Hospice nursing

Lucy RN · Dec 9, 2001

I started working for hospice a year ago and since that time we have actually doubled our census! It seems that people are more aware of what hospice is and does. My supervisor said that she thinks that the PBS special on Dying with Bill Moyers really helped to bring hospice to the forefront in peoples minds. I think everyone would like to die at home with good pain control and loved ones near if they have the choice!!!

There is a Hospice and Palliative Care Nurse certification that you can take- but you must have worked in the field for 2 or 3 years before you can take the course (I can't remember which it is)- at least in New ¥ork there is- I'm not sure of the rest of the U.S. :confused:

I hope that helps to answer your question some!!

Best Wishes!

Lucy

SharonHopson · Dec 20, 2001

I started working in hospice about a year ago, also. I started out prn and was averaging 15 visits a week. A couple of months later I was working full-time and average 30 visits a week. Our census has also doubled! I've also noticed in the past couple of months that docs are referring their pts. sooner. I feel so helpless when we admit on Thursday or Friday and lose the pt over the weekend. Neither the pt or family has really gotten any of the benefits of hospice.

As far as the cert training....it's 2 to 3 years of practice in the hospice field b4 you can take the class here also. (Louisiana)

Fergus, there is a BIG demand for hospice nurses. I think the demand will continue as more and more pts and family become aware of hospice and the benefits it provides. Some people just aren't aware of this service or they think hospice is only for cancer pts. Only about 1/3 of my current cases are cancer. I have several COPD and Alzheimers pts @ this time. Like I said, more and more docs are referring pts than just a few months ago.

Hope this helped!

Sharon

nightingale, RN · Dec 20, 2001

Nurses:

I had this over on the General Discussions Form and thought I should post it hear:

I saw this post in the Denver Rocky Mountain Newspaper and had to share it....

Here is the website:

URL: http://www.rockymountainnews.com/dr..._913325,00.html

or the story if you can not get it on your puter..... :

Rocky Mountain News

To print this page, select File then Print from your browser

URL: http://www.rockymountainnews.com/dr..._913325,00.html

Amole: Very blessed am I and ready to die

Detached.

My hospice nurse says I have tissue-paper skin. There is a medical term for it, but I can't remember it. My skin appears very thin, almost transparent. I have lots of splotchy, purple bruises.

These are caused by two medications I am taking, prednisone and coumadin.

The prednisone is for pain, and the coumadin prevents blood clots from forming that might cause a stroke.

These marks appear mostly on my hands and arms and not on my face. They do not cause any pain. I mention this because my skin condition is one of the signs that I am dying.

Trish and I had a long talk with my hospice nurse about how and when I might die. We need as much information as we can get so it will help us plan to use the time I have left.

Will I be able to die at home, or will I have to spend the rest of my last days in the Hospice of Metro Denver residence facility? Of course I want to die in my own bed in our own home.

If my care becomes too difficult for Trish to manage here, I would want to die at the residence facility. I have seen it, and it is very pleasant and well-staffed with caring professionals.

It isn't likely I shall have an "event," a term used to define death as the result of a stroke, massive heart attack, or some other sudden happening.

It appears now that I will gradually surrender my life as a result of what is called a multisystem failure. That means my vital organs will no longer be able to sustain my life.

This process is already under way. One sign this is happening is I am gradually becoming "detached," as my hospice nurse describes my condition.

This means I am sleeping a lot. As I noted in this diary before, I actually nod off while writing entries in it, or go to sleep while reading a newspaper, or talking to friends on the telephone. I just drift away.

I try not to be detached completely from reality. I still want to know what is happening around me. I want to see my Trish, my sons and daughters, my son-in-law and my precious little Jacob. I want to cling to those I love as long as I can.

I think I shall be able to enjoy Christmas with them, but how much time after that, I don't know. At this point, I feel fortunate that my passing has been as pain- and anguish-free as it has.

I have Trish, my caregiver, and drugs to make this possible. It is so sad that for many years the medical profession was not schooled in helping their patients die comfortably, and doctors hesitated too long in prescribing pain medication.

They are rarely present when a patient dies. They are not there to ease the pain, to offer emotional as well as palliative support during the last days of life. It is more often the nurses who have had to assume these roles.

It is because of them that the hospice program has evolved.

Some medical schools are beginning to include training in their curriculum to help physicians be more responsive to their dying patients' needs.

As for me, I am grateful for the care my family and hospice have given me. They have made it possible for me to reflect on my life in the most positive terms. I have no anger, no hate, no fear. I am blessed, and I am ready to die.

Contact Gene Amole by writing [email protected]. Previous columns in Amole's diary of dying are available online @RockyMountainNews.com.

December 19, 2001

MORE AMOLE COLUMNS »

B.:)

SharonHopson · Dec 20, 2001

Thanks!

I'm going to read more of his articles later tonight.

Sharon

Lucy RN · Dec 22, 2001

Thanks Nightngale! I enjoy reading these kinds of things......they make me feel so proud to be a nurse!!:)

EVERYONE HAVE A VERY MERRY CHRISTMAS!

Mags · Dec 29, 2001

Thank you nightingale,

Reminded me why I do this Job.

Mags