I am finally employed as a palliative care nurse!!

[midazoslam]

A good few months ago I posted on here about wanting to transition from my current specialty of aged psychiatry into palliative care. I had an interview with my hospital's oncology department, however I didn't get the job because I didn't have any recent acute medical experience. This was a blessing in disguise, although at the time I really felt that I was doomed to remain in psychiatry.

I finally completed my Master of Nursing, and a short palliative care course and I was itching for a change for 2016. I had been perusing employment in a major metro town that is closer to my family and to my partner; I am 2.5hrs away from them at the moment. I popped in a couple of applications for jobs here and there, but none ever felt *right* in my soul. So, I prayed to Jesus for a miracle, and He delivered well. Within a week of each other, I found two positions that were ideal for where I want to be -

1.) A palliative care position at a reputable organisation, and the one I did the palliative care course through

2.) A dementia behaviour consultant position, at another reputable organisation

Both of these were an easy 45minute drive from my family and partner. So with anticipation and more nerves than I care to admit, I submitted an application for both of them. I honestly didn't think I would hear from either of them; first interview was regarding the dementia behaviour consultant, and they seemed to like me and I liked them. I currently work with a clinician who works with the same team, however is based in a rural area so I was lucky to know a lot about the intricacies of the job and values (non-phamarmacological strategies to manage BPSDs as a first line strategy please!!).

Anyway, the day my boss gave the reference check, they called me to say I had the job. It is a 0.6EFT position, and only until June as it will be going up for tender again, but I took it. I was stoked. By this stage, I had pushed the palliative care position aside because it was a good week and a half since applications closed, I had called them and asked what was happening and the NUM said she'll call me back but didn't at that stage. It was literally two hours after I accepted the dementia consultant job that the palliative team called me to ask for an interview. I accepted of course; the interview was in the same week so I had to travel down to the city to do it.

The interview went well, and I was quite open about my angst about having to relearn technical skills, but also stressed that I am more than happy to learn and I can bring a unique skill set to the team, namely surrounding delirium identification, dementia strategies and managing mental illness. They seemed to like me because they laughed at my ridiculous humour and found what I said about the scenario relevant, because a week later (being today) they offered me a position. I am going to be working 0.4EFT with the palliative care team, and the DON seems to think I will be a good fit. I am so excited, so nervous and ecstatic all at once.

I really thank the big man upstairs for giving me the strength and courage to even apply. It is seriously not something I ever would have imagined being able to do.

Anyway, if anyone has any tips, tricks, resources or wisdom that they would like to impart of a soon to be practicing palliative care nurse I would be most appreciative!!

Squee, I did it!!!

Midaz x

[nutella, MSN, RN]

Brush up on the advanced directives in your state - I have conversations about care goals non stop.

In addition, get a solid knowledge of symptom management especially but not limited to pain, nausea/vomiting, anxiety and so on.

Become a member in the HPNA - they have a magazine and a webpage and if you decide to do some certification one day or go to their stuff you will get a discount.

I do not think you will have much problems with the behavior consultant position because you have worked in mental health. In the more palliative position it may be evident that you do not have first hand clinical experience with symptom management but if you are willing to learn and get oriented ok I think you will be able to do it.

[midazoslam]

Thanks for your kind words, nutella. I'll need to find the Aussie equivalent of the HPNA, but thanks for the tip. I shall have a look at their website at the very least. The course I had done was excellent and has lots of information about symptom management, which I've read again and again. I've done a short course for Advance Care Planning too, but it never hurts to learn more 😄. So I've got the theory, it's just putting it into practice!

Thanks again!

[indygirl526, ASN, RN]

Congratulations! I begin my new job on a palliative care unit next week! I am a BSN, RN. New graduate however. I did my senior practicum on this unit and loved it! Best of luck to you!

[midazoslam]

Congratulations back to you, indygirl!! What an exciting and wonderful opportunity to have as a new graduate - I wish you all the very best 😄

[CelticGoddess, BSN, RN]

Congrats on the new job! I work palliative (have actually worked with hospice patients since I got my first job). I find it to be very rewarding.

My only advice (and this is particularly true if you work in a teaching hospital): Be prepared to have to educate some physicians about use of pain meds in a palliative pt. I have had to go over residents head to get a patient adequate pain meds. (They were okay with the Robinul, were willing to give me lorazepam but for some reason didn't think my dying patient needed more than 2mg morphine Q4 hours).

I had one resident question me about an order for 2mg Dilaudid QH. "Isn't that a bit excessive? what about her respirations?" Me: "She's dying! Sadly, there are docs out there who are afraid to order adequate meds for those who are dying.

Best of luck to you!