New Grad in Hospice

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Good Morning Everyone!

So I am a New Grad and just started working as a Case Manager for Hospice. I actually just finished my first week. I went out with several nurses and shadowed/provided care for their patients. On Monday I start working with the nurse whom I'm going to take over some of her patients. Currently, I am feeling extremely overwhelmed with... I guess everything. The medications and equipment used, I am not familiar with. I write down meds and study them at night and am as hands on as much as I can.

My question is, how long did it take for you to be comfotable with the requirements of Hospice field work. I am starting to doubt myself and am wondering if I have enough skill to provide patient care by myself in the field. Obviously, I am going to give it more than a week, especially since my orientation time is open in length. I am just feeliing sick to my stomach and wonder if I 'can do it'. Thanks!

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Nicole, I am a new grad too so I can't answer your question, but I wanted to just say that I think it is great that you went for a hospice job right out of school. I too would like to work hospice, but am starting on an oncology unit of an acute care facilitiy for a few years first. I really wanted the chance to learn basic nursing skills in a hospital environment with support -- I just heard that being a hospice nurse can be difficult for new RNs because you are out on your own so much. So I thought this was better for me. I'd be curious to know how things progress for you. I would say good luck but I don't think you need it!

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

Most hospices start out very inexperienced case nurses with just a few "simple" routine patients. Nothing too exotic or intensive. Very elderly bedridden people. Nobody too young, certainly no Pedi cases unless that's what they hired you for. Those patients with stable care giving arrangements. No patient on the fringes of the region...central/easy access location. Your preceptor should have a "lighter" schedule so as to be available to you. The clinical manager should be a phone call away...on speed dial with the preceptor.

Have you met the other field nurses yet? Get to know them. Ask them about themselves. We really do help each other out sometimes...things as simple as running supplies to a patient when we are in the area, etc.

It is true that learning hospice from the field is a hard way to go for the new grad, IMHO...but it can be done. Good luck!

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Thanks for the advice. I have been out in the field with several other nurses. They have all been very helpful, esp since I feel like I am bombarding them with questions. I have been informed on multiple occasions that I will always be able to get ahold of someone if I have a question or if I need another nurse to come look at something. Plus, my orientation is as long as I need (of course within reason).

My case load will consist of 13 patients to start. Luckily, I will be providing care to these patients while orienting so I will have an opportunity to get to know them before being out on my own. Also, the nurse that is orienting me will still have several patients in the same territory, so I will be able to call on her if need be.

I know deep inside that I can and am meant to do this. I've been told by multiple people that I am too hard on myself, which I may be. I just wonder if I should have went into the hospital first to get down my skills, but then again the hospitals are not hiring new grads. I was told by the other nurses at the company that the DON interviewed about 30 people and selected me. May be they saw something in me that I am not aware of yet. All I know is that I am doing my very best.

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Specializes in PICU, NICU, L&D, Public Health, Hospice.
Thanks for the advice. I have been out in the field with several other nurses. They have all been very helpful, esp since I feel like I am bombarding them with questions. I have been informed on multiple occasions that I will always be able to get ahold of someone if I have a question or if I need another nurse to come look at something. Plus, my orientation is as long as I need (of course within reason).

My case load will consist of 13 patients to start. Luckily, I will be providing care to these patients while orienting so I will have an opportunity to get to know them before being out on my own. Also, the nurse that is orienting me will still have several patients in the same territory, so I will be able to call on her if need be.

I know deep inside that I can and am meant to do this. I've been told by multiple people that I am too hard on myself, which I may be. I just wonder if I should have went into the hospital first to get down my skills, but then again the hospitals are not hiring new grads. I was told by the other nurses at the company that the DON interviewed about 30 people and selected me. May be they saw something in me that I am not aware of yet. All I know is that I am doing my very best.

I think you should feel very encouraged. It sounds like you have a supportive management team.

IMHO, 13 is a large caseload for a new hospice nurse...even one with nursing experience. Please do not be afraid to call on your preceptor whenever you need help or feel uncertain.

I wish you the best of luck. Please feel free to post questions here about symptom management or case load management...there are a number of experienced hospices nurses who will take the time to provide some really good advice for you.

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Specializes in Hospice.

I agree, 13 is a large caseload. To be honest with you, I can not imagine starting hospice right out of nursing skill. I find my medical skills learned in the hospital to be very important in my practice. I think the right person could do it, but it is a lot to learn. I think I finally felt confident in myself after about 6 months, but a year later I realize even then I did not know as much as I thought I did. But I think it is like that in all nursing.

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I have found other hospice nurses to be extremely supportive to new grads..years ago my first RN job was with hospice. I had a nurse on call available to me at all times. Talk with your supervisor about your concerns. Like any new nursing job there will be some fear of the unknown involved. Take care and hang in there.

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Specializes in LTC, Hospice, Tele, ICU.

Hospice nursing ROCKS!! I did it prn for a while and never had I ever worked with such a supportive bunch of nurses. I truly believe its my passion and hope to get back to doing it soon. My problem is that I found most hospices pay less than hospitals and I need to get out of debt before I can take a pay cut.

Good luck and God Bless :)

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Specializes in Pulmonary, Cardiac.

Hi, I am a new grad in Las Vegas and I just interviewed for a case manager position. I was told the pay would be "competitive. Negotiable. depending on what I asked for and what I used to make" She is interviewing other applicants, and said we would discuss it if I recieve an offer. I probably didnt get the job, but that's okay. This company gives RN case managers caseloads of 16-18 patients when they pull full case loads!

May I ask what new grad RN case manager make? I'd like to know what to ask for hourly wise. Here, new grads make $24.00/hr in hospitals.

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Hi all, I have been a nurse for about 8 years and have worked in a small hospital on the med-surg floor since day one. I have learned alot! Everyday I learn something! I just got offered a hospice case mgr position. I work in central WI. The hospice job pays more than my hospital job. I just wanna offer the advise that any good company will make sure you have the resources you need to learn and become a great nurse. They don't waste 10-30K on orientation to have you quit. They will help you with whatever you need IF you are not afraid to ask for HELP/ADVICE.

good luck!

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hi nicole.. I am also on orientation as case manager, yes it is overwhelming! I am working in a nsg. and rehab center just started June 21. I don't know much about case management that's why I ordered a book for me to catch up. Well good luck to us!

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I am part of a very supportive team. All the nurses tell me all the time that they are available by phone to come out. The nurse whose caseload I am taking over always says to call her if I have a problem. I am actually the 3rd New Grad this company has hired in the last year. I was told they actually liked New Grads because they could train them how they wanted and not have to break bad habits.

My husband has told me countless times, "Why would a company hire you, spend lots of time, money, and energy for you to fail? They wont." So far it's true. My nurse said I am doing wonderful and wanted me to go out on my own next week, but I asked for one more week to be sure. I love how everyone really works together and is not out to get eachother. Even the doctors are supportive & friendly.

Thanks for all your advice. So far, everything has been working out extremely well!

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