New nurse, new to hospice, overwhelmed

[faithful64]

I just got my license a little while back and I'm still in school full time for RN. I was thrilled when I was offered the job at the in patient hospice house that I did my clinical rotation in this summer. I have wanted to work in hospice care since long before I started school.

After six days of orientation I will be starting on my own, with 5 patients. This is a 10 patient unit and there will always be an RN on the other side as well as a NAC working the whole unit.

When I agreed that I was ready, I didn't quite understand that she meant and now I'm not so sure. Last night I had my first swing shift (4th day on the floor orienting) and it got pretty intense when an older gentlemen kept wanting to escape. I gave him his prn haldol, but it didn't seem to help at all, he just got more agitated, when he got his second dose an hour later he eventually settled down, but not without a few tears and some belligerence. Because I was still orienting with another nurse, she was able to stay with him for almost 2 hours while I attended to the other patients. But I still had to ask her questions about what I was doing and I wondered what I would have done if I were alone? When I'm been on day shift there have been social workers, chaplains and volunteers there too, so there is always an extra hand if you need one, but not in the evening.

I'm also still learning the paper work and protocols there and have not experienced a death. I have voiced my concerns to my supervisor, but she told me that she wouldn't have asked me if she didn't think I was ready, I just needed to get out there and do it.

I am comfortable with patient and family care, I love hospice and find most of the staff very supportive. I still have two more evenings orienting before I'm on my own, but I'm losing sleep over this. Any advice

would be great.

[leslie :-D]

when a prn isn't working, you call the doc and get a repeat order.

it's likely the dosage was on the low side anyway.

before you're on your own, make sure your supervisor knows what you haven't been oriented on yet.

best of everything to you.

leslie

[faithful64]

Thanks Leslie, I appreciate the advice. I will make sure she is aware of what I don't know yet! How do you deal with a patient who needs one on one when your other patients have needs?

[MollyA6]

Sorry to hear you are feeling overwhelmed. Trust me it does get easier. I have been a palliative care nurse now for 12 years and I love every minute of it. Palliative care is not easy. It takes time, and the thing about palliative care is that it can be very unpredictable. My suggestion is to not try so hard. Step back take a deep breath and relax. Just think what is the worst that can happen, and can you deal with that. Probally so!!! I find this to be the most rewarding of all nursing. Think of it as helping someone to make a transition from this life to the next.

Take care

MollyA6;)

[faithful64]

Sorry to hear you are feeling overwhelmed. Trust me it does get easier. I have been a palliative care nurse now for 12 years and I love every minute of it. Palliative care is not easy. It takes time, and the thing about palliative care is that it can be very unpredictable. My suggestion is to not try so hard. Step back take a deep breath and relax. Just think what is the worst that can happen, and can you deal with that. Probally so!!! I find this to be the most rewarding of all nursing. Think of it as helping someone to make a transition from this life to the next.

Take care

MollyA6;)

Molly,

Thanks for that. I believe you hit the nail on the head...I am trying too hard! I think I was expecting myself to know how to do everything as soon as this orientation is over. But I can tell I'm really going to love this once I'm a bit more confident. I'm already crazy about just about every patient I've had so far and feel honored to be there with them while they make their journey.

Faithful:redbeathe