LPN's in Hospice, what do you do?

[kstec, LPN]

I just got hired on at a hospice company. They say I will be doing home and nursing home visits. What does it entail? Is it difficult getting passed the whole concept of helping family deal with the death of a loved one? What are you aloud to do in your scope? I know I will report to the case manager (RN), but other than that it sounds like I will have a lot of autonomy. I do orientation next week and I'm excited yet nervous. Any words of wisdom or advice would be greatly appreciated. Thanks in advance.

[crazy4Him]

I've been a hospice nurse for about a year now. Got the job right out of LVN school. I've done vists as well as crisis care. The visits are going from home (or facility) to home visisting the pts, taking vitals, reordering prescriptions, general assessment of pt for new problems and DX management and progression. I may also need to call the Dr to change orders. I then call the info in to the care RN and then on to the next pt. If there is family present, which there usually is if they are at home, I am a welcomed support to those taking care of them. They look to me for a lot encouragement and letting them know that they are doing a good job. (not always but I can't do much about that other than teach some more). I usually have 4-6 pt a day and unless there is a problem I only work about 5 hours a day (get paid for 8 because I'm on call should one of these pt have a problem later in the day) The visit could intail a new foley or irrigation of the foley, bandage change, and a lot of teaching.

I also do what is called crisis care. That is where the pt is some sort of crisis, usually resp. distress, pain management, needing further teaching, or they could be actively dying. In crisis care the pt is on around the clock nursing care until the symptoms are under control. I am with the pt for 8 to 12 hours. Some days are extremely busy if symptoms are raging and other time I feel like I'm just babysitting while monitoring. When a pt dies I do the pronouncing, DC any oxygen, foleys, clean the body up some if needed, etc., call the coroner (needed in some counties and cities), call the mortuary, call the office to have the death broadcast, dispose of all narcotics and support the family if they need it.

I really like my job. There is a great deal of satisfaction in helping a pt die without pain and anxiety and in peace. Also, we hospice nurses are an incredible source of comfort for the family. This is a very scary time for them, pt's too. I actually just had a pt have me sit down with him and tell him what it is going to be like at the end. The information seemed to bring him a great sense of peace.

This is probably more than you ever wanted to know but I really love my job and could go on and on.