Inpatient Unit

[nurseontheway]

I have found an agency that is willing to train me for an inpatient hospice unit. I am very excited and will be working prn. What exactly is your role as an inpatient nurse? How many patients do you typically have? I know that they have a Pyxis so medication administration will be part of it. I was told that there is a lot of documentation involved? I am trying to transition into this specialty and I know that it will be a slow process but I am very thankful for the opportunity. I keep running into the 'two year experience' requirement and it is impossible to meet when you can't even get your foot in the door!

[lifelearningrn, BSN, RN]

I don't know much about in patient hospice, just wanted to say CONGRATS on getting the position! I didn't have the golden experience either but was lucky enough to get hired by a home hospice company. I think you'll really enjoy hospice. Good luck.

[MissyWrite]

Congratulations on landing your hospice job!

Hospice inpatient units typically have patients who are already part of the program and are receiving intermittent care in their homes, but are suffering from worsening symptoms (such as pain, nausea and vomiting, or respiratory distress) and need close monitoring and around the clock care to bring them under control. Often, you'll have patients who are actively dying and you will keep them comfortable during the process and interact with their family members. There is usually a social worker and chaplain to help with psychosocial needs (unless you work nights). Other patients come straight from the hospital -- usually these patients are in very bad shape and hospice was involved at the last minute, unfortunately. You may also see some patients there for 'respite' care, which is to give their caregivers a break for a few days. Some inpatient hospice units have longer-term patients, but I didn't work in a facility like that so I don't know much about it.

As an RN, you'll do all the things a nurse would usually do on any type of inpatient unit -- assessments, meds, admissions, discharges, communicate with doctors and other members of the team; whatever patient care needs to be done. You'll probably work with a nursing assistant. I can't say how many patients you'll have -- that varies per facility. There's a lot of documentation, but I wouldn't say it's worse than anywhere else.

I hope you'll get a decent orientation. Hospice truly is a specialty, and many things are done differently than they would be on a med/surg unit or in home health. Some meds are used in unusual ways, so be alert for that (for example, you may see atropine eye drops given sublingually, to dry secretions, or you might administer morphine via nebulizer).

Hospice doctors were some of the nicest and best I ever worked with -- I hope it's the same for you. Ditto for the nurses.

Best of luck to you -- please let us know how you do.

[PomMom65]

I work on a 12 bed Hospice inpatient unit. It was my first job out of nursing school and I love it. When we have a full house I have 4 patients. We get just as many full admission (not on Hospice services) as we get level of care changes. MissyWrite gave a great description. We treat symptoms that cannot be managed in the home: dyspnea, pain, N//V, agitation, constipation. We do offer one bed as a respite when caregivers need a break. On my typical overnight shift there are 3 nurses and one CNA, we work as a team and everyone helps everyone else. I am proud to work with the folks I work with and proud to be part of this amazing team. I hope you love it. Please keep us posted.

[chopwood carrywater]

Eight bed inpatient facility.

One RN for the entire group.

I think I heard myself crying when I read the 1 to 4 ratio....

Oh well, keep calm and carry on.