New Grad going into Hospice

Specialties Hospice

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Specializes in Hospice.

I posted a while back about an interview I had with a home hospice company. Turns out I got the job, and I am thrilled. This is the job I thought I would have to work up to over several years. Everything but 2 things is wonderful about this job: 1 is that the scrubs are teal, which I don't much care for. I think I can get over that pretty easily :D The other is that instead of full time I am starting out as PRN. The wonderful woman who hired me said it wouldn't be anything close to a year before I become full time, but I have no idea what kind of hours I might get with this status. I realize it will vary from facility to facility, but can anyone give me a ballpark? I know all my questions will likely be answered when I begin orientation next week, but I have nothing to do until then ;)

Also, are there professional organizations I should join? Is it worth the $ to join ANA? How much benefit is the Hospice & Palliative Care certification? Would ACLS be beneficial? Any suggestions as to how to be a better hospice nurse would be greatly appreciated. TIA

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Specializes in COS-C, Risk Management.

I can really only answer the question about ACLS--I can't for the life of me see any reason why a hospice nurse would need Advanced Cardiac Life Support. Basic CPR sure, but you generally don't have access to a defibrillator, ET tubes, and meds for ACLS protocols in the home. I wouldn't waste the money for ACLS unless you plan to go into an ICU environment and then your facility should provide the ed.

Honestly, I'm really surprised that a place would hire a brand new grad into Hospice. I would've expected at least two years of experience to be required of any home health or hospice position, unless you're in a hospice facility rather than home visits. I would offer one caveat to taking this position with no nursing experience--consider the company. Do you really want to work for a company that hires nurses who have no experience? Would you want to be their patient? I was offered a job two weeks ago in home health by a company whose only requirements seemed to be a warm body and a license. I had to decline because that's not the sort of company that I want to be associated with. Not saying that the company in your scenario is bad or that you're not a great new grad, but it really does take a while to get your feet wet in nursing. Check out their reputation in the community, not just with nurses but also with families. Find out what you're getting into. My two cents.

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Specializes in Hospice.

I wanted to be a hospice nurse since the first day of nursing school. I did work in a hospital for about a year before I went to hospice. The director of nursing at the hospice was my supervisor when I was an aide so we did have some history together. I would have accepted a position in hospice as a new grad but I think I benefited from the acute hospital experience. The main thing I learned at the hospital is that I did not want to be a hospital nurse. Good luck in your hospice career. I hope you find as much satisfaction in the work as I do.

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Specializes in Hospice.

Just an update: Today was my 1 week anniversary in both nursing and hospice, and I am loving every minute. Everyone has been incredibly supportive at our company and I'm starting to get very comfortable with the work. I can't think of a single aspect that has been anything less than fantastic. If I can be crass for a minute, it's like I told the nurse I was paired with today: it's like sex; even when it's bad it's pretty freakin' good :D

Anyway, I still have tons to learn, but I thought I'd take a minute to share my bit of happiness.

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Congrats! That's so great. This goes to show that us newbies don't always have to "pay dues" before we get where we want to go. We are valuable too.

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i am so glad i came across your post.am a new grad too.i just got an offer in hospice,besides the fact that it intrests me what i want to do,i have followed countless advice and gone on to apply to new grad programes but to no avail,i have countless bills and cant just sit at home anymore waiting for new grad openings in hospital.i wish i found one i'd go for it but i guess with the hiring frezzes more of us new grads are finding ourselves in places we never thoght we would be.

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Specializes in Hospice.

Sunday will be my one month anniversary. I've been assigned 4 patients and taking the occasional visit from other nurses. I still love it, although it's getting steadily more emotional. My coworkers are still extremely supportive and quick to give advice on any question I have, and I've gotten a lot of positive feedback on how I'm doing. I could go on and on about how perfectly this field of nursing fits me, but I'll keep it short.

