Hospice Nursing

Keepstanding, ASN, RN · Jan 6, 2010

sounds like you have already made up your mind by taking the job. only you can decide.

but your post does not show a lot of confidence in the job you will do. good luck on whatever you choose.

praiser :heartbeat

FLArn · Jan 6, 2010

Do not assume you won't be using your skills. Hospice patients receive lots of different treatments. Assessment skills are crucial as a lot of the patients are no longer verbal and you must be able to pick up on subtle changes in condition as well as nonverbal cues to indicate pain etc. Our patients often receive IV or SQ pain and symptom control. Plus you must be able to assess and treat various problems just using your senses -- no fancy monitors and machines to tell you what is wrong with the patient. Overall the pace may be slower but when things change they can change in a BIG hurry.

missy--kay · Jan 6, 2010

I graduate in May and am wanting to go into the Hospice setting. Please keep us posted on how your new job is going. Good luck!!

Nurse2919 · Jan 6, 2010

Thank you everyone for taking the time and replying to my post. I will keep you all posted. I am excited for this job just bit scared I guess.

Nurse2919 · Jan 6, 2010

Encouragement needed!! Thank you allll!!!

leslie :-D · Jan 6, 2010

is this for home health hospice or an inpatient facility?

all my experience is with inpatient, and is actually called a picu- palliative intensive care unit.

you will not lose your skills in this type of setting.

we have pts on vents, multi-gtts, and lots of symptomology.

assessment skills are key, and understanding concepts of multi-organ failure, are equally as important.

we don't employ lpn's so it will all depend on your work environment and scope of practice.

but one thing that is consistent, is you will be dealing with lots of emotional trauma from pts and families (as well as physical pain/trauma...but we knew that. ;-))

lots of dynamics that you wouldn't encounter elsewhere.

take a peek at our hospice forum here.

slow-paced...absolutely not.

if your heart calls out to hospice, you should be just fine.

it is also extremely helpful to explore your thoughts on dying, death, afterlife/not.

once you feel secure in that, it makes your job a whole lot easier.

let us know how it goes, and best of everything to you.

leslie:nurse:

Nurse2919 · Jan 6, 2010

Thank you Leslie!! It is a home care setting. Will keep you posted.

carolcowanrn · Jan 6, 2010

I worked as a home hospice nurse for 8 years. Every nursing job requires different "skills". While you may not be working with maintaining IV's and surgical cures, you will be learning new skills. Programming a CADD (pain) pump, managing symptoms, teaching caregivers & patients, and providing emotional support are the focus. The rewards are phenomenal. Hospice patients have their priorities straight and family members/caregivers that you meet are there for the patient because they want to be. There are often volunteers involved, or they can be accessed. The volunteers are angels in disguise. I've cried, acted as a volunteer myself at times, and attended funerals - on my own time, not as part of my job. I was like a member of the family in many cases.

My only caution is to recommend that you embrace the support that is available to you through your employer. It's easy to blow it off and say you don't need it, but eventually you may come to the realization that every patient you cared for is gone. That can be addressed by the support available to you. :nurse:

EmmyBee · Jan 6, 2010

Hello Everyone,
I've been an LVN for almost 2 years. I recently accepted a job as a Hospice nurse. I am just concerned if I made the move too fast I mean I am still a baby nurse I myself have SO much to learn and at hospice I wont be using much of clinical skills I am afraid I might loose them. Also I've been used to working in fast pace and this would be a very slow pace. I am worried if this is right place at right time.I do want to do this because I feel it is right purpose of being a nurse instead of working at rehab center and pop narcotics. PLEASE ADVISE!!!

I began working home hospice cases 8 months ago, when I started my RN program. I figured that it would be slow-paced and not overwhelm me, since I'd already be overly stressed with school. I didn't think there was much to it, but my views have changed since then.

I have taken care of patients with anything from brain cancer to end stage dementia to Hodgkin's Disease. And their reasons for continuous care have been a wide range of problems, such as shortness of breath, medication teaching, or change in level of consciousness.

