Can a new graduate be a hospice RN?

Specialties Hospice

Published

Hi there.

I just finished my 1st year of nursing and will graduate next May. I have pictured myself as a hospice nurse, even before I entered nursing school! I was with my step-dad who battled lung cancer for 7 months before he passed away. His death was the first that I have experienced, and I was surprised by the experience. I was witness to him slowly dying day by day, lose of his independence little by little, pain (which was managed very well), and eventually he lost his hope (which was the worst of all for me to see). When he died, surrounded by his family, I felt relief that he was no longer suffering...no more pain. I am a spiritual person, and I found the experience of being with a human as they transitioned from earth to heaven, very rewarding. I felt honored to have been there...I was also relieved that he didn't die alone! That was my worst fear as his disease progressed. I was very sad at the loss of my step-dad, but never felt anger as I knew where he went...no more pain, no more suffering. From then on, almost 2 years, I have wanted to be a hospice nurse. Even though I am spiritual, I realize that not everyone is, and I am not preachy about my beliefs. I am just explaining my experience.

I would like to hear from hospice nurses, if I can be trained as a hospice nurse right out of college, or if I have to "do my time" in a specialty such as Med-Surg? The thought of working in Med-Surg makes me nauseous! I would not be a good Med-Surg nurse, as having 4 or more patients to focus on at one time will not leave me any time to build a proper rapport with my patients. As I am still a student, having only 1 patient on clinical at a time, I haven't figured out how a nurse priorities care -- medications, wound care, trach treatment, foley insertion, and head-to-toe assessments! During clinical, I tend to spend more time with my patient than my classmates. I love talking to them and getting to know them. Being a hospice (or a home care) nurse appeals to me as well, because I would be with one patient at a time (as least from what I have read/heard). I am 32, never married, no kids, so being on-call, working nights/weekends isn't something that would bother me. I have lots of friends and family, and I do know that having a social life and taking care of myself would be of importance as a hospice nurse, so I don't burn-out. I just don't want to be any other kind of nurse, other than a hospice nurse!

Does anyone know of agencies who hire graduate hospice nurses? I currently live in PA, but will ultimately like to relocate to CA where I am originally from.

There is a hospital in my area that offers a 6-month internship for new home-care nurses. The first 3 months are spent in Med-Surg/Oncology and the next 3 months are spent training as a home-care nurse. I am thinking about applying for that, but there is certainly no guarantee that I would get it!

Any advice you have would be appreciated. Thank you! :redbeathe

In some newer hospices it's all about the money honey. It really is. Crazy stuff out there, keep your ears open.

There are hospices that hire RNs just to do HTH and vitals for charting and validating payment from medicare. These hospices that don't often do home care, primarily only do LTC, and have no inpatient facility of their own often fall into this catagory. They rely on LTC staff to do all care. The hospice RN's role is just to keep the money coming. Lots of admits/revokes. They are very aggressive marketers. Very little if any nursing care, so they hire a lot of new grads who will never learn how to be nurses as they have no clinical orientation other than how to use the charting software and shadow someone taking vitals. No patient care except maybe some SL meds, and being a "sitter" on active dying.

Truly sad on many levels. For the patient, and for the NG nurse. They will be stunningly ill-equipped to perform as an RN anywhere.

Gosh, the "low down" I've heard from RNs and MDs as well about this places is amazing.

Specializes in Telemetry, PCU, Private Duty, Hospice.

Hi Everyone,

Just wanted to provide an update. I graduated from nursing school 3 months ago and have been orienting on a progressive cardiac unit. I am completing a 5 month internship program and then will be released on my own on nightshift. I still have dreams of being a hospice nurse one day, but felt that starting in acute care was the best option. I am learning so much...some days are really great and all days are filled with wonderful learning opportunities. I didn't realize until I started working that the true learning would take place after college and can't be taught from a book. That was hard. Many of my days are felt feeling stupid and incompetent, but I'm trying to keep a positive attitude.

Anyway, thank you all so much for your words of encouragement. I truly love being a nurse and am just taking it all in and absorbing as much as I can.

Congratulations Fireball78! I work for Hospice in the SF bay area and we always love to hear of clinicians who have a passion for hospice work!

Hospice usually seeks out clinicians who have hospice/home health experience (even if it is just one year; that experience makes a big difference). We also seek out experiene in acute care, med/surge, and oncology.

If you are still interested in working for hospice, look us up; hospicebythebay.org

We have a wonderful reputation and we are the second oldest hospice in the nation.

Specializes in Pediatric Bone Marrow Transplant.

Hey Fireball!

Looking forward to seeing how you progress towards your dreams!! I developed an interest in palliative care/hospice during school -- shadowed a hospice RN during CNA training, then in nursing school did a rotation in a free-standing pediatric palliative care/hospice facility that was incredibly moving.

I did go to work at the bedside as advised, and have been working pediatric oncology/BMT for about 9 months. It's a really amazing unit and I am learning a ton! I am also learning a lot about the discomfort around hospice/palliative care in the medical setting especially when working with critically ill kiddos.

I hope I can do some work to improve our culture of comfort and openness to these difficult transitions. We have an INCREDIBLE palliative care team in house, but they can only be ordered to consult by the patient's physician & they are very underutilized on my unit. At my one year review, I am hoping to present to my managers an interest in ELNEC training to bring back to the unit...we'll see!

In the meantime I discovered a cool non-profit organization near my work that trains volunteers (licensed massage therapists & healthcare professionals) to offer compassionate touch services to hospice patients in my area. I see this as an opportunity to see the workings of various hospice organizations, network, and get a better feel for the patient populations/work.

