Leaving NICU for hospice

[BabyRN0513]

I've been a nurse for nearly 2 years now and was luckily enough to be hired in the NICU as a new grad. Overall I've enjoyed the babies but usually have the ones who aren't super critical. I'll cut to the chase - I had an experience with a critical patient that had made me realize that the stress and anxiety of this field is something extremely overwhelming that I don't think I can work past. I was terrified and rather than feeling like my critical care instincts kicked in, I stood back and let more experienced nurses jump in. I know my nearly 2 years of experience is just barely enough to even begin feeling comfortable as a nurse, let alone a critical care nurse. The hospital is also a place I'm realizing I don't want to be in. Consistently being short staffed, heavy assignment loads, and the endless holiday and weekend requirements make it that much less enjoyable.

Ok, I said I'd cut to the chase and I'm rambling..the bottom line is, I became a nurse because my grandmother was a hospice patient in our home when I was 15. She is the reason I wanted to become a nurse. I wanted to be a hospice nurse. The be able to be there for a family in this difficult time is something I have a strong passion for and was my original dream when I became a nurse. Does anyone have advice? Words of wisdom? Am I silly for not allowing myself time to get accustomed to my critical care area? I know many nurses say it takes them 5 years to feel comfortable but do I really want to wait that long? I'm just not happy anymore with what I'm doing.

[RN_SummerSeas, MSN, APRN, NP]

First congrats on your choice, I love hospice. And can I say you are sups lucky to have started in a hospital. I didn't get to do that as I only have an ASN right now. I have been a nurse for 3 years and have done mostly home care with 6 months in a terrible TCU, but at least I got that 'experience' they all tell us we need!

Also don't beat yourself up about your experience with the critical patient. You are still quite new and a NICU is a lot of work! You should be happy you got that job, it is awesome experience. It is totally up to you if you want to spend time getting used to the NICU. Ultimately we all go into nursing ( I think) with the expectation of hospital nursing, at least to start, but not having done that I have to say I love home care and hospice. Don't be fooled, if you get a big hospice or work inpatient you will have to use those critical care skills. hospice patients are sick sick folks, adults and kids. They can change condition on the drop of a dime. You have to be able to symptom manage, triage, change treatments, call MD's, nurses etc but mostly work on your own (unless you are inpatient, that is different from what I gather). People often think (from my experience) that hospice is 'easy' but it is far from. It is hard, demanding, tons of work, constant learning, understanding the disease process as it progresses and how to treat rather than cure it. But for those of us who love it, it is rewarding, it is amazing.

You do need to be happy doing what you do, nursing is hard work and if you don't love your speciality then it is not a good fit. Research, visit hospices in your area, talk to hospice nurses, get a feel for it. It may just be for you. OR you may like regular home care or med surg. the possibilities of nursing are endless.

Talk about babbling on sorry!!!!

[softrbreeze]

I went to hospice after only 9 months experience in the ER (as a nurse). That was over 9 years ago and, generally speaking, I love it. The key to loving it though, imo, is finding a hospice that sets reasonable expectations for you and taking time for self-care on a regular basis. Many hospice nurses seem to be run ragged and don't even have time to stop for lunch. Another hospice I worked for briefly gave the RN case managers so much to do, we were routinely working 60, 70, even 80 hrs a week. We attempted multiple times to work with management on this without ANY success. They literally did not care. I found my best fit with a small local hospice who FROWNS on any OT (yay me!- life is too short for OT). If hospice is where your heart is drawing you, don't fight it. I knew from clinicals in nursing school that hospice was where I wanted to be and it has proved true. I wish you the best of luck

[RN_SummerSeas, MSN, APRN, NP]

Most hospices don't pay OT so consider yourself luck for that! My first hospice I was salary and they still expected way above 40 hours! There are many that do it! I LOVE where I am not, we aren't small, but we aren't huge either. We are part of a hospital group and we have an amazing team. If OT is necessary they will allow it but they's rather the nurses not work that much. I am not a CM here but float evening and on call for prn pronouncement visits. i love it. It is very easy to get burned out, but if you pace yourself, leave work at work and take care of yourself (as with most nursing jobs!) it is great!