I've had patients with foley catheters, colostomies, decubitus ulcers, and PEG tubes. Others have been on oxygen, requiring breathing treatments. Some have been alert and able to ambulate, while others have been confused and bed bound. I have had to give multiple types of routine medications, for ailments such as high blood pressure or diabetes. And I've administered many forms of narcotics, as well.

I've read to patients, played music for them, and relayed messages from relatives. I've played chess with some, and even watched favorite game shows with a few.

Hospice is not just about sitting around giving pain medications, which is something I didn't realize, until I started working in the field. I've seen a lot of the same things that I have in hospitals and long term care facilities. So you will be using your skills. Granted, you might become rusty on some things that you are used to doing, like starting IVs or dropping NG tubes. But you will definitely be performing nursing skills on your patients.

And you will also get to experience a different, possibly more intimate, kind of nursing. You will support family members as they lose their loved one. You will get to listen to funny stories of when patients were young or in good health. You will realize how fragile and precious life is. You will cry at times. You will be sad at times. And your heart will go out to those patients with no family at all.

But you will also feel happy at times, knowing that the family and patient appreciated you being there until the end. They will often tell you so. You will make some feel better, by telling them encouraging words or simply by listening to what they have to say. You will offer a shoulder for others to cry on. And you will feel honored to have been there, for that little elderly lady who lived alone.

Even though I will be leaving hospice after I graduate, I am thankful for the experience. Every field in nursing is needed. And if your heart is telling you to do this, listen. It might only be for a short time, and maybe you'll find that it's not for you. But you will have made a difference for those patients and family you served, and they will appreciate it more than you know.

CBYRN · Jan 6, 2010

Congratulations on your new job. I hope you love it as much as I love hospice nursing. I work for 3 different hospices. I work for one at home and travel to 2 other ones in Arizona spring and fall. One hospice does not use LPNs at all. Ours at home uses LPNs mostly for personal care which could certainly mean "not using all your skills". They also fill in for RNs, though, when we're short. They could be doing all foley care, all bowel care, all wound care, blood draws, all charting. I'm not sure what their license lets them do with CADD pumps or central lines. They make med changes according to physician orders. That will take a call in to an RN in the office. At another hospice I work for, the LPN fills in for the RN who is off that day. If the RN has a week off, an LPN sees her patients all that week. If there is anything that needs done that she can not do, another RN will make the visit but she is basically the casemanager during that time frame. One major difference from in the acute setting is that you are pretty much on your own. You can always call in to the office and ask for an RN but it's pretty much you and the pt/family. It will be the most rewarding work you ever do. It's not rush-rush in that you can focus on only 1 pt at a time but you may have a very full day and lots of driving in between and then lots of charting. It can be crazy but a different kind of crazy. Keep us posted. LOL:nurse: cbyrn

CBYRN · Jan 7, 2010

Congratulations on your new job. I hope you love it as much as I love hospice nursing. I work for 3 different hospices. I work for one at home and travel to 2 other ones in Arizona spring and fall. One hospice does not use LPNs at all. Ours at home uses LPNs mostly for personal care which could certainly mean "not using all your skills". They also fill in for RNs, though, when we're short. They could be doing all foley care, all bowel care, all wound care, blood draws, all charting. I'm not sure what their license lets them do with CADD pumps or central lines. They make med changes according to physician orders. That will take a call in to an RN in the office. At another hospice I work for, the LPN fills in for the RN who is off that day. If the RN has a week off, an LPN sees her patients all that week. If there is anything that needs done that she can not do, another RN will make the visit but she is basically the casemanager during that time frame. One major difference from in the acute setting is that you are pretty much on your own. You can always call in to the office and ask for an RN but it's pretty much you and the pt/family. It will be the most rewarding work you ever do. It's not rush-rush in that you can focus on only 1 pt at a time but you may have a very full day and lots of driving in between and then lots of charting. It can be crazy but a different kind of crazy. Keep us posted. LOL:nurse: cbyrn