StJohnRiver

The hospice I work at does hire new graduate nurses, but most of them leave after a couple of years. They say they want to learn more, and I can see why they make that choice. I think hospice is wonderful, but you will be much better prepared for it if you have previous experience, preferably acute care in a hospital. One of the great things about hospice is the autonomy nurses have. You earn that by earning the trust of the doctor. And you will be much better equipped if you have experience in handling meds and orders and dealing with all the specialists you'll deal with in a hospital setting. Another thing needed is life experience -- much of hospice work is dealing with families and their emotions at such an intense and traumatic time. That's something that just comes with getting older and all the experiences and learning that comes with that.

I will be retiring this week as a hospice nurse. I expected the Covid patients would all die in the ICU, but they are spilling over into hospice. I considered sticking around until the economy gets better, but I turn 65 on Tuesday, and the chances of having a Covid patient keep going up, and the last thing I want to do is get sick instead of getting out.

Hospice. Two years. Love it. Prior to that, Neuro/Tele. Hated being a floor nurse. So much better helping people die than aiding their suffering by trying to keep them alive via drugs and machines. Hospice can be hard, but it is very rewarding and most families are so, so thankful for what we do.

Definitely helps. We do bedside report, but a quick "heads up" outside the room is much appreciated. In fact, that is usually the most important info I can get on a patient. I need to know what I am getting into. Many times I get a patient because I am a male and that patient has been, shall we say, making odd requests or comments about his female nurse. I know he is disappointed when they see me, but I usually have no problems from these patients.

As an atheist, I was a bit concerned about going into hospice since I expected religious beliefs to be in the forefront. I figured most of my patients (and their families) would be hoping they were headed for heaven, and I would be drawn into that world. I have been pleasantly surprised that this is not the case. I have never been asked to join a prayer (we have a pastor for that), and I have never felt awkward when dealing with patients who are overtly religious. I have seen how deeply religious families can create a beautiful environment in a room while waiting for their loved one to pass, and how it can bring the peace. And I have had some very interesting conversations with my fellow nurses about my beliefs and how being a hospice nurse has actually strengthened my own conclusion that there is no God. But that is a whole other topic.

I work in an inpatient hospice unit in a hospital. We often get patients who come from ED or ICU and are there to be evaluated before a decision is made on where to place them. Saying the right things at the right times, and being consistent, is critical. Patients MUST be told before they come to the IPU that the unit is for short-term care only, and if a patient is stable, they will be sent to an appropriate place, hopefully back home, or to the nursing home where they had been living, or to a SNF. The problems arise when patients come to the IPU with the expectation that it is the long-term solution to their problem, that the patient has just found a new home. When they arrive, we determine if they have been given the correct information and understand the policy. If not, we make it clear that we do not do long-term care, and we provide a letter detailing this, and why, and what the cost may be if the family does not want the patient to leave the unit despite the consensus that the patient is not appropriate for further time in the unit. This is necessary because, as unfortunately is usually the case, a few families have tried to take advantage of the situation. They don't want the patient back home, for whatever reason, and don't want him or her in nursing home, and really, really like the idea of having them stay with us where they get really good care. We explain that Medicare will not reimburse us for patients that do not qualify for the higher level of service, and unless the patient is End Of Life or in a Crisis, they can't stay. We aren't kicking them out, we are putting them in the appropriate setting (that fits what Medicare will reimburse). Despite all that, some families will continue to kick and scream, but eventually, when faced with a bill of $525 per day, they will relent. I happen to agree with this, since our beds should be for those patients at EOL or actively dying who require the level of care we can provide.

I get the admissions, and I have quickly learned who I can trust to bring in appropriate and, more importantly, appropriately educated patients/families. You don't want the RNs who take report from you cringing when they hear your name because you have passed along inappropriate patients, or painted too rosy a picture of what awaits them in hospice. No, there will not be a nurse with them 24/7 -- that is very different than a nurse being on-call 24/7, for example. Be clear with your admissions and honest with the RNs who will be doing the work caring for that patient, and all will be well.

I have heard this tale of woe before. The thing with being a hospice nurse is that when you visit a home, you have no on-site backup, no fellow RN you can pull aside and ask for guidance when you encounter something new. And as a new hospice nurse, everything will be new. So adequate training is a necessity. Non-profits definitely do it better than for-profits, but even they can fall short. The new RN must ask for more training time. That is about the only way around it. Or you need to establish some type of phone support that you can count on -- someone you can call at anytime to guide you through a situation. Don't accept "Oh, you'll figure it out" as an adequate response. If you could have figured it out, you wouldn't be calling. It's a shame that too many hospices scrimp on the training, because from what I have seen that is the No. 1 reason nurses leave. They feel overwhelmed and don't see a way out. If you can hang in there and get past that initial phase and gain some confidence, hospice nursing is a great job. I'll never be leaving.

