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Discussion

Trying to find my Niche

Hi all, I am an LPN working on my ASN/RN. I have been an LPN for 6yrs pretty much exclusively in LTC. I have dealt with a lot of death and dieing. When I first went into nursing school I thought working with dieing pts would be my most hated and stressful part of nursing. It turned out to be the opposite. My first experience with it was in clinicals. My pt was actively dieing and very near the end, she was a DNR. It was my job while waiting forthe family to arrive to make her comfortable and presentable for the family. I was working with a wonderful aid. We gave her a bed bath, lotioned her from head to toe with a wonderful smelling lotion the aid had brought in herself. We clipped her fingernails, put her in her prettiest night gown, brushed her hair and did oral care on her. We fluffed her pillows, put her softest blanket on her and put moisturizer on her lips. I gave her the prescribed pain medication as often as ordered. It was an awesome experience. I felt touched that we were doing all we could to make her comfortable and to make her look good and restful/comfortable for her family(I know I would want that). So anyway since then each experience I have had with a dieing pt. I always try to provide the comfort and pain management that I would want if it were me. I know this probably sounds nuts but I somehow feel a calling to hospice. I know I am good at it and I really feel it is the last kind and important thing we can do for those about to pass on. Problem is I don't know how to get into it. In my county they do not utilize LPN's for this however the surrounding counties do. It is not generally advertized in the papers either. Should I just send my resume and references to the hospice organizations? My last question is I have been told that hospice nurses are easily burned out and do not last in the field for long. Would you agree with that assessment? Thank you for any input.

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I was an LPN for 12 years. I worked sub-acute and LTC. I always wanted to work in hospice but LPN's were really not employed in hospice in my area either. When I finally finished the RN program, I applied for a job as a case manager in hospice and got the job. I love hospice and after 1.5 years as a case manager, I became a Patient Care Manager (equivalent to Director of Nurses).

Hospice is demanding and rewarding. Burnout happens but not so much if you are aware of setting boundaries and keep to your role on the hospice team. I have seen too many nurses act as social workers as well. We have Social Workers on the team and they should be utilized for their expertise. After all, you don't see Social Workers administering medications.

We have LPN's working for us but more on a PRN basis as they cannot act as case managers due to scope of practice. This is unfortunate as you and I know how capable most LPN's are at providing care.

If you are unable to work as an LPN in hospice where you live, I would suggest becoming a volunteer for now. It would give you great exposure to hospice patients and an opportunity to meet hospice nurses. Take opportunities to learn pain and symptom management. If it is truely what you wish to do, you will pursue it after you become an R.N.

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Thanks for the excellent advice. I think I just may do that. It would be awesome experience.

Thanks for the excellent advice. I think I just may do that. It would be awesome experience.

Being a voluteer first is a great idea. After you are a RN, it would not hurt to place an application at the nearest hospice. I was a hospice nurse for 7 years and left a few months back. But after seeing what else was out there my heart told me to go back to hospice. I guess it was just the rest I needed and am back full steam ahead. Good luck. Remember one thing, keep your eyes on the goal as a hospice nurse.....comfort both physical and emotional. It will get you far.

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