what does it take to be a hospice nurse

[MadpeysRN]

I have a life ling friend that says I have a job at hospice the day I graduate, so while I am excited about having a job when I graduate because of the horror stories of new grads looking for a year! And I feel it will be a blessing to be with someone at that point in their life, I am afraid I won't be cut out for it, emotionally. Is hospice nursing something a GN can step right into difficulty wise, or is it better to have experience? I also have a handful of other RN's in my family, but I am afraid since they all work for hospitals that knowing them for an in won't be enough with hospitals cutting back.

[westieluv]

The main requirements for a hospice nurse, IMHO, are excellent physical assessment skills, compassion, and empathy. When you are doing home visits, it is just you and the patient--no charge nurse or peers handy to get a second opinion about something--so you need to know what you are seeing/hearing when assessing a patient. You also need to know the signs to look for when a patient begins actively dying, such as mottling, increased dyspnea, decreased LOC, and increased secretions, to name just a few. The family members will ask you if grandma is dying and if so, then how much time does she have left? As a general rule, it isn't a good idea to give a specific amount of time, since none of us really knows and can only guess and patients can sometimes rally or rapidly decline, making liars out of us if we try to pinpoint a specific time. The best thing to do is to be really well versed on the S&S of dying and be able to tell the family what symptoms you are seeing and what they probably mean. This is why it is critical to have good assessment skills and a good knowledge base about changes in a body when a person begins dying.

Compassion and empathy cannot be underestimated as qualities that a hospice nurse must have. If a nurse can only see a patient as visit number two for the day who might make them late for lunch goshdarn it, instead of as someone's mother/grandmother/sister/aunt, then hospice nursing is not for them. We need to be able to empathize, to put ourselves in that patient's or that family's shoes, to understand the grief and sadness that they are experiencing, and to accommodate ourselves to that grief. To remember that every time you go out to do a death call you are going to encounter at least one person who is experiencing the worst day of their life is important and helps us to show love and compassion, even if we are tired, hungry, or want to go home.