LJLeach

Dear Angeludance, Please don't get discouraged. Many of us (long time hospice nurses) have had similar experiences where bosses have stabbed us in the back. :angryfire Don't give up. You are now an experienced hospice nurse (however long or short your tenure). That makes you a valuable commodity. Put your resume out on CareerBuilder and see how fast you get calls....you'll be amazed. God bless you. Linda

I was beginning to think that all of California was moving to Phoenix!!!

What I'm curious about is: Why, after being struck by this first patient, do you still have her on your caseload? Doesn't your agency have a policy in place that would protect you? (At my agency there is a criteria for admission that clearly states that admission will be denied and/or revoked if there is any risk to the safety and well-being of the nurse.) You shouldn't be at risk for physical abuse. God bless you, Linda

Take it EASY on yourself...You'll do fine. Don't be afraid to ask a LOT of questions... (remember your other team members WANT you to succeed, otherwise their caseload increases). One thing I've discovered in Hospice is that the biggest portion of it is relational. You become a part of the family. Listen. They want to tell their story. Use phases like, "Tell me about..." "What is it like for you ..." Open ended questions convey an active interest in what they're going through, and when the families sense that you REALLY care about them by listening to them, they give a lot a latitude for your inexperience. God bless you, you'll do great.

hooray for shay!!! congratulations!!!:balloons: :cheers:

The only time I've had a Hospice patient that received IV fluids was one that was admitted with ideopathic diarrhea. The doctor left to the Hospice nurse the responsibility of telling the patient that the only thing keeping him alive was the IV fluids...not a fun chore. (I hate it when doctors drop the ball on their responsibilities.) Within a couple of days he decided to stop them. Since then, I've been told by each Hospice I've worked at (east coast and here in Phx) that IV fluids are not part of Hospice care. I've not used them since.

I recommend "Pain: Clinical Manual" by Margo McCaffery. It's available through Amazon http://www.amazon.com/gp/product/081515609X/qid=1150952081/sr=1-1/ref=sr_1_1/002-7019929-8705644?s=books&v=glance&n=283155 A large aspect of Hospice nursing that I had the hardest time grasping and treating was the different kinds of pain: somatic, visceral, or neuropathic. This book does a great job describing them and explaining the rationales for treatment. God bless you in your new career. I'm sure you'll find that it's the most rewarding field of nursing. (My pastor once told us, "You know when you're working within your gifting when people look at you and say, 'HOW can you DO that?'. And because it comes so easily to you, you think, 'Can't EVERYONE?') Linda

I work for a large Hospice in Phoenix, and as a case mgr, I work standard business hours (8-5), and take a lot of paperwork home. Because it's a large Hospice, they have enough staff to have nurses that only do admissions, other nurses only do nighttime triage, and other nurses only do off-hour visits. I've found that the smaller Hospice agencies have their nurses do EVERYTHING!!! Not fun...especially when you factor in all the paperwork involved. The nursing philosophy of "If it isn't written down, you didn't do it" carries a lot of weight when you're out in the field and have the freedom we do...the paperwork is enormous. But, I can't think of a more rewarding field of nursing.