Hospice as first RN job?

FallingInPlace, ADN, BSN, RN · Apr 8, 2020

To answer your question, yes, some hospices will hire new grads, but I personally recommend some acute care experience before going to hospice. My med surg experience was invaluable in assessing what I was seeing in patients. In hospice, you are often alone as the RN making a judgment call on how to treat symptoms, and you need to be able to accurately convey what you're seeing to the MD to get the med orders you need. Hospice is not a common choice for new nurses, and I don't want to discourage you in any way. It's a great choice, and I hope you make your way there at some point.

brume, BSN · Apr 9, 2020

@calliope26 That is pretty much what I suspected. Thanks for your reply!

StJohnRiver · Apr 12, 2020

The hospice I work at does hire new graduate nurses, but most of them leave after a couple of years. They say they want to learn more, and I can see why they make that choice. I think hospice is wonderful, but you will be much better prepared for it if you have previous experience, preferably acute care in a hospital. One of the great things about hospice is the autonomy nurses have. You earn that by earning the trust of the doctor. And you will be much better equipped if you have experience in handling meds and orders and dealing with all the specialists you'll deal with in a hospital setting. Another thing needed is life experience -- much of hospice work is dealing with families and their emotions at such an intense and traumatic time. That's something that just comes with getting older and all the experiences and learning that comes with that.

Polly Peptide, BSN, MSN, RN, APRN · Apr 16, 2020

I went into hospice is an almost-new-grad. I, too, have a heart for it and my experience confirmed I was right...I love hospice and my patients. However, I am doing what the above-poster said and quitting to go to acute care. I have other reasons too, but I feel I've missed some valuable experience/education as well as skill development. I am a mid-life career changer and I felt quite comfortable in most of hospice's often-challenging emotional situations. You have to be calm, compassionate, level-headed, and able to talk through tough topics. Another thing that I wasn't totally expecting (but maybe should have) is the family discord that pops up with end of life issues. It is one of the reasons the interdisciplinary team (social work, chaplain, etc) is so valuable, but as the nurse/case manager, you have to be able to comfortably talk to people with heightened emotions.

I will miss it and expect I will come back to it later. For now, I am going to go learn in another environment/around other nurses and professionals and develop my skills. I did NOT like the feeling of being scared to hurt my patients with a straight stick or some other procedure (yes, we do those in hospice!) because I haven't done them in MONTHS or maybe only ever did it in school.

brume, BSN · Apr 20, 2020

@calliope26 @StJohnRiver @Polly Peptide
Thank you so much for your valuable wisdom!

peter feliks · May 4, 2020

To be a good RN Hospice Case Manager, one needs to be confident enough in their assessment skills to act in an autonomous manner. I know I dodn't feel that way when I first graduated.

MikeMSN-RN, MSN, LVN, RN · May 10, 2020

I became a nurse to primarily work for hospice. I worked for hospice for 5 years as an LVN, then a few more years as an RN. You mostly work alone, so you need solid assessment skills. Nurses think acute care experiences will help develop the skills.
I was very lucky to have had very good RNs who taught me a lot when I started working for hospice.
I left hospice about 3 years ago because I was burned out. I needed a change. I miss hospice now, so I know I'll come back to it.