LPN hired into hospice.. only have ALF experience

[zelda2012]

Hello all. I've been an LPN for almost three years, and I've only really ever worked in assisted living. I recently got hired PRN with a local hospice company, I still work my ALF job part-time. So far, I've shadowed 2 crisis care shifts and 1 at one of their inpatient hospice houses, as they can call me to fill in for crisis care or the hospice houses. I don't get any more shadowing for crisis care, I only get 2. I think I can handle the crisis care shifts on my own, except I'm terribly rusty with basic care, bathing/cleaning pts.. my ALF residents are not (usually) bedbound. I've been watching videos on YouTube to help refresh me on personal care and also inserting foleys, etc. Also, I'm a small-ish female and I worry about how I would turn/change a large pt if, say, family was unwilling to help.

The pts in the hospice house seemed very acute.. I was told it's a mix of actively dying pts and pts in crisis, recently d/c'd from hospital, very sick, can have trachs, still be on tube feedings, massive wounds, IVs, etc. Nurses can have up to 5-6 pts each. I'm not used to such sick pts, coming from a standard license ALF. I was already offered to pick up shifts on my own next week in the hospice house but I declined, told the scheduler I'd rather do 1-on-1 crisis care shifts right now, that unless I had more orientation at the HH I wouldn't be comfortable. The staff there was very nice, offered constructive criticism but I just felt nervous/awkward being there!

In a way, I feel like I've hindered myself by working in ALF the past few years. I am planning on starting my RN bridge this summer. Should I ask for more orientation? I don't feel like I need to shadow a CC nurse for a full 12 hours, I'm comfortable with giving meds PO/PR/IM/SQ but I'd like to go over things that I haven't seen before I come across them by myself in the field, such as the pain pumps. I want to be a good hospice nurse, I just feel like there's so much I don't know that I feel like I should being 3 years out of nsg school. Any advice is appreciated, thanks.

[Kittypower123, BSN, RN]

I think I'd ask for more time at the HH, not just shadowing, but helping the nurses and actively seeking to be involved with procedures you're not familiar with. You need to get hands-on as much as possible with someone there to guide you and help you learn. It's hard to learn when you're by yourself.

[TammyG]

When you are at hospice house, you will have access to RNs and others to help you. So it is not as difficult as it sounds. I think your background is great for either hospice house or crisis care, and you will do wonderfully.