Like you, I am really drawn to this field. I also believe your time at the bedside will be invaluable to you -- it can really only improve your foundation for wherever you end up. Not to mention, there are lots of opportunities to bring the spirit of palliative care/hospice to the bedside as well.

Best wishes to you on your journey :)

Specializes in Telemetry, PCU, Private Duty, Hospice.

I finally got an interview with hospice after being a nurse for a year and a half! It's an inpatient hospice unit, not sure of the details yet, but it would be a per diem position. I am excited and nervous. I don't interview well. I just hope my passion and heart for hospice shows through. What makes me a bit nervous is that I am sick of working in a hospital environment...combative patients, restraints, bed alarms. I am going through sensory overload and so stressed that there isn't enough time to give all my patients the proper care they deserve. I believe the inpatient unit will be like a med-surg unit, but I am really really hoping that it is somewhat less stressful and I'll be able to provide more hands-on care to my patients. That is what I am really desiring. My ultimate goal is providing one on one care to patients in a non-hospital setting, but this is definitely a step in the right direction and a step closer to my dream of becoming a hospice nurse!

Thank you all for your encouragement these past few years. I so hope I get this job!!

It's very possible. I know a friend who graduated with me that is RN Case Manager for a Hospice company here in CA. She got the job as a new grad and LOVES it. So it is possible. Talk about "1-2 years experience is required" from acute care is not always true. That company loves hiring new grads and they stay. I'm actually looking into hospice care because bedside nursing is not for me anymore. Been a peds acute care RN for 7 months and I'm just about done! The hustling around back and forth is a little bit much and you know what... It's OK. I have some experience in home health and when long term care... You don't have to be in acute care if you don't want to. Find out where you are comfortable and be satisfied and love what you do. =o)

Hi, LoveThisNurse - I would love to know the name of the hospice agency in California where your friend got a job as a new grad. I am also a new grad RN in California, have volunteered at a hospice agency for almost a year, and am very interested in becoming a hospice nurse. I look forward to hearing from you. Thank you!!!

I wouldn't recommend it, but it is up to each hospice agency to set their own hiring practices. I had 15 years of experience in the hospital before I went to hospice, and believe me that background was extremely helpful when I was suddenly out their "on my own", doing critical assessments of patients in their homes. I was very glad for my extensive background in med-surg nursing and the years of learning concerning pathophysiology. I am very glad that I got out of hospital nursing, but I sure wouldn't want to be a hospice nurse without such a background.

I have known a couple of new grads that were hired directly into hospice, and both of them went through an extremely difficult time and neither were adequately prepared to dealing with the medical crisis at 2:00 AM. They learned and improved, but I know it wasn't the best situation to be in.

Good luck whatever you decide.

fireball78

Im located in the philly area. I really would like to do inpatient hospice. I have about 6 month experience in a fast paced medsurg unit. I've been apply all over the place for inpatient, but have had no luck at all. I haven't heard back from anyone. How are you liking your job? What does you day look like? What is you patient ratio? Any suggestions on getting my foot in the door at an inpatient hospice unit?

Well, I'll be starting as a new RN Case Manager on March 4th in the Bay area (San jose,ca). I'm a new grad, I graduated in May 2012 with my BSN, BUT before becoming an RN, I have 4 1/2 years of LVN experience under my belt. I was a charge/floor nurse in the LTC....and the last 2 1/2 years I was working as a hospice LVN. As a hospice LVN, I would just get one patient for "continuous care" and would have to monitor symptoms that were unmanaged (i.e: SOB, PAIN, ANXIETY, N/V, etc). Anyways, I'm SUPER excited and nervous at the same time to start being an RN case manager for hospice. I absolutely LOVEEEEEEEEEEEEEEEEEEEE the hospice environment, but I'm also nervous that I'll look like an idiot even though I do have somewhat of the hospice background.......such an exciting and nervous time. :confused::)

It is difficult to get an inpatient position. I had hospice experience and still couldn't get an interview in an inpatient unit. I would encourage you to keep trying, and if you can take some CE in palliative care, that would look good on your resume. Also, get to know the people on your hospital's palliative care team (assuming your hospital has one). Your med-surg background is the very best preparation for hospice work. Keep trying and bolster your skills with an emphasis in palliative/hospice learning.

Specializes in Telemetry, PCU, Private Duty, Hospice.
fireball78

Im located in the philly area. I really would like to do inpatient hospice. I have about 6 month experience in a fast paced medsurg unit. I've been apply all over the place for inpatient, but have had no luck at all. I haven't heard back from anyone. How are you liking your job? What does you day look like? What is you patient ratio? Any suggestions on getting my foot in the door at an inpatient hospice unit?

Angels91084 ~

I did not get the job on the inpatient hospice unit, so I cannot answer any of your questions. I can't give you any advice on getting your foot in the door as I haven't been able to get one myself.

Good luck in your search though!!

Specializes in Telemetry, PCU, Private Duty, Hospice.
It is difficult to get an inpatient position. I had hospice experience and still couldn't get an interview in an inpatient unit. I would encourage you to keep trying, and if you can take some CE in palliative care, that would look good on your resume. Also, get to know the people on your hospital's palliative care team (assuming your hospital has one). Your med-surg background is the very best preparation for hospice work. Keep trying and bolster your skills with an emphasis in palliative/hospice learning.

Thank you for your advice Areensee!

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