Tips for a new home health hospice nurse

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Hi all! I desperately need some guidance! I am a newer nurse, I have worked in LTC and office nursing for a total of about a year... I started hospice homecare a couple months ago. I came to hospice because my mom had ovarian cancer and during my last semester of nursing school, she was put on hospice.. At 21, I gave up everything including school for a bit to be her care giver and it was the best decision I've ever made and something I feel very proud and honored to have been able to do. A little over a year later and here I am! I was hired PRN, but due to some issues I was asked to temporarily take over a full time case load my first day off orientation. I have also been working nights and weekends and at times am the only nurse working for more than half the state. I am also in school full time. To be honest, I am completely overwhelmed. I am still learning my skills, there are some I've never done. I'm trying my best to just go out there and try to figure things out on my own, but there are just so many things I don't know how to do still! I want to take care of these patients to the best of my ability, but I feel like they deserve someone more experienced to be their primary nurse.... I am still stumbling on my own two feet so to speak. If you have any tips I would greatly appreciate them... I often feel I don't have the resources I need and for someone who isn't someone who cries , I have done so more days than I can count. Everyone assures me I doing great, but it certainly doesn't feel that way..... Any and ALL tips and advice is welcomed. I want to tackle these fears and become more confident in my abilities.

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So do I understand you correctly? You are working FT AND going to school FT? No wonder you are wringing your hands! That is too much to take on for even an experienced nurse! I hope your employer is doing something to remedy the situation! There is far too much at stake (for you and your patients) to allow those hours to continue.

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Specializes in NICU, PICU, Transport, L&D, Hospice.

I have serious professional reservations about assigning new and inexperienced nurses to field hospice case management. Your story is indicative of why.

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Yes school and work full time.... Well actually starting next week I will work one shift less a week thank goodness! That has been a big relief. I just try very hard to remind myself that I won't know everything from the jump, and I call and ask questions all day long. It's better to ask then to assume and make a mistake!

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Luckily, I will be case managing only temporarily because if they offer me the position permanently (as indicated they might) i plan to say no, which is not something I do often. I think I need time to learn, and also that the patients need someone who has more experience. Maybe I am wrong, but that's how I look at it.

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Did they not do any orientation or provide you with a mentor? That's what I do every day. I train all our new nurses statewide and answer their calls on a mentor basis. Sometimes even riding along to difficult patients.

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I did have about 3 1/2 weeks of orientation. But there's really no one we can other than the other staff nurses. Since this post originally I have gotten better acclimated and feel more comfortable, which I am grateful for

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We don't have a program for new nurses unfortunately. The answer is that because we are not for profit we cannot afford one.

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Oh ok. Well I am a hospice staff nurse also, no extra pay involved, I just do it to help out our new people. Hospice is unlike anything nursing school teaches you, my school anyways, and can be intimidating. I ran a busy ER before hospice and thought after that, nothing would intimidate me. Boy was I wrong haha.

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WOW!! Thank you for sharing that, it definitely helps me realize that it is a challenging field. I just have tried to do my best to take it one day at a time and realize I am only one person so if I do my best that is the best I can do. Slowly I'm figuring things out. Still so much to learn, but I feel more comfortable with the things I have learned so that helps.

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Specializes in Hospice Nursing.

It sounds like you were thrown into an impossible situation. That said, I would suggest using all of your available resources (nurse manager, nurse educator, peers) to help you through this time. I have done hospice for 10 years, and feel that it takes 6 months to a year for a new hospice nurse to feel somewhat comfortable. Also, the fact that you are a newer nurse will make this transition harder. Sounds like you are doing a good job...don't give up!

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I have serious professional reservations about assigning new and inexperienced nurses to field hospice case management. Your story is indicative of why.

.......that's encouraging

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