Peds Hospice/Palliative Care

[rnin0513]

I'm 43 and finally getting my RN! I'm interested in pediatric hospice or pediatric palliative care. Will I need any additional education, certification, etc? As a new grad will I have trouble getting into that field? I live in a relatively small town with no children's hospital but two hospice companies - is that where I would start? I always see Peds OR Hospice but haven't found much info on them together. Any input, advice, etc would be appreciated! Thanks so much. =oD

[lkisby]

Hi,

Getting into hospice can be challenging because we are always looking for nurses with experience. That being said, there are certain qualities I look for when interviewing. One big quality is maturity, along with a true passion for the work of hospice.

As for training, yes, get as much info on end of life care as you can get your hands on. NHPCO.org is a great resource along with the state organization where you are from. Books are a great resource as well. Ira Byock is a good start as is Kubler-Ross. There are books by hospice nurses offering insight into their experience. Final Gifts is a good book and Dying Well by Byock.

I hope that helps. Pediatric hospice work will require a lot more work to get into. An agency might be willing to train you, but learn the basics of nursing if you haven't already.

ljk

[ErinS, BSN, RN]

You will have a hard time finding a specific hospice pediatric job without a large pediatric hospital near by. In our agency, we get about 3-4 kids per month. There are certain nurses who are more comfortable working with kids, so they are the ones who manage them. From personal experience I would NEVER work exclusively with dying children. Watching someone's baby slowly slip away, and the struggle that often comes (children die hard and often very slow deaths) is an emotionally and physically exhausting experience. After the death of a child I often have to arrange my schedule so I have fewer visits. While I enjoy the chance to care for the children, there are certainly some difficult days.

[Hospice Nurse LPN, BSN, RN]

In my city there is one hospice company that accepts peds. Everyone sends referrals to them. They have 2 nurses who handle only peds cases and I thank God for that. I don't think I could personally handle taking care of a dying child.

[westieluv]

I work for a hospice that has 50% of the hospice market share in our city, a city that also happens to contain one of the largest, most renowned childrens' hospitals in the country who refer all of their peds patients to us. Even at that, we only have maybe 4-5 peds patients at a time, if that. We have one case manager who takes all of the peds patients and she usually has to take some adult patients as well to fill out her caseload.

I work on-call and have attended the deaths of two peds patients. It is the most stressful, painful thing you will ever do if and when you do get into this field of work. It is hard enough on families when an adult dies, but at least that person had a chance to live their life to some extent. Looking at a lifeless two year old...well, that is something that you really can't even describe. You will need to be extremely sensitive and able to give comfort to grieving, sometimes literally out of their heads with grief, parents, grandparents, etc. It is just plain awful. When I attend the death of an elderly grandmother, I hug the family members, laugh with them as they share memories of Grandma, and just feel like I really was able to provide some comfort. With parents of deceased children, often times there is literally nothing that you can do besides arrange referrals for chaplain and social work follow-up care, grieve with them, and in my case, pray, pray, pray.

I'm not trying to discourage you, I'm just saying that it is the most stressful kind of hospice nursing that there is. It would be a good idea to get some good experience dealing with adult deaths first, at least until you get used to the whole dying process and learn how to handle various situations that come up. God bless you, and I hope you find work where you are a blessing to the people that you serve. That's the best thing that can be said about any of us, that we were truly a blessing to a hurting family.

[leslie :-D]

i did peds hospice for around 6 months.

i didn't want to, but was strongly pressured into taking this position (from within my facility).

my last pt was a 6 yo girl...

the same age as my dtr, when she was killed.

to this day, i don't know if it was my dtr's death and this 6yo pt, that 'did me in'...

because the other peds pts, also, took a tremendous toll on me.

i cursed, screamed, wept, mourned with God, every day i came home.

for the life of me, i don't know how these nurses do it.

but they do, and thank God for them.

if it's something you feel called for, then go for it.

i didn't feel called...i was pushed.

big difference.

no 'formal' training...hands on w/other peds hospice nurses, educational handouts from reputable institutions, other informal classes.

God bless you and all others, who want to do this.

i certainly couldn't.

leslie