PumpkinsMami

My mom volunteers for our hospice and she talks to the family before she sees the pt. (She mainly goes to nsg homes). She'll find books or music that the pt likes. Even if they are Alz pts, she'll read to them or play music for them. Thank you for making a difference & being a volunteer!! :yelclap:

Well, the biggest difference for me is time. When I did home health, we had to see a lot of pts in a little bit of time. With hospice, it is so different because you have time to give. That is what pts and families need most. No hurry, no rushing. You have time to get to know your families and pts. To hold a hand, give a hug. It is tough, getting attached at times, but you learn to deal with it. The biggest reward for me are the families. Knowing that they know what to expect and that they were able to spend those final moments with the pt. And when the time comes, they don't have to worry about who to call and what arrangements to make. We take care of that for them. It definitely takes a special kind of person to be a hospice nurse.

I was the intake nurse at a hopice that I used to work for. We had a pt to be admitted with Lung CA & Brain Mets that lived quite a distance from where our office was. I mapped the address for our admit nurse & sent her on her way. She thought she was lost, because she had traveled quite a distance and hadn't found where she needed to turn. She called the pts home and asked for the pt's son to make sure she was headed in the right direction. He had answered the phone and gave her a new set of directions. Again, she called back because she felt even more lost and got yet another set of directions. Finally, after the 3rd call, she realized that the first two times she was actually speaking to the pt w/brain mets who had her going in circles for at least an hour. No one tells the story as well as she does!! It was hysterical! :roll

We have team every two weeks, so it can get crazy!! The hospice I worked for before had team weekly and split the pts up. Half were discussed one week the other half were discussed the next week. We are too small now and don't think that would work for us. Anyhow, we have an agenda that we follow every team. We first discuss discharges, then admits, then recerts and then the rest of the pts in order of next recert date. The pts we spend the most time talking about are in the first 3 categories. After that, we only discuss pts with pertinent changes. If there is no change, then we move on to the next pt. We still get out of hand on occasion, but there is someone always asking "Any changes???" to keep everyone on track. Hope this helps!

I have worked for 2 hospices and both are for profit. I don't think that there is a nonprofit left in New Orleans. Anyway, both agencies are very different. The first one I worked for was a corporate company and the bottom line was #1. The second one, which I've worked for 2 years is locally owned and all about pt care. It is nothing for the owners (2 of which are nurses) to be out all night or weekend with a pt who is imminent or needing xtra care. Find out from the community who gives the best care. Go to a LTC facility and ask around on which co gives the best care & who is the most visible. They can be honest with you and have nothing to gain.

I completely understand how you feel! I cannot stand to walk into a pt's room and see dry crust on their lips & tongue. It just seems to me that as the tongue cracks and bleeds, it would be painful! The sponge toothettes work well if used often. When a mouth is in such terrible shape, it should be done hourly to loosen the layers of dried skin. Once you're on top of it, it can be done PRN....which is usually every couple of hours or so. When I do mouth care, I always end it with applying a moisturizer on the lips! I also hate to see pts eyes with dried mucous and they can't open their eyes! I'm anal about all of that too!! Good luck!

Being a hospice nurse is definitely a calling!! It would be an asset to get some experience for a couple of yrs before going into hospice. Try volunteering to get a feel for the company. Pain management is an area that you want to pay close attention to! How to find a good hospice?? Ask around. Find out what families say about the hospice care they received. How experienced is their medical director? The hospice that I work for has been in business for 2 years (I've been with them from the start!). We are like a family and I feel truly blessed! One of my favorite things about the company I work for is that we start every week with Monday morning prayer. You'll know when you get there that it's for you!!

I've been a hospice nurse for 4 years. When I first started, I was a continuous care nurse. The pts great grandson was 4 or 5 yrs old. He would constantly come to her bed and talk to her. He would ask why she was sleeping and his mom & grandma would say that she was very sick & tired. When she finally passed, I truthfully thought he would have a difficult time and not understand. He would still run in and out of the room, but didn't say much. When the funeral home came to pick her up, he came running through the hallway, with a huge smile, calling out "THE ANGELS ARE COMING, THE ANGELS ARE COMING! GET OUT OF THE WAY." It was so touching. At our hospice's memorial service almost a year later, this family attended and the pts dtr still became teary eyed over it and couldn't tell the story of her grandson! It's definitely one that I'll never forget!

...is the title of a great book written by hospice nurses that discuss experiences such as these. It was the first time that I saw it termed "Near Death Awareness." I truly believe in it and have witnessed similar experiences myself. I've been a hospice nurse for 4 years and know that when a pt starts to talk to "entities" not visible to us, or reaching out into thin air...death is near. Some pts become agitated (terminal agitation) and some pts experience an immediate calm. Those pts that I've witnessed with terminal agitation eventually experience that calm or peace. I have read & heard that pts near death see family members or loved ones that give them comfort when crossing over. As for your mom's experience, it seems that it was a stranger and she probably felt that she wasn't ready. When she gave you an early b'day present, she was finally ready. As far as my personal experience, my grandmother died in Oct 02. She did talk to family members that had passed 1-2 days before she died. On the day she died, she was unresponsive until minutes before she died. She suddenly opened her eyes, looked up and smiled. A few minutes later, she took her last breath. It was a great source of comfort for me (and my family) to see that she was happy going where she was going. You are not crazy! :-) ...check the book out!!