New job. Help!

[missourirn1234]

I've been a RN for about 15 months now. I've been working at an inpatient psychiatric hospital straight out of school. We have limited skill experience at my hospital, mostly emergency IM medication administration, accuchecks, insulin administration, psycho-social assessments...

I recently got an opportunity to work at a brand new inpatient hospice - 20 beds. I'll be working nights there with another RN, 2 LPNS, and 2 CNAS. I'm very intimidated to start working there because of my limited skill experience. I let my hiring manager know my reservations but she told me there would be an orientation period of 2-3 weeks.

What skills should I prepare on using? I know that I'll have to assist with paracentesis/ thoracentesis procedures at times, an occasional IVF hydration. I'm just a little intimidated to begin. At the same time I'm very excited that I can start to 'hone' my skills a little more because I feel that I've lost a lot working with psych. My manager told me that sometimes they do venipuncture but not routinely. Any tips?

Thank you :)

[sailornurse]

I would say you should inquire of the manager as to the skills but from my experience with inpatient hospice, also limited skill sets. Foley, tube feeds, pain management, wound care, dealing with all types of cancers. Alzheimers Dementia, Parkinsons, end stage COPD, ESRD. You are going from one specialty into another but the psych experience will help you deal with the families.

Perhaps the other nurses have more experience and can guide you. I must say the staffing mix sounds high for a 20 bed unit. IMO.

[toomuchbaloney]

The tasks you will be asked to complete will be easy enough.

It is the assessment, critical thinking, and psychosocial/emotional skills that are often difficult for nurses new to hospice. The fact that you are in an inpatient unit makes all of those easier as well, at least in part because you are not alone in a remote patient home trying to decide what to make of the situation or the POC.

Perhaps the staffing is high because the facility is used primarily for GIP level of care rather than as LTC beds.

[PghRN15]

I work inpatient hospice GIP. It is all I have ever done as a CNA, LPN and now RN. We are a 12 bed unit with 2 RNs, 1 LPN and 1 CNA. In my opinion the biggest skill needed will be physical assessment and teaching. You will continually use the nursing process. You will assess, intervene and evaluate continually. You will teach patient's and families about hospice, medications, the dying process and many other things. The tasks that I use often are: foley insertion, IV starts for IV meds, dressing changes etc. Please remember, anyone can learn to do these tasks. Your skill will be knowledge ad compassion.

Let us know how it goes.

[KDMFLRN]

I am a Florida RN who is leaving the ED to work as a Hospice Admissions RN, never worked in Hospice before. Any suggestions on reading material, etc. to assist me in preparation for this new role? Much appreciated.