love this! I just sat with my grandmother while she passed away, I was her main caregiver for 2 years as she declined. The last month was the worst and I gave her all of her meds and changed her and all of the end of life stuff. I have had difficulty ever since graduating high school (7 years ago lol) figuring out what I want to do and taking care of her I realized I want to be a hospice nurse. Me and my grandmother loved eachother a lot however sometimes it was very tumultuous and we fought a lot (a little because we were very much alike but her way was her way and mine was mine and because I struggled watching the woman who raised me slowly die) but there was never a minute that went by we didnt know how much we loved eachother and I just want more people to feel that type of love and compassion when they are in their own end of life.
Thank you for sharing your story! Being a caregiver is a tremendous undertaking and I give you so much credit for doing all of that- I know it can be hard at times, especially watching a loved one decline- it’s takes physical and emotional toll on you. I know she greatly appreciated having you there though- you’re an a amazing person and I think you’ll be great in hospice- you’ve got the heart ❤️ it is never too late to start working towards your passion- the time will pass regardless so you might as well do something with it ☺️ good luck with your journey! I’d love to hear back from you on how it’s going 🥰
I have been a nurse for 5 years, and in that time I have done many things. I have been a support person on the other end of hospice with family. I have accepted a hospice position within my area! I start next Monday! I am excited about this new adventure!
I worked hospice for a year I freaking loved it..this was a good video. It really is like that. A lot of the stuff yiu did I did too. It's an amazing job and experience. God bless you .
I’m a new registered nurse as of August 2020 and I was offered a job as a case manager hospice nurse, and I must say this was soooo helpful. Thank you so much for taking the time to share these valuable tips and tricks.
You will! It’s truly a calling and a blessing to work with hospice patients and I think that our patients make us better nurses and people. And if you applied for the job you already have the heart for it, the knowledge will come as you grow in your career. I read a lot of my fellow nurses notes to learn how to “chart towards the decline”- and you’ll always have your team to call if you need to!
Hi Allie-could you give me a list of skills that are included in hospice? Such as IVs, caths, Trach etc? This would be helpful for me. Thank you for this super helpful video🥰
I’ve thought about doing this but seeing as it’s not a glamorous career I haven’t but I’m so glad to see someone talk about hospice ❤️ and such good tips !!! (I enjoy working in hospice but it’s difficult for people to listen about my work day)
I am not a nurse. I have just had five friends die in the last six months. No, I am not killing them! I have witnessed the work you do and I am totally amazed. I am a senior so I am not looking for a job but I am seriously thinking of volunteering. Second thought...the prep in your work reminds me of my work....banking. People think that you just walk in and start serving them. No, you have to be organized. And you made me think of my cleaning habits in my work area. Wash my desk and common equipment like pens and phones. I rarely got sick. Very interesting and informative video. Thank you.
Thank you so much! I truly admire my patients loved ones who rally behind them during that time. it is so much harder to watch someone you care about pass away, but also know that you gave them choice to pass away under their terms. I absolutely recommend volunteering! It is incredibly rewarding and our patients are so grateful for having someone with them. Also, I had many friends that worked in banks and it is a lot of prep work that people dont even realize.
This is very informative. Thank you for sharing! I’ve been in blood banking for 18 years and have never worked in a hospital or SNF. Hospice nursing has recently interested me but I’m afraid my lack of med/surg experience will prevent me from being hired as a hospice nurse.
So happy to what that! Love that you’re considering hospice nursing as well! It’s a hidden gem of the nursing field IMO. Good luck hunny buns! You’re going to do great things ❤️
Wow! I love your organization and suggestions. I am an "older" nursing student and want to work in Hospice. My mom was one of the first Hospice nurses in St. Louis, she even got her picture in the news paper! I will continue to follow you! I'll be looking for a good company or hospital to look for. Please let me know of recommendations. I'm in Florida, willing to travel. Thank you!
I definitely will! There’s so many good ones out there. I started at a smaller agency which was nice! But the larger one I’m at has so many more resources. There are benefits to both
Did you graduate? I’m an old “new grad” and am having problems finding a job. I’ve been working in aesthetic dermatology for 3 years and now I can’t find a job in a hospital or any kind of bedside nursing.
