LemonIndiscretion

I did palliative care for a bit, My hospice agency had me see palliative patients (basically mostly patients with cancer still seeking treatment), their goal was to bridge them over to our hospice. I enjoyed it but became overwhelmed at times, trying to balance my hospice and palliative patient's needs, plus I had no designated palliative team- no support- it was very challenging but I felt like I really helped quite a few people, even when their goals and beliefs didnt exactly match up with the hospice philosophy, wish I had more structure and support around me to assist them more. Ultimately our hospice grew and they needed me for just hospice patients Good luck!

I've done home health and hospice and I find the documentation equal. Hospice requires more frequent family phone calls, documentation for IDT, documentation for care plan meetings for facilities. Not to mention constant med changes! I find hospice more challenging but more rewarding... Never going back to skilled home care!

I also work for a smaller-ish agency. My current case load is 23, mix of home patients and facility, more facility but I'm in 4 buildings. I'm managing... Earlier this year I was on call every day for 2 months straight with a few weekend days off here and there when my clinical manager was feeling generous. I had a case load in the 30's AND did they majority of training of 4 nurses. But... we are good now!!! I'm only on call 1-2 days a week AND I have every weekend off (which I spend a huge portion of documenting but I'm really not complaining!) Life is good right now. We are on call 5pm to 8am and we have someone who works friday-sunday 8am-8am which is a blessing!

First off Good luck on the exam! I took it on the 17th of this month and passed with an 85! I've only been doing hospice for 9 months but I have oncology/ palliative experience (about 2 years) and I studied for one month. Techically I studied for 3 week because I went on vacation and didn't touch a thing. I read the core curriculum front to cover and did all the practice questions. study guide There were alot of oncology questions on mine so I really lucked out Spend a lot of time on symptom management and pain management. I had a few math questions, (know opioid equivalent conversions!) I do not think you need to take a prep course.

My case load right now is 30... I'm also on call every other week for a whole week at a time... 5pm-8am then work regular work day then Friday 5pm-Monday 8am with literally no help whatsoever... lord help me!

Y'all I'm dying right now because of on call... it was every 4 weeks, 7 days straight... then it was every 3 weeks, now it's every other week so 7 days on call 5pm to 8Am then 5pm Friday through Monday morning at 8am then I have to do a regular work week...sometimes I take a day off during the day but right now that's pointless since I have a caseload of 30 so If I take a day off during the week I end up seeing them Saturday, plus admissions, revisits, chart Evals, prn visits etc... my job makes me feel like I'm whining if I say that something doesn't feel right or say one day I just literally cannot do another admission... they make me feel like I'm the weak link or something when I'm one of two nurses right now and the other nurse has a case load of 12 because many facilities do not like her. We have an LPN who's amazing and helps with revisits. I'm also training 3 nurses right now... I've never felt so burnt out in my entire life! Is this an anamoly in the hospice world or am I being a little dramatic? Dont think anyone will see this since it's an old thread...

I got a job at a home health agency as a new grad, was asked to be part of the chemo team after 4 months, got the ONS cetification in April (agency paid for it), started doing chemo disconnects and hydrating clients with cancer in their homes, and just got a per diem position at a cancer center! It took 8 months but I'm hoping it turns into full time, Good lucK

Rhode Island

I've removed a few in the home, to do so I need to see the xray and I need measurements, I pull then measure to make sure nothing is left behind, then apply occlusive dressing

Anyone else doing them? My HHA paid for me to get my ONS certification to give chemo/biotherapies in February/March last year... Since then I've been doing 5 FU disconnects, accessing/deaccessing clients' ports for hydration/ IV pain medication etc... There are only 3 of us doing it so we cover a HUGE territory, like 150-200 miles a day and I have no idea where I'm going until the night before. We're also responsible for bridging clients' with cancer to hospice often, plus we see other clients with PICCs who are on antibiotics and other IV meds. Also if a client's port is leaking or their pump is malfunctioning we HAVE to go out, myself and one of the other nurses take turns... I'm wondering how other angencies handle the chemo disconnects I love my job but it's very stressful! Any tips/ pointers/ suggestions would be helpful! Thanks!

Admission nurse should do it

Hi nurseinstinct! I'm now on the IV team, doing mostly chemo clients, it's stressful and I cover a huge territory but I LOVE IT! I'm still case managing for an LPN but am slowly giving that responsibilty up because we're getting so many chemo referrals. I have a lot of clients with pancreatic cancer now and we've been helping them bridge to hospice when they're ready which is challanging but very rewarding. I haven't even thought about grad school... I think I'd need at least 5 yrs experience doing this, probably because I spent 6.5 years in school and I'm just not ready yet!

My pay was 30$ per visit for the first few months, then additional $ to case manage, I'm at 40$/visit Nurses who have hospital experience start out 40-45$ per visit. Nurses who have worked in a hospital say they make more in home health, hope that helps

I live in Rhode Island Graduated with BSN in May 2013 Passed NCLEX end of July, I started seriously looking for jobs in August, went on 3 interviews after applying for a few dozen jobs, in September interviewed at my current job but didnt start until beginning of November. So 4 months or 2 months depending on how you look at it :)

My pay sucked at first but right now I'm at 32$ per visit 64$ for an admission,it's much less than what the other nurses with experience make. I do between 32-34 visits per week and work 5-6 days per week.

