Interview for Inpatient Hospice

[tokidoki7, ASN, RN]

Hello!

I have an interview next week at an inpatient hospice facility. All I know about hospice is that it provides comfort to patients who are dying, plus I've done post mortem care in the past. Does anyone know what types of questions I should ask at the interview? Is working on a hospice unit similiar to working on a med surg unit? Pros and cons? Thanks!

[MissIt]

There are similarities to med-surg. Something that surprised me was how sick these patients are. We have the occasional patient on a vent, severe wounds, patients with intractable seizures. You use all your med-surg skills and learn a lot of new things too. We do end of life care and respite, but we also do a lot of acute symptom management with the goal for many patients being to return home if at all possible. There is also a lot of emotional turmoil involved because some families, or even the patient, haven't accepted that this is the last phase of the patient's life. It's heartbreaking when a patient is crying and saying that they don't want to die. But then we also witness beautiful deaths, family reconciliations and forgiveness, outpourings of love. This is a very "real" place to work. People open up to you in a different way. Death brings out the best and worst in families. Something that is really special about hospice, though, is that there is a team there to help and support them. We have on-site social work, chaplains, volunteers who can just "be" with the patient if needed. We also have all the clinical support like you'd have at a hospital-- respiratory, dietician, etc. At the hospital I always felt like I wasn't able to spend any time with my patients. I do feel like I have more time to spend with patients now and, if I don't, I don't have to just leave them on their own, there is a lot more support. Almost every day I feel like I've made a real difference in someone's life. That's pretty awesome.

Ask about staffing, the type of orientation they offer, the level of patient acuity and what types of patients you'd be caring for, if there are CNAs and volunteers working with you. I'd ask for a tour of the facility and try to soak in the "vibe." Are the nurses running around like crazy or all sitting at the computers typing frantically trying to get their documentation done or do you see staff really interacting with the patients. Almost everywhere I've ever interviewed, hospice or not, they had a nurse working there show me around and I could ask "what's it really like" type questions.

[tokidoki7, ASN, RN]

Thanks for responding! I'm a little worried about the emotional aspect of it as I'm not sure how I should respond it. I"m also a softy and I wonder if it's something I can handle. I will ask if there are volunteers at the facility because one thing that really makes me sad is when a person dies alone with no friends, family, or pets by their side. This hospice facility is new and will open very soon, so I hope this interview goes well!

[MissIt]

Different people have different things that bother them. I don't get upset every time someone dies; most of the time I feel like we did a really good job helping them and their families. IMO, there are few specialties in nursing as fulfilling as hospice. I do get upset when we have a hard time controlling symptoms and the patient is suffering or if the patient is similar to me (middle-aged with young kids) because it's hard not to think about your own mortality. That bit might just be something you don't know exactly how you'll respond to until you're there. Good luck with the interview!