.

I have done both and I would disagree, I think the focus of both is a death that reflects the wishes of their patient and family as much as possible. I listened to plenty of family stories with patients who could not go home.

Sometimes in the home I was spending a great deal more of my time actually managing symptoms and providing direct nursing care minus the "kittens and rainbows".

BerryhappyRN, MSN, RN · Nov 2, 2015

I have heard really rough stories about working hospice admissions. You must have excellent assessment skills, strong counseling skills, work well independently, and have the tenacity of a used car salesman. Our admissions nurses may work on one admission from 4-6 hours and are often stuck being the first line of therapy for a newly diagnosed patient/family. I honor the admission nurses hard work, but would not want to do their job. Make sure you are well compensated!