new grad straight to hospice

CANRN, MSN, RN · Jun 10, 2008

I am going to graduate soon and thought I wanted to go to the ICU-until today. Today I followed a hospice nurse as part of my clincial rotation and loved it. Loved it. I liked being able to take the time to visit with the patients instead of rushing out of the room to get to the next one whose meds were already late. I especially liked the autonomy of it. As a Mom of three kids and a wife of a traveling husband, I'm thinking this job would be an ideal fit for my family.
Here's my question though. The nurse I was with today said they do hire new grads but she would recommend that I do a year in ICU first to which I agreed. Then as the conversation progressed, I gently reminded her that I was not a 19 year old new grad (This is my second career) and that, unlike most 19 year olds, I was dealing with circumstances like kids, mortgages, husbands and that maybe I could bypass the year thing.
She did agree with that. She just said that you don't get the clincial skills like IV's, cath's, hanging blood that you would get in the ICU. BUT, If I do ICU for a year then move to Hospice for the rest of my career, I would lose those skills anyway right? I'm so confused right now. This is the problem with nursing, to many optons! :chuckle
Thanks to anyone who can give me some input.

I agree, your life experience is a big plus and will serve you well. I do think that having some critical care experience is also needed. I'll tell you why. When I graduated, I was offered a job at the hospcie that cared for my father. I had also done my community nursing practicum with hospice. All I wanted to do was be a hospice nurse. Because my Dad had recently died and my sister was diagnosed with cancer, I felt I was too fragile emotionally to do hospice. Like you, I was not a 19 year old, actually, I was 45.

I am glad I spent some time in critical care (ER, ICU, SCCU, and MED SURG), I built confidence to handle being out there, all alone, when a patient is crashing, and the family is emotional.

Working in hospice, I have learned more about how the body functions by watching the dying process than I ever did in school or the hospital, if that makes sense. You must decide for yourself. Hospice is the most rewarding nursing career there is, in my opinion, I can't image ever going back to the hospital ever again.

I wish you luck. Whatever you decide, I believe you will be fine. Hospice nurses are very supportive of each other. You can learn much by listening and ASKING them for help and bounce ideas off of each other. I still ask questions and input from my co-workers and vice-versa.

Take care, let us know what you decide.

Cindy

CONGRATS on graduating nursing school!!!

brighella · Jun 10, 2008

As an older student nurse (believe me, 32 is considered older in my class where the avg age is 21) who is moving into her second career and also feels called towards hospice, I have been asking questions like this to the people who I have been introduced to. My understanding of what I have been told is that:

a. hospices are required by medicare/insurance companies/the powers that be to have nurses who have had a year of experience as a certified professional. For instance I have health care experience, but id need to be licensed to be a home health aide to be able to work for them now while im in school. Its first off a money thing. That may not be the case everywhere, but its what ive been told about California from more than one source.

b. that year in an ICU or a medsurg environment is important experience with self organization, assessments, understanding how you best work etc etc. It is for gaining that experience that says 'something here is wrong' when you walk into a room, and allows you to determine what that is.

Finally i think its important because most hospice is done in home, and when you're by yourself, you cant just poke your head out into the hallway and say 'hey can you come look at this with me and tell me what you think?' You have to feel comfortable taking care of people in a setting where you have most of what you need, before you can go into the field and become MacGuyver when you need to.

You do have the benefit of your previous experience, and itll only continue to serve you. Theres just more knowledge to be gathered along the way. I'm considering a year in med-surg as an investment, not unlike the time in school. In the meantime, I have yet to find any hospice nurses who are not interested in helping nurture more hospice nurses, so the more talking you can do with them is also only going to help you. We'll get there! :)

Sarah

bsngrad2be · Jun 11, 2008

Thank you so much. I've really been thinking about this today and I want to do the right thing for my patients as well as for my family. I had a thought that I can't get out of my head while cooking dinner of all things. If I do a year of Critical Care-which I loved and have been saying that's what I want to do pretty much since I walked through the doors of nursing school-it can only help me, if I don't, it might really hurt me. I agree that the experience will only benefit my patient and help "hone" my skills; all positive things. I'm also questioning if my interest is more the scheduling than the work and I don't want to do this for the wrong reason. I really felt like I'd made a difference in the short time I'd spent with the three patients we saw (one even told me God was looking down and blessing me for being there--I about cried). I have only my capstone left which is in critical care so I have some time. Thanks again, your input is very valuable and helpful to me.

doodlemom · Jun 11, 2008

As an older student nurse (believe me, 32 is considered older in my class where the avg age is 21) who is moving into her second career and also feels called towards hospice, I have been asking questions like this to the people who I have been introduced to. My understanding of what I have been told is that:
a. hospices are required by medicare/insurance companies/the powers that be to have nurses who have had a year of experience as a certified professional.
There are no Medicare/insurance company requirements for hospice nurses to have a year of experience. It would however, be a smart move to work in the hospital for a year. Hospice nursing requires quite a bit of autonomy and a new nurse might be overwhelmed. I have worked with hospice nurses that went right into hospice from school and they did OK, but I have met others that did not fare as well. We don't have a policy against hiring right out of school but a person would have to be pretty super for us to do so.

IMAHospiceRN · Nov 12, 2008

I work at an inpatient hospice facility and the difference in care given between experienced hospital nurses and newer grads is very significant. The less experienced nurses generally fail to see what they lack, but patients know who gives more knowledgeable and highly skilled care. They sometimes even refuse things like IV changes on the shifts of the "greener" nurses, waiting instead for an old hand to come on duty. There is no substitute for hard earned experience.