I work nights and invariably patients develops runs of A-Fib, A-Tach, PVCs, etc at 2 a.m. I know anything ventricular is not good, but does a 10-beat run of V-tach that comes out of the blue and is not repeated require an immediate call to the attending or cardiac consult? If it was 20 beats, would that make a difference? Do you have set policies/perameters at your place for tele patients and when to call the physician?

The market in Florida is strong. I am a male nurse who graduated last May and got my license in June. Things were a bit slow at first, but then I had four interviews and three offers in the span of two weeks and started my job in August. I ended up at the place I did my preceptorship and in their new-nurse program. That is the best way in -- someplace you know and that knows you and that has a novice or new nurse program.

I see the influx of second-career RNs as very positive for the profession, and not just because I am one of them. My nursing school class was filled with people who had quit decent jobs to pursue nursing. They had not "failed" at their other profession, they left for a variety of reasons, but mostly because they felt unfullfilled in some way at their old jobs. There were engineers, accountants, teachers, salesmen and women. Most, including me, knew they would be taking a pay cut, but were willing to do that. The result was a nursing school class filled with educated, motivated, mature individuals who will step into their new jobs with a lot of life and work experiences that will help them and their patients. I see the same in the coworkers in my novice nurse program. Only a couple are right out of school. The others have had other jobs and degrees in other subjects. I find myself challenged to keep up with them. I don't see any negatives in this. I think the patients will be the beneficiaries.

Being a minority (male) helped me get into nursing school and also gave me an edge when it came to getting a job. That's the reality I experienced (and I am not about to complain). Fair? Well, life ain't fair, but what goes around comes around.

1. South Florida 2. Novice nurse (no experience), with BSN 3. Tele 4. $25.72 5. $2 evening (5 to 11), $3.50 nights (11 p to 7 a), $2 weekends 6. Union in name only (no fees paid, no impact at all -- Florida a right-to-work state)

All depends on the facility and HR requirements. I interviewed at one place on a Tuesday, and thought I nailed it. Got a call Friday that I didn't get the job. Interviewed on a Thursday at another place, got a job offer the following Monday. Another time, went for a Wednesday interview at 11:30 A.M. and the recruiter told me before the interview I would hear by Friday. After the interview, she said they were impressed and I would hear that afternoon. Got a call offering me the job at 2:30 p.m. I have learned to never read into the interview. The ones where I felt things had gone really well are the ones I didn't get, so I quit setting myself up for disappointment. I agree that if you don't get the job, you should try and get back with someone who interviewed you and ask what you need to do to be in a better position. Sometimes they will be honest with you, and that is a help.

I followed this debate while in nursing school. I graduated in May, got my license in early June, and for six weeks was in the "There Is No Freakin' Nursing Shortage" camp. Then over the next two weeks I had four interviews and ended up with three job offers. While the current situation is obviously tougher than pre-recession times, there are jobs out there. You do have to be pro-active -- when I didn't get a call from the hospital where I did my preceptorship, I called the nurse manager of the department I worked in and asked him if he would put a good word in for me, and he did and I got an interview and a job offer. I also took a CCRN review course at a nearby hospital. Since I am a newbie without a job, I can't even sit for the test, but the two-day class was cheap ($75), and I figured I could meet nurses and network while also getting some good knowledge. The class was great, and better yet, I met a lot of nurses working at the hospital hosting the event, they put me in touch with the recruiter, and we had a good chat. Followed that up the next week, got an interview, then a second, and another job offer. Bottom line -- you can make your own luck.

SugarNSass: I am a former journalist who decided there was no good end for newspapers and decided to go to nursing school. I graduated in May and after four interviews had three job offers. Given that I went to work each day as a journalist wondering if it would be my lasts, to have three job offers was pretty overwhelming, and amazing. Become a nurse. You will never regret it.

After a career change, I graduated from nursing school in May and start my new job as an RN in two weeks. At age 58. So no worries. You are doing the right thing.

I am a student, and after being in clinical for two months, I developed two warnings that I pass on: Don't fall when you are over the age of 70, and don't become obese at any age. That is because most of the bad scenarios I came across were directly related to either of those underlying factors. Old people who fall are at risk of breaking an imporant bone, and when they do, the downward spiral kicks in. Hips, femurs, you all know what I am talking about. Obesity creates a whole host of problems, all preventable. Don't make excuses. Lose weight. Especially if you are a nurse and responsible for advising patients on what how to stay healthy and avoid ending up in the hospital. Calories in, calories out. It ain't rocket science, but it is critical to your health and to avoid bad things happening that burden not just you and your family, but the health care system. Willpower and discipline is required. Simple as that.