To the other new grads out there: I am one of 2 new grads at our hospice. The other has been in for 4 months, and seems like a pro. Hopefully I'll be in the same position in a few months, but I'm still very thankful for where I am now and wouldn't discourage anyone with the desire to go the same route. I feel lost once in a while, but no more than (and possibly less than) I would in any healthcare setting.

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thanks so much for the encouragement! its just so hard for most of us new grad,i think nursing is about sacrifices too,if we sarifice our joy and peace and time working in feilds we did not intend to and still put in our best as we would if we were where we wanted then that is truely the spirit!

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wow that is exciting! I am getting ready to start nursing school at the end of this month(LPN, then RN) and I too am very interested in becoming a hospice nurse. My grandfather had a wonderful experience with all of his hospice nurses and it made me very eager to become one. so a few questions....do you have to have your RN to be a hospice nurse, or do they hire lpn's as well? also, where should I start out at to get experience in order to be consider for a position as a hospice nurse? (LTC, geriatrics, etc...) any info would be much appreciated!!

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Specializes in CCU, ICU, Cardio Pul', Hospice.

Its wonderful that you feel this way now. I too would have to worry for you in the field being new grad. This is no reflection on being a new grad whatsoever... we all were at one time. However. Right now.. you are paired with a nurse who probably has all the answers.. and can see what is happening with a patient and knows why it is happening. Sooner than you think you will be on your own making your own judgement calls, having to explain sometimes in rather graphic detail what is happening to the patient.... some times not. Families will question you and question you.

When we say you need at least (minimum) two years on the floor its because your not only dealing with the patients... your dealing with the families... your learning the doctors.... and they in turn start to learn you. You are mostly on your own in the home...and for whatever reason.. Doctors seem to trust Hospice nurses more than do nurses in the hospital. Typically we call them with what we want and the dosages but only because I am familiar with which drugs are within our hospice formulary and which are not.

I would suggest you study up on end stages of diseases, in our hopsice its a lot of lung ca, breast ca, parkinson's, colon ca, failure to thrive, demensia, alzheimers, it goes on and on.

And to be prepared for small babies, children and teen's as well.

We definately do need more hospice nurses... but in this job you experience serial grief, your patients sometimes drop like flies...and you can't help but to get attached to them. Always remember to take time at least once a month and do something good for yourself..... take time to grieve for your patients... if you dont.... it will sneak up on you like it did me my first 6monts in Hospice... I ended up taking two days off work and cried like a baby.

I have a healthier respect for this job now... and I am thankful that I had my years in ICU/CCU I even did a year as a charge nurse on a pulmonary/tele floor to get the experience of having more than 3 patients at a time... because ICU/CCU is different than floor nursing...

Just remember study study study and take time for yourself....

Best of luck in your new position!

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Specializes in Ltc, Hospice, Spinal Cord.

I was glad to read this thread. I am also a new grad hired onto, what I was told was, a long term care facility in a hospital. What it actually turned out to be is a psych/acute care/rehab/long term/hospice unit... and anything else the cat drags in! :uhoh3: I find myself drawn to the hospice patients more and more. I really love the idea of providing them physical and emotional comfort during their final days. But it is a specialty of its own and it takes a special kind of nurse to do it well.

Good luck to you all!

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Specializes in Hospice.

To Shelbee:

You don't need your RN to work in hospice, but the positions for LPNs are limited because they can't be a case manager or pronounce, so you would be backup for the RNs.

As far as preparation & getting your foot in the door, I would suggest trying to find a job in LTC, home health, or hospice while you are in school. I know our hospice is always hurting for volunteers, too.

In general:

I'm still doing very well & loving it. I was up to 5 patients until a census drop coincided with the hiring of another full-time nurse. I was down to 1 until the family of a husband & wife pair of my patients put up a stink about losing me, so I got them back :) Unfortunately, the husband passed away so I'm now back down to 1 :(

I did sign up to take call 4-5 nights a week though, and that's been great. I'm still getting decent hours & learning a ton. I also seem to have developed a knack for predicting when patients will pass, which I don't know if that's a good or bad thing.

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