Freedom? That's an interesting word I never would have thought of applying to hospice nursing. Autonomy maybe. It certainly can be stressful, or it can be delightful. It all depends on what comes about. Certainly every day is different as no two admissions are alike. Every patient, every family is unique. I'll tell you what a day is like under our model, but recognize that many hospices use different models for admissions.
The day generally starts with coming to the office and updating the laptop and pulling in information about the days assigned admissions. Usually we do two, but sometimes the plan changes at the last minute as to which ones we will be doing. Lots of times referrals are made at the last minute so there is often shifting of assignments to meet the needs. You learn never to get too mentally attached to any plan for the day.
You head out for the appointment. Spend maybe 20 minutes talking about hospice, showing the patient/family how it will meet their needs, getting papers signed. Then about another hour assessing the patient, making a med list, careplanning and educating the family, ordering equipment, collaborating with other team members etc. Then there is about another hour of charting and phone calls to do getting that all typed out in the computer. If there are medication changes needed to get the person's symptoms under control (and there often are) that can add to the time involved.
If things go smoothly, it will take close to 4 hours all inclusive. If there are a lot of hurdles, it can easily expand to 6. We do A LOT of stuff up front though. Some hospices do less on the admission visit, and may even have a rep who goes in before the nurse and explains about hospice and gets all the consent forms signed. In those situations, the admissions nurses generally do 3 admissions or even 4 in a day.