I was hired as a new grad. They trained me for 2 months with an RN and now I work with an LPN everyday. The first few weeks- months on my own were hell. But I think if you know when you're in over your head and talk to your clinical managers often you'll be fine. They've put me on the high- risk of rehospitalization team and certified me to give chemotherapy so my agency must have some faith in me even though I'm a new grad. I think it can be done.

Any other new grads in home health? My only experience was 2 years as a CNA and 7 years as a residential counselor in group homes. I graduated with a BSN a little over a year ago. I was lucky enough to be hired by my home health agency after I passed the boards, they only hire 1-2 new grads per year and no other agencies in my area hire new grads. My training lasted about 8 weeks. My first weeks- month on my own I cried every single day. I was not prepared for the paperwork, every patient I had had new procedures/ wound treatments/ diseases that were new to me. I applied at a drug treatment facility and was offered a job but for some reason I turned it down. For the next weeks- months I got a little better at dealing with the stress and paperwork and driving. I learned when to ask for help from my clinical managers. The nurses at my agency were divided into teams to try to decrease our number or re- hospitalizations and for some reason I was assigned to the high risk or "A" team. We have to call into a call conference each morning and choose amongst ourselves which admissions we want to take. Talking to the nurses each morning I got to know all of them and then a miracle happened- I met an LPN who still saves my ass every day. I talk to him multiple times a day every day. He has 30+ years of experience and I can't imagine doing this without him anymore. He comes with me to help me with things I've never seen/ done before and I do admissions for him and keep him at our quota (all our nurses do 30 visits a week) We end up sharing most of our patients and I don't feel nearly as alone. I wishI had done med surg for a few years first but if you have the opportunity to go right into home health it is extremely rewarding in many ways and I really do love it. They also paid for me to get certified to administer chemotherapy/biotherapy at home and I am extremely grateful to get that experience and I am enjoying doing that as well. I love home health and I don't see myself going anywhere anytime soon! The only negative is the pay... any other new grads with similar experiences?

Wow I'm a dummy and totally put this topic under articles instead of just general nursing. I'll try to figure out how to move it/delete it! Lo Siento!

My school was also in support of us reading strips, or at least being able to recognize the biggies! Besides on exams I had a clinical instructor in med/surg 1 who would pop quiz us on the spot with asking us what was off on an ECG strip, and she would quickly draw dysrhythmias and we would have to name them off quickly while we were on the hospital floors to keep us on our toes! She was great at her job and I appreciate professors like her!!!

julz68 I really appreciate you posting this! These situations might seem black and white, but as a brand spankin' newbie It's definitely got me thinking and I'm sure I will encounter situations similar in the future! I love reading everyone's responses.

I'm so sorry! We'll all be here when you come back.

I just finished nursing school!!! Just waiting to take the boards... I just wanted to say I couldn't do it without this site! (Well... maybe I could have but members on this site have definitely helped me over the years!) Many of you gave me strength to continue after my mothers death, even though sometimes I thought I had nothing left. I received guidance when I needed it most (and of course I reallllly appreciated the help with care plans!!!) I started this journey 10 years ago as a nursing assistant when I was in high school. I worked my way through 7 years of school, I didn't do it the right way... but I did it my way. (pardon the Frank Sinatra lyrics) And I know that my education is just beginning. As my cousin said to me yesterday, here comes the hard part... being a nurse! I look forward to a long career (hopefully) of doing what I love. Even if I didn't always post... I read ALOT. This has been my quick reference and my resource to read real nurses' opinions, many of whom have been nurses for years, are nurses from different backgrounds, from every specialties, with all kinds of experiences. LPNs, ADNs, BSNs, Masters and Doctorate prepared nurses allnurses I just need to say Thank you Thank you Thank you!!!

They have a flu clinic that my school participates in and they offer the opportunity for students to basically give injections all day, I highly recommend this experience if your school offers it. You volunteer and its not for credits or anything but its worth your time!

You may do a lot more next year, especially because it's an accelerated program. I'm in a traditional bsn program and I didn't start doing a lot of injections, dressings, feeding tubes, IV meds etc. until this past year which was my junior year. At this point we each give all our patients meds and treatments each clinical day. Have you had medical surgical nursing? That's when we really started doing more injections and dressing changes. I don't feel like I am good at anything but I do feel a little more confident, especially with injections and meds. I work at a group home too, which may be why I feel comfortable around meds and dressings because I've been giving meds there for 6 years. I don't know what state you live in but in my area, there are a lot of Student Nurse Internships that you can apply for after taking at least one semester of medsurg. I just applied to 3 of them. I've heard some are better than others and by participating in one you have a better chance of getting a job after you graduate. I hope you get to do more and feel more comfortable over the next year. Good luck!

I have the breast cancer edition too and mine looks GROSS!!! I feel like it makes me look like a dirty pig every time I use it. I'll have to try this!