Hospice nurse with no nursing experience

SoCalRN1970 · Jul 9, 2011

There is a huge learning curve for the speciality of hospice. One as an RN must have sharp assessment and clinical skills. These can not be taught but rather learned on the job. Hopefully your employer will make good on the "gonna train you" part. So many hire and then lack the support internally for a new nurse. I wish you luck.

ErinS, BSN, RN · Jul 9, 2011

Honestly, unless you are in a inpatient setting I think this agency is setting you up to fail. Hospice is VERY autonomous, and you really have to be able to assess and predict what is going to happen to a patient. I started with 2 years of acute care experience, and it was still a 3 month orientation and solid 12 month learning curve for me. I would also be concerned about an agency who is desperate enough for nurses that they are taking brand new nurses...There are some BAD hospice companies out there.

Hospice Nurse LPN, BSN, RN · Jul 9, 2011

I graduated in 2005 and i got my license in 2010.i never worked as a nurse before.The agency said they're gonna train me.Is it hard to work as a hospice nurse if you dont have any experience?What do i need to expect?Than you so much :)

I'm in agreement w/ the other posters. I came to hospice w/ 3 yrs experience and was on the phone LOTS w/ my CM the first 6 months or so. You will need to have sharp assessment skills and be able to anticipate problems for both the pt and the family. A good knowledge of the progression for different diseases is very important as well as managing pain and symptoms. Where I work, our doc just asks "what do you want to try?" You didn't mention if the job offer was in patient or in the field. I was also wondering why you waited 5 years to take your boards. I'd check the reputation of the company before I commited to the offer. Good luck and keep us posted.

SoCalRN1970 · Jul 9, 2011

I'm in agreement w/ the other posters. I came to hospice w/ 3 yrs experience and was on the phone LOTS w/ my CM the first 6 months or so. You will need to have sharp assessment skills and be able to anticipate problems for both the pt and the family. A good knowledge of the progression for different diseases is very important as well as managing pain and symptoms. Where I work, our doc just asks "what do you want to try?" You didn't mention if the job offer was in patient or in the field. I was also wondering why you waited 5 years to take your boards. I'd check the reputation of the company before I commited to the offer. Good luck and keep us posted.

I also wondered why one would wait 5 years before taking the boards? There are alot of reasons I am sure.. But... if you don't use it you lose it.

I know that I was extremely lucky.. and I mean lucky to have been hired as an IP, and get my license within 3 months of graduation. I worked for 6 years... acute beside, and did float pool for 2 of those years, I held certification in Tele, Chemo Cert, and Post Partum.. lots of surgical and med experience too. I also worked 3 years home health as a case manager. BEFORE I DID HOSPICE.

Yes, I have strong assessment skills, I have not uncomfortable admitting that. I also am not uncomfortable saying, had I not had this experience.. I wouldn't be independent, think on my feet and have effective clinical management of my hospice patients.

I came to hospice 8 years ago. I was a very strong clinical RN. BUT!! I needed to be supported and trained. I would say, with that background. A good 2 years before I felt comfortable enough walking into a situation where family is nutsy cooko and telling them here is how it is. Its second nature now. but it was hard as hell early on.

I would suggest one thing.. WORK HOME HEALTH A YEAR. then consider hospice.

Steeleworks · Jul 12, 2011

One study found that it takes on the average, 10 years to become an expert. Like other posters here, I had several years in the hospital on the floors, in high tech peds, ICU and home health. Most agencies will not take a nurse with out 1-2 years of hospital based experience.

You may be doing yourself and your patients a disservice. If you burn out early, you will not be of any value to yourself or your patients.

arg928 · Jul 20, 2011

I had 5 months of L&D experience when I took a position as a hospice CM. It can be done, but you are going to have to work very hard, especially the 1st 6 months. If you do it, make sure you get thorough training and have a great PCC or administrator that you can call and ask for help. A lot of hospice is TLC, people just want to know you care. Skills can be learned, but you can't teach compassion. You almost become part of the family when you do hospice, but you have to maintain boundaries (easier with some, than others). It is not an easy job, but I believe it has to be one of the most rewarding nursing specialties that one can choose. Good luck to you!

tewdles, RN · Jul 20, 2011

My husband and I were talking the other day about this very thing (he is an RN also).

In the field hospice setting nurses rely upon their assessment skills. Much more than on a M/S floor...because we are alone with the patient and family. There is no colleague down the hall who can run in and "take a look" at whatever you are uncertain of. It is important to remember that the ONLY way we develop confident and accurate assessment skill is through "hands on" experience. That experience is gained by seeing hundreds, if not thousands of patients, and touching them, looking at their skin, listening to them, talking with them using appropriate therapeutic communication, and then understanding what all of that means (using the nursing process). The key is the volume, or the number of assessments.

I believe that novice nurses are not best suited to field hospice nursing. I believe that the Inpatient Hospice setting is MUCH more appropriate if management is interested in that nurse growing into a successful and well balanced hospice nurse.

Good luck.

leslie :-D · Jul 20, 2011

A lot of hospice is TLC, people just want to know you care. Skills can be learned, but you can't teach compassion.

while i agree that compassion is a part of hospice care, it is the clinical skills that make the difference betw a good and an unacceptable death.

compassion doesn't mean diddly in times like that...which are frequent.

hospice is a mult-factorial, complex process, involving many different qualities and skills.

compassion is only one of them.

me?

i would never hire a new grad for home hospice care.

too many risks and deficits for the pt's mgmt, and i wouldn't do that to a pt.

inpatient? sure.

if able, start there.

much luck.

leslie

TinkerBelle_81 · Jul 31, 2011

I only had 2 months experience in a skilled nursing home before being a hospice nurse. I only do admissions in my full time hospice work, so most of it is assessment and paperwork. I was thinking of doing case management but i am worried that i do not have much nursing experience and skills to be a case manager. Even with admissions, if i get a more complicated pt (someone w/ chest tube, port a cath), i easily feel uncomfortable. I had a pt whose chest tube had to be drained PRN and i asked our manager to send someone else to drain the chest tube because i don;t have experience. i also had pts who needed an IV to be started via peripheral and port a cath and i again asked the manager to send someone else. i feel that they have to have a skills lab or some form of training on these things for new nurses. i know someone who has been a hospice nurse for more than 20 yrs and she is not comfortable with starting IVs too.

Jelliott1984 · Aug 12, 2011

I'm also a new grad who is going into hospice nursing. I will be working at an inpatient center so I will not be unsupervised. Thank you guys for the advice, I'm sure I'll need it!

I'm excited and nervous to start my job next week but I will do my very best! :)

kimcamRN · Aug 13, 2011

Wecome to hospice and good luck with your new job! Be patient with yourself. It can be overwhelming, but rewarding in ways you can't imagine!