LTC/Rehab CNA to Hospice CNA?

[DigTilDaylight]

I am currently working at a rehabilitation and living center as a CNA. Prior to this, I had four years of experience working night shift at a LTC center.

I live with depression and anxiety that have lead me a few times to fear of burning out on the healthcare field entirely. One one hand, it's sent me home in tears and frustration and fills me with a hopelessness that I can't do anything else BUT CNA work because that's all I've ever done. On the other hand, however, there's a genuine sadness to the thought of giving it up. Most of my frustration stems being expected to juggle too much in too little time and not being able to make the contact or provide the service I feel my residents need.

I want to love my job again. I want to help people and make a difference, not just rush from one person to the next and then next.

Realistically, would that be possible as a CNA working in hospice? Would there be more than 5, 10, 20 minute chunks of rushed time to spend with patients? Or is it just more of the same but with higher demands on time and compassion?

What strengths are needed in this field more than others?

What could I do as a hospice CNA to support my nurses and my patients and their families?

[nutella, MSN, RN]

I am sorry you are having a hard time due to depression and the work load!

As far as hospice CNA work goes:

Usually the hospice CNA has only one patient at a time for perhaps 2 hours a day - it depends on what the hospice agency covers. If you work for an agency that also does continues care it could be even more hours.

In home hospice, the hospice CNA have to drive to their patients like the nurses do and get their schedule with times from the scheduler. Usually you stay with the same patient/family until they die. In home hospice the responsibilities are similar to LTC with primary care, help ambulating if safe, feeding, support of the family, at times assisting the nurse to put in a foley, dressing and so on. The hospice CNA is also a very important member of the team - they call the hospice nurse assigned to the patient if something is not ok - patient has pain, breathing is labored, skin not ok, family not coping - you name it.

If you work in home hospice you have to be able to go to people's homes - some of them are not that pretty, they may have animals, you may have to improvise, parking may be difficult in a city. But the good thing is - if there is something that bothers you - you know that your time is limited with hospice.

If you work as a hospice CNA in a facility you also get assigned a specific patient by the hospice agency and you go to that patient only for the allowed time - usually around 2 hours to provide the primary care, repositioning and so on. You still collaborate with the nurse but also with the facility staff - which can be hard when they do not help you at all. The plus is that all the things you need are usually already there and if you need help to pull up somebody you will find a person - at home you rely on the family.

I think hospice CNA is a great option for CNAs who like to be independent and who have a good common sense and solid skills. You have to be mature enough to collaborate with everybody but also be able to keep boundaries. Families and patients value the CNA very much in hospice and the nurses do the same! I had close work relationship with most CNA in home hospice and they would call if something was not ok, I would call them regularly to ask how the family /patient are doing.

A lot of CNA who like to work in facilities get assigned in the same facilities or one main facility if possible to reduce driving and to have a good relationship with the facility. But I found that most CNA do not like to work in facilities for hospice and like home care better because they feel more autonomy and less struggle with the facility environment.

If you look for a job make sure to ask important questions like:

- pay rate and mileage reimbursement (don't sell yourself under worth - if you worked in LTC you should be able to get a good hourly rate based on your experience and time worked already!)

- how does the company provides materials like gloves etc?

- how much time is allowed for travel between patients?

Do some home work and find out what they are paying in your area - home care often pays less hourly but may give you more days off.

You can even get certified as a home hospice aid:

The Path to Becoming a Certified Hospice & Palliative Nursing Assistant | CNAThrive.com