Thank you! And congratulations!! Pediatrics is so tough, thank you for working with them and being there. Those nurses helped me and my little through some rough nights.
I feel like a lot of nurses feel their only options as nurses are hospitals or SNFs. Everyone has their niche and hospice is definitely worth looking into! Thank you so much for watching ❤️
@@HospiceNurseAllie Yes, that is definitely true! Hospitals are very loud, busy, and crazy which is hard for an introvert like me - I have an interview for hospice this coming week so I'm hoping for the best!
A day in the life of a hospice nurse is 14-16 hour days... Every day!! It is holding your pee for hours on end because they aren't supposed to go at the patients house and there isn't always a safe, clean restroom in the hood where some patients live. It is not having any time to even eat lunch. I used to pack her lunches but they kept coming home uneaten. I'm like "why not nibble through the day while your going from one patient to the next?" Her answer "because while I'm driving I'm on the phone either placing med orders, calling the doctor, coordinating with others who don't know wtf they are doing, or fixing wounds ignored by slackers because they know the next nurse will catch it on the next visit" When a hospice nurse does finally get home about 7:30-8:00 (so already a 12 hour day) they get to scarf down some random food and then do documentation of their day on the tablet for several hours more. All the while a steady stream of venting to colleagues via text or call. Finally at 11 if she's lucky she can head to bed. No interaction with the kids, no real interaction with me, no time for friends, no time for anything. On her 1 day off every 14 days or so she is so worn down all she can do is sleep all day trying to recharge for the next long string of craziness. 7-8 patients per day.
Definitely depends on the agency. Our weekday crew doesn’t tend the work too late because actually have nurses who work evening shifts. Not all hospices have that so case managers need to get every visit done, even PRNs. But usually when I work weekends this is what my day is. It is tiring. And the bathroom situation has gotten worse since covid since restaurants won’t allow you to use their facilities. One boundary I have managed to set is to not talk on the phone while driving, we legally can’t in our state so we put up our “away” messages while driving. It’s not easy!
It definitely sounds like they need more supplementary staff. Most people do document some after work but it shouldn’t be hours. Seems like they may be stretching her thin. I wish your loved one the best and hopefully she can find a better work/life balance.
I graduated H.S in 2015 never went to college.5 years later and I just applied for the 2021 spring semester to get my nursing degree in hope to work in hospice. I spent a year working with seniors and got close with the residents. I wanted to be able to play a bigger role in their end of life and just their care in general. Glad you've made these videos because it is just strengthening my goal to become a hospice worker.
You’ve got this!! I love hearing that you’re interested in working with the geriatric population- we need more passionate caregivers in this field like you! You’re going to do great ❤️ I am so happy you made the decision to start school- it seems like it will be a great fit!
thank you so much for this video! I will be a new grad nurse in December of this year and I have a passion for hospice/palliative care nursing. Is an RN case manager and a hospice RN the same role? Is this a good job for a new grad nurse? I am nervous about it because people keep telling me that I need a year of med surg., but I know that's not where I want to be.
There is many roles in hospice for an RN not just case managing. You can do admissions, pre admission, Baylor weekends, or oncall if you want to stick with bedside nursing. I would say if your independent assessment skills are strong then yes, it also depends on what your background is (I.e. CNA). I would definitely check around to see if hospices near you have any new grad orientation programs or residency programs! Those are wonderful to transition new grads into becoming great hospice nurses. But you DO NOT have to start in med surg.
Working for hospice is hard enough and you still do those everyday? So sorry your company does not seem to supply you with anything. Mine oversupplies...lol! Chux, ziplocks, paper towels, hand sanitizer, pens, papers, stickies, etc... We use small tablets to chart (I still remember the time when we used laptops and bring printers) and my trunk is basically my supply room. I don't bring anything as much as possible inside the car. Here is a trick I use to wash. Know those $5 jug sprayer at Walmart they use to spray weeds with? I use that to spray water on my hands and I have liquid soap supplied by my hospice company. We even use the same saniwipes...
Ooo that’s smart! I have a system now that uses a water pump too! $12 For the pump and it uses those Poland spring water containers (I Jsut refill it). Mine does supply me with sani, pp towels etc, but I do always like to carry my own extra just in case.