The industry I am in was dying, so I wanted to be proactive and have a plan B. I love my job, but I also had to be realistic. It so happens this was just at the time my father was dying of lung cancer and he ended up in hospice care. The hospice nurses were amazing, and I had a lot of time to talk with them. Never saw a doctor, just the nurses handling everything. And they did great work, both with my father and the family. And that reminded me of the birth of two of my children at a birthing center run by midwives. Our first was born in a hospital, and the experience was horrible. When we visited the doctor during the pregnancy, all he did was complain about malpractice insurance. At the hospital for delivery, it was crowded and noisy and my wife was hooked up to all kinds of monitors, and then the doctor came in and to speed things up gave here an episiotomy (totally unnecessary). She was stuck in the hospital for another night (totally unnecessary). At the birthing center, we never saw a doctor. The classes were all about achieving natural birth, the cost was about a third of what it was at the hospital. The nurses were amazing. I still have vivid memories of them surrounding my wife and helping her. We were back home eight hours after the birth of both kids. (This was back before hospitals realized they needed to change and started their own birthing centers based on what the midwives were doing). Those two experiences made me give nursing a hard look. I checked into the job market, future prospects, the kinds of nursing jobs available, and it became pretty much a no-brainer. Signed up for A&P I, nutrition, sociology in the fall of 2011 (thank god for on-line classes and community colleges) and am starting in an accelerated BSN program in May and will be out in May of 2013.

I was in a similar spot -- what you need to do is get your pre-reqs done and ace them. The accelerated BSN program I got into calculates only the relevant pre-reqs (A&P, micro, etc.) for the GPA, so you could have a 4.0 and get in with that. The cutoff for my class was 3.78, and my overall GPA was closer to 3.0. Use the ADN as a backup. I got accepted into a community college and started there before I got accepted into the BSN program. BSN will end up saving you time and money.

Check your FAU e-mail account. That is where they e-mailed a confirmation about the April 6 orientation with directions to the parking lot. It also had a link to where you can sign up for the required CPR class at FAU ($25). It did not contain any information about other requirements, like background check and drug test, immunizations, etc. I was hoping we would get that so we can get going on getting that stuff done. From my experience at PBSC, there is a lot to do and it does cost money, so be prepared. I had to get a flu shot and updated tetorifice shot, proof of TB screening, proof of immunization for rubella, etc. That required a trip to my doctor and a blood test. Also a drug test and background screening ($150 total for both), and all that needed to be done three weeks before the start of classes. And then I had to buy the right uniform and order name tags, and those take a week to get done. ($100 for uniforms and name tags). You'll need a good stethoscope ($100). Then there are books, and the first semester is expensive, since we needed a drug book and others that you will use all year. Figure maybe $300 for that. Just saying be ready to cram a lot of stuff into a short time frame and have the credit card handy. I just wish they would get this out sooner.

56 now. 57 when i start the accelerated BSN program in may, 58 when i graduate on may 2013. i have become used to being the oldest and one of few, it not only, male in my pre-req classes. looking forward to a new career at an advanced age, but going back to school and getting accepted into nursing school have made me feel a lot younger.

I started the two-year program at Palm Beach State in January, so I am getting a taste of what we are in for. First, for those thinking they can work full time during this year, I say good luck with that. If you can pull it off, it will be a pretty amazing feat. I still am working full time while trying to do the nursing school, and even with two classes on-line, it has been near impossible to stay afloat. And PBSC is a two-year AD program, not a one-year BSN, so I am figuring I am if for double the work load I now have. I know I would risk failing if I tried to continue working when I start at FAU, so please factor that in. That said, the classes are interesting and the clinicals will really get you juiced and keep you motivated. I wasn't 100 percent sure I was making the right choice for my career change, and was afraid I might run out of the hospital screaming after helping with my first bed pan, but after my first week of clinicals, I knew I had made the perfect choice. I learned something every time I walked into a patient's room, every time I looked at a chart, every time I checked off on a new skill. I find it all fascinating. It is challenging, but since pretty much everything you will learn is something you need to know and will use when on the job, it makes it easier to study. You'll find that those A&P classes you took come in really handy. You also learn that there is a huge variety of nursing jobs. OR, ER, OB, Cath lab, hospice, etc. I just wish I had done this about 20 years ago. For those wondering what to do to prepare -- not sure I can advise anything. Much of what you learn is hands-on, such as the skills lab stuff (taking blood pressure and vital signs, dispensing meds) and in clinical. You can't prepare for those at home. Be prepared to be overwhelmed, there is no getting around that, but once the initial shock subsides, it does get better. Do get your affairs in order -- eliminate any unnecessary drama from your lives. There is no way to avoid the stress that comes with this, so get rid of excess baggage now. Been meaning to dump that significant other who doesn't understand why you are doing this? Do it now. Hope that helps.

We should have time, but be prepared for initial expenses in addition to tuition -- drug and background test, uniforms, books, skills bag, etc. Not cheap. So plan accordingly...

I was told we will get an information package after the class has been filled. That should be shortly after the deadline for letting them know if you are attending.