JNF RN

I work in Hospice. I have tried to treat off nights like work nights but it usually does not work. I have nine hours between shifts and you have to take care of business sometimes during the day. They have talked about cutting our shifts back to 12 hours rather that 15. I have to drive 250+ miles many nights. That being said I love hospice and want to help our patients. I'd like to hear about other agencies handle their on call hours.:):)

I work on call overnights from 5pm to 8 am the next day. I am paid regular time from 5p to 3a and over time if I go out after 3am. This makes for a very long day at times. Even if you don't get a large number of calls you don't really get good REM sleep and what you do get is often broken up by calls and or visits. Being in a rural area the distance to make a call can be great and driving fatigue is a problem. How does your company handle the overnight on call?

When the trash goes to the landfill it is unlikely to enter the ground water. The landfill is a closed system where the area where the trash is being dumped is lined with plastic. This prevents toxins from reaching the ground water. I am surprised that your agency allows you to transport meds. We are not even allowed to transport an aspirin. It is funny that we can have morphine delivered by a cab driver who's background in unknown but we cannot deliver any meds. Go figure

I like this idea best of all. I'll take it to the powers that be and see if it flies. Thanks.

I did just over a year in an acute care hospital before hospice. I think I benefited from that experience. Believe me, a year goes by real fast when you are a new grad!

The previous post is right on target. You need to take care of yourself and the hospice team needs to take care of each other. I had a nurse working on my team that just did not know how to set boundaries. She got so involved in her patients that they all had her home phone number and she would go out at all hours (off the clock) and sit with patients and attend to whatever needs there were. Then she would try to do her regular caseload during the day. I love hospice work but I turn it off when I am off duty. I do overnight on call and some nights there are several deaths and one must be careful not to cross over that line that separates a professional hospice nurse from grieving family and friends. Depend on your team for support as you get oriented to this new field of nursing.

HE is the Great Physician. We just help!

The water from the toilet or the sink ends up in the same place. In the rural areas we have septic tanks so the problem is more localized. I sure would like to get my agency to start using the cat litter or some other procedure. I attend 1-4 deaths on some nights. A lot of drugs go down the drain.

I went from many years as a CNA to RN. If that is your goal GO FOR IT! The CNA experience will be a good foundation to build on.

When I was a CNA in a nursing facility I took care of a man and his wife. After giving AM care and dressing them I would wheel them out to the lobby as she loved to watch the traffic, passersby, etc. Every day, like clockwork, she told me how much she liked this "hotel" and I was her favorite "bell boy". She would go on about other hotels where the service was not as good as it was here. This is what I call pleasantly confused. In her world she was being pampered in a hotel rather than spending her last days in a nursing home. I can only imagine what went on in her inner world as she looked out that picture window with her husband of 50+ years at her side. If you have to have dementia, this is the kind to have. I would go ahead and use "pleasantly confused".

I knew a one armed nurse long ago. Don't let a disability get in the way of your goals.

You have already received some good advice regarding your situation. I would echo the advice to take some time for yourself. In hospice it is very important to set boundaries. Hospice nurses who don't take care of themselves don't last long in this area of practice. Take some time off and then get an appointment with your manager and get things on track.

I started in hospice after one year acute care experience. My goal from the start was to be a hospice nurse. If your agency gives you a good preceptor and does not just throw you out into the field you will probably do fine. When going form acute care to hospice care you have to change your mind set when establishing a plan of care. The goals are different. You have to be able to give 100% to your patients while keeping good boundaries and taking care of yourself at the same time. Hospice nursing is not for everyone. If it is your niche you will know before too long. Go for it. Good luck.

When we have a death we dispose of the liquid meds (morphine, lorazepam etc.) down the sink and the po meds down the toilet. What are some other methods that are used in your agency? Disposing into cat litter or coffee grounds are two other methods I have heard of. Right now our policy is to put them down the drain/toilet. I am not thrilled with this method. Thanks for your input.

I am a gun owner, shooter and second amendment advocate and depending on the situation I would not feel comfortable with an armed patient. There are too many variables in hospice patients that make the possibility of a serious accident very possible. I carry a gun but not when I might be having a cocktail or doing anything else that might impair my judgment. A patient with terminal agitation, on large doses of morphine and facing imminent death is not the person I want to have a loaded .45.