Our father’s hospice nurse walks into our home barely acknowledging us because she is busy talking on her cellphone. Then she asks if we need refills on his med - which they have almost entirely stripped away - measures his heart rate, and leaves in about 2 minutes. I would rather personally die alone without hospice involved if that is the extent of medical attention.
Just know that not all hospices operate this way and also all hospices shouldn’t be put under an umbrella due to one experience. I’m very sorry you experienced this, we tend to spend about an hour or more with patients at visits depending on the need of the patient. I’ve spend over two hours with patients at times. What you experienced is an exception to the standard of hospice most give. There are definitely hospices that need improvement and it sounds like the nurse needed some bedside manor education.
I’ve run into patients families after passing and often we receive letters and phone calls with gratitude towards our exceptional care for their loved one and family during their time on our services. It seems your loved one didn’t get the level of care and attention they truly deserved at such a tender time. I’m very sorry for your loss and I hope in the future you’ll give hospice a chance if it is indicated.
I need help from a case Manager perspective because OH BOY I’m overwhelmed like crazy with about 25 patients five of which I won’t have in a couple weeks. I’m thinking I need a change. I’m up till 1-4am charting I’m so stressed out!!!
Wow that’s a lot of patients even with 5 less and you shouldn’t have to be charting at home that much my dear! It’s not you, it’s the company you work for giving you too much to manage. That’s unrealistic.
They do not and should not. Sometimes families or even the patient is worried about breaking their sobriety. We always work out a plan for when the time comes in regards to using pain medications so that we don’t have delay care. It’s absolutely heartbreaking when someone denies comfort medications for fear of a stigma.
I just got a hospice job and will start in oct. I'm excited! Thanks for the tips I plan on watching more of your videos. I'm suppose to see 6 patients a day is that a good amount?
*Questions: First, most patients visited at home 2-3/week? Second, does it sound right that Medicaid pays the hospice company $190/day for any day that he nurse visits a patient’s home for a one hour visit?* I know nurses don’t deal with the billing, I just wonder if that sounds about right. I looked up online for Medicaid reimbursement and that’s the number I found. It actually didn’t say it was for a one hour appointment, but it did list to home health care line items, one was just listed as home health care and the other was listed as 24 hour healthcare. $190 for one hour seems like a huge amount. I don’t care so much about the reimbursement rate, I just wonder where all the money is going since I don’t think it’s going to the RN staff. I feel like it’s a lot of money but I also know that Medicaid is not known for big reimbursements to providers, so that in itself makes me doubt that $180 number is really as big as I think. Or I could just be mistaken about the reimbursement rate in some other way.
So as far as visits- nurses visit patients anywhere from once a week to daily. Nurses are only required to be in the home for 20 min (at least) but we often do spend more time. As far as reimbursement I am not sure. But the hospice is paying for more than just the nurses hourly pay rate. It’s also for mileage reimbursement, equipment for the nurses, supplies for nursing staff, etc. When it comes down to it, that really isn’t an extensive amount considering hospices are not for profit and really do pay for a lot more than what people realize.
I have an interview on Monday for a HH Hospice position. I’m kind of having 2nd thoughts. M-F 8am-6pm. They expect you to see 25 pts. a week (I heard that’s a lot and that 15-20 is more doable), be on call one weekend a month, and you can be still be called at midnight to pronounce a death at any time. I would feel like I’m never off! Ugh, I have 10 years of acute care experience and had high hopes for hospice nursing. Do you still recommend it?
Just keep in mind not all hospice agencies are not the same- but most do require some on call (or at least to be oncall back up on a weekends two.) it is not unheard of to be called out at any hour to pronounce or for an emergency when on call. But...8-6 seems like a really long day especially for a 5 day week though. And the caseload is a bit higher then most I’ve seen. If you are second guessing it then it may not be the right fit. There are hospices out there that don’t require 10 hour days (I’ve worked for two and neither had days that long) Hospice case management can be a commitment- I know some case managers who catch up on charting at home and struggle with a work/life balance but there are others who manage it all well. You need to find an agency that fits you and makes you feel comfortable. A few things to keep in mind if you do move on to another agency are the required on-call, what happens if the census becomes high (do they hire agency or expect you take on more patients?), reimbursement for mileage, how large the territory is you will be covering, and typical case load. You want to love your job, and while all jobs have their stressors, you do not want to feel overwhelmed. Don’t settle! I hope this helps!
