How do you do such a wonderful but difficult job?

[DocRecon]

My mother is terminally ill (COPD), and is under hospice care. I have vast experience in combat medicine (traumatic amputation, gsw, sucking chest, etc...) but my clinical experience is non- existent. I've noticed that hospice nurses make a lot less money than other nurses, yet they are the most caring and tender people a person could ever meet. I took care of my Marines like they were my own children, even when I had to go into the middle of a firefight to drag one or more back to where I could start patching them up & wait on a dust-off. Nothing mattered but saving their lives. It was instinct when I acted. What is it about working hospice despite less money, 100% mortality rate among patients, longer hours, and virtually NO good news??? You are very special people & I just wonder what drives you to do something so very very difficult.

[ShesanRN]

It's actually the things you mentioned: 100% mortality rate and virtually no good news, that drew me to hospice, I believe. (Less money and longer hours, just bonus ha ha!)

Having worked in long term care (which has similar results over a longer period of time), my focus in nursing was giving my patients as many good days as I could. In hospice, when my patients decline (I work weekend on-call, so I'm dealing with a LOT of sudden or subtle decline), when asked "What now?" I usually answer, "We are going to take one day at a time, and make it just as good as we can." It is the sweetest, most sacred work, imho. My patients and families are walking such a difficult road, and my heart won't let them do it alone...

[lifelearningrn, BSN, RN]

It's hard to articulate, but I feel like it is an honor to take care of people in their last months, weeks, days or even hours of life. Death is inevitable. Everyone has to die, and our job is to make that process as smooth and pain free for everyone involved as possible. People can have beautiful deaths, what better way to serve a patient and family but to be there for them through such a difficult time?

Nursing in this specialty is like any other. Only the goal is different. Where your goal may be to administer antibiotics and breathing treatments until the fever is reduced and the bronchitis is cured, our goal is to administer medications and treatments to maintain comfort and provide emotional, spiritual, medical and social support through our interdisciplinary team from admission to death. Our bereavement team takes over and provides support for the next year to the family.

I love my job.

[toomuchbaloney]

It is wrong thinking to assume that there is no good news in hospice.

First, EVERYBODY DIES...all of us, even you. People who have elected their hospice benefit have, by and large, made peace with that reality and move on to enjoying things in the here and now.

Secondly, not all hospice nurses are underpaid as compared to acute care nurses. It depends entirely upon who employs them.

Third, most hospice nurses that I am acquainted with work 8 hour shifts 5days/week.

We do what we do because we want patients to have good outcomes. In hospice that means that we don't want our patients to be medically tortured during the last months of thier lives. We want them to have the highest level of quality of life that is available to them. Many times a very high level of professionalism is the basis for successful hospice nursing. We advocate for patients for whom much of the medical community says "we can do nothing more" knowing that there is often quite a bit that can be done for them, as long as you don't give up when cure or maintenance of status quo is no longer an option, a gentle heart might get what is needed but a steely and sharp professional will get what is needed MOST of the time.

I am sorry that your mother is at end of life. I have lost my mother, my grandfather, and one of my uncles to this disease and now understand that my father has been diagnosed as well. It is a cruel and difficult pathway to death and I hope that your hospice team is successful in helping her to find a quality of life that suits her preferences.

[PomMom65]

I agree with newhospicern, it is a honor to walk this road with my patients. We will all be there one day.

[nutella, MSN, RN]

First of all - I am an all rounder and I love that I can basically use all the knowledge I have accumulated during my years as a nurse in palliative care and hospice. It goes from basic care to accessing port a caths to teach how to tube feed at home to teaching comfort medication and so on. I have experience in ICU, med-surg different tele floors, step down, and more -- and I can use everything I ever learned! I even use how to access a Pleurx catheter - which I learned when I worked on thoracic surgery. I feel that there is enough diversity and different tasks - I do not get bored at all! There is also a huge focus on teaching when patient are home hospice or palliative. When I go to see patients in the nursing home I collaborate with other nurses and recommend comfort measures - it is interesting to work in different settings. There are sometimes unique problems that need creative problem solving. Sure - my car trunk is full of nursing stuff including bedpans and groceries have to go on the back bench but well - need to be prepared when you are on the road and might need this or that. I like to meet people and like new situations , also challenging ones - this position is perfect for me!

But I want to say that it also felt like a calling to me. Taking care of patients who are at the end of life is a privilege, it really takes a team to care for hospice patients.

As a case manager I also head the care team and am in contact with other providers, there is of course a lot of computer work and a lot of phone calls to relatives.

It is true - money could be better ! I am underpaid compared to what I made in a major teaching hospital.