Words of wisdom/advice for new hospice nurse?

Specialties Hospice

Published

Specializes in Ambulatory Care/Community Health.

I've just accepted a position with hospice, and am excited and nervous all at once. Excited to begin a new career with an amazing team that I know is dedicated to compassionate care (they came in to my home to help my family while my father was dying), and nervous that I don't have the skills to be a great hospice nurse. I'm coming from ambulatory/community health center nursing, which seems like a totally different world. I want to be a great hospice nurse. Any of you veterans out there have any words of wisdom or advice for me? Books to read, or skills to brush up on? Anything? :)

Thanks in advance....

Get organized! That's true for all nursing. There's a lot of paperwork/documentation in hospice, to the point that sometimes it feels like all I do is do paper/computer work.

Some of the best advice given to me was, "In Hospice, the 'patient' is anyone you encounter behind that door." You have to get out of the mindset of caring for just the patient, because in Hospice, the patient's family and loved ones need just as much - if not more - care and support. Although I have been a Hospice nurse for just a short time, I have already found that quite often then family needs much, much more support than the patient does in coming to terms with death. Some nurses rail against how the family complicates things or "gets in the way," and these interactions can be difficult at times. Grief brings up a whole slew of other emotions which aren't always pretty, and may be directed at you. Try not to take it personally, and remember what the family is having to deal with. If you can adopt the correct mindset from the beginning, it will be a help to you...and you will have some very thankful family members.

Specializes in Hospice, Geriatrics, Wounds.

Remember the dying are STILL LIVING...

Thank you. I am about to embark on a Hospice journey, being a new grad with no Tech training, just clinical experiences on mainly med-surg and tele floors, I'm terrified and hoping my compassion and drive to do good for my patients will be enough to make me the nurse I need to be for them and their families. God please help me to be competent, efficient, and available to my patients.

i am in your exact shoes. how are u doing so far with the new job??? best of luck to u!

Specializes in Urgent Care, Hospice, Home Health.

My heart is in hospice. Although I switched to home health for better hours, I miss hospice terribly.

As the above poster said, the patient is anyone you meet behind that door. That is so true. 90% of the time, the family just needs to hear a kind person in scrubs tell them that what is going on is just a normal part of the process. Most people have never seen death before and their fear is based on not knowing what to expect. Sorry for the cliché, but knowledge is power. The more you educate the patients and families about what to expect, the better their experience will be. Make them comfortable with the medications. Hold their hands and be honest. Be honest, but tactful, about the fact that death is not pretty. When you are with an actively dying patient, tell the families why you are medicating the patient, i.e. "his breathing looks a little labored. I think it would be a good idea to go ahead and give him some morphine to make him more comfortable." It's ok to be frank and it doesn't mean you are callous. Be honest and don't give false hope. Be realistic without seeming uncaring.

With patients? Most of them know they are dying. Listen to them. Validate their fears and concerns. Reassure them that you will do everything you can do to help them leave in the most comfortable way possible. Let them vent. A lot are ****** that they are dying. A lot are ****** that they are still living.

Death is scary to most people. You are their guide through the process. Support the family and they will never ever forget how you helped mom make her transition. Support the patient and know that they passed peacefully and safely.

Before I ever became a nurse, I worked with midwives delivering babies at home. The dynamics are very similar: the fear, the waiting, the uncertainty. I helped bring souls into the world. As a hospice nurse, you are a "midwife" at the other end of the life cycle. You are helping a soul leave the world and helping their family through the process.

Good luck to you!

In addition to the excellent advice that you have already received, I would strongly suggest familiarizing myself with the medications that are frequently utilized in the hospice setting. In the home care setting I will instruct the pt and family on the use, side effects and when to administer these medications. For example, I write out a sheet with the times and dosages for each med and leave it with the family. I also watch them draw up the medication and administer the med to the pt if needed at that time. If not then I have them draw up some syringes and have them put it to the side for when it's needed. That way they aren't trying to remember how to do this when they are in a panic.

Hope this helps!

Allison BS, RN, CHPN, CM

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