VA nursing vs Hospice

tewdles, RN · Mar 12, 2010

I would not recommend hospice nursing for someone who does not have a sincere desire to work in the field. It is demanding in every imaginable way and although it can be an incredibly gratifying field of practice it can "eat you up" if you are not well suited to the work.

Every nursing job has it's inherent stressors, hospice is no different. Hospice is decidedly different from home care apart from the fact that both involve visiting people in their homes and involve serious driving. You must be comfortable working autonomously, developing strong relationships with patients and families, teaching medical stuff to lay people, and dealing with people who are physically and emotionally burdened (cranky). You must have a comfort level with the knowledge that the vast majority of your patients will die within weeks of your first meeting. The documentation can be grueling.

I would recommend that you think carefully about this change. If you feel that this type of work is a good fit for you, then go for it.

Marshall1 · Mar 17, 2010

I agree - hospice is not like home health tho' a lot of people think it is. Are there not any other home health agencies near you that are hiring FT? I know what you mean about the VA - I worked in a VA clinic - pay was great but the job - yuck

twokidsmom,rn · Mar 17, 2010

I know hospice is not like home health, what I meant was you are on your own versus working in a hospital or LTC company. You are much more independent and don't have the "office" type politics as you do when you work at a facility all the time. I think I will like hospice, I would like to try. Thanks for advise.

DelanaRN, MSN, APRN, NP · Mar 19, 2010

Interesting. I am a Hospice Nurse as an RN Case Manager. I do like my job for the most part. However, I am looking into going into VA nursing as my husband is active duty and we are PCS'ing this summer. After the move, I would like to go into other fields, specifically, more of a Med-Surg type environment and ideally with government employee benefits. The only part I really don't care for too much with Hospice is that I never really feel like I am off of work. Even now, I am the RN/Case Manager on call. We have an LPN on call nurse which has helped tremendously in that I don't have near the "in field after hours" visits I had when I would work a full day and then be on call at night as first responder. With Hospice I have found I can make a plan for the day, but it has to be very fluid. For instance, today I had myself scheduled to see 4-5 patients and then do some paperwork, phone calls, and care planning. Instead, I saw one patient and then headed off to do a new admission. Because at this time, we have a low census, I was able to dispatch an LPN to see the other 3 patients I had really intended to see today, thus enabling me to get home in time because this admission went very smoothly. I think the point I am trying to make is you never know what each day will bring. In Hospice, patient's get acute illnesses both directly and indirectly related to the terminal diagnosis and these illnesses must be addressed quickly and efficiently. Routine visits get pushed to the side, but in most cases, at that point, what you had scheduled for today goes on to tomorrow's caseload, which then gets pushed into the next, etc...and in the end, you can have some very, very long days...sometimes working 12-14 hours, coming home, changing into pajama's and then getting another call out due to patient decline or emergency. It can really wear on you at times and becomes very exhausting. I adore my patients, but as in all fields, politics inevitably get involved and facilities get upset with something you or your team did or did not do, your census drops, upper management gets involved, etc.... it's part of every area of nursing though.

My advice to you is, do your research. Call some local hospices and ask if they are hiring and/or if they would mind you job shadowing for a few days. Inquire as to your responsibilities. Really get a feel for the field. You may find you love it!

tewdles, RN · Mar 19, 2010

right...forgot to mention that flexibility thingie...yeah...thats a really big part of the job!

AtlantaRN, RN · Mar 26, 2010

it can "eat you up" if you are not well suited to the work.

Amen!