@@HospiceNurseAllie thank you so much for all you do and your informative YT vids! I think I’m going to look elsewhere. Would a regular home health (not hospice) be more manageable? Or are they both pretty much the same? I’m also interested in case management and/or utilization review. I’ve been applying to these positions, but they are hard to come by. I am so burnt out at the bedside after 10 years.
I totally understand the burnout. I definitely think hospice is more manageable but I’ve only done a few home health visits before. I know nurses who work in HH and typically they get paid per visit and need to do a certain amount of visits per day (I believe it’s 5) in order to be considered full time. The acuity of homehealth patients is usually higher as well, so the charting may be more extensive. I definitely prefer doing my hospice charting over home health charting any day. I would also check out contact tracing jobs for nurses- usually work from home or an office- and you basically get reports from contact tracers daily. Hospice defiantly is bedside nursing, we do wound care, Foleys, pericare etc, but it is not as strenuous as working medsurg or working in a s SNF for sure.
Thank you Allie for this video and all the tips! I enjoyed your humor too :) I applied to a weekend only hospice position, this would be my first home health job. Silly question, but why do weekend nurses see the most patients? I'm not complaining.
For some reason, probably Murphy’s law, things tend to go south on the weekend 😬 also there is not usually as much staff on (depending on the agency). At my job we have quite a few nurses on weekends and still get calls rolling in. You’ll do routine visits (for wound care etc. and also PRN visits on top of those. I’m so excited for you and I hope you love working weekends! It’s a blast and welcome to the rock show 🤘
Sometimes! It depends on the day and how many visits there are and what time patients need or want to be seen. I like to start on time just so I get out earlier though.
It depends on the area. If I’m downtown it can be challenging. Usually there is off street parking in most areas I cover. It is good to figure out the parking situation before the visit. Sometimes I ask the families where they’d like me to park when I call them to set up a visits The case managers know their areas so parking usually isn’t too much of an issue for them whereas I do mostly PRN visits and am not familiar with the areas as much. I totally feel you on the parking thing, I get anxiety about it sometimes, but in the end it ends up working out somehow.
I toss em in my company’s medical info shred bin, and on my days off it stays in the same locked compartment of my work back as my laptop. I don’t play around with when it comes to my patient’s info 😉
Thanks for making this video. I’m surprised at all of your cleaning process b/c I wouldnt think there really are harmful germs that need to be cleaned off. So I assume she is germaphobic. Maybe I’m wrong, but that’s what I’m thinking. It’s not like these people have the Black Plague. But I would say there’s nothing wrong with her taking strict steps to sanitize things. No I will say that currently because of coronavirus I think it does make sense to clean equipment. Doesn’t seem like it’s a big deal normally because it seems like COVID-19 is transmitted through aerosol droplets much more than touching a surface and then touching our face. That doesn’t mean touching one’s face/eyes/nose/ears/mouth is safe regarding coronavirus, it just seems like it’s not a big issue normally. But my household actually use the sanitizing wipes to clean off anything that comes outside the house inside the house. This includes groceries, purses/wallets that were touched, and we definitely clean our hands and phones anytime we come home. I even clean my glasses because I could’ve touched my glasses instinctively without thinking about it or even remembering it. It does get old, but it’s a safe thing to do. We go on and live our lives like normal so we’re not petrified of the coronavirus, but we wear masks and try to practice social distancing and clean off items coming inside.
Nope! This is required by state! We go into peoples homes not knowing what has been on the surfaces. It is to prevent cross contamination between patients since we are working with a very high risk population. We go into patients homes as well as many nursing facilities with many different diseases as well as precaution rooms, and every patient has a different level of hygiene. but she is me, and I try and read most of my comments. I do have a family to protect and patients and there is a possibility of germs from any surface being crossed to a person. I’m sure if you had to do it everyday you would do just the same. But per state we clean down all our equipment after each patient, just like they do in a hospital.
I’ve seriously thought about hospice, but feel like I would want to be inpatient only. Idk about all the driving. Do some facilities let you do that? Or are home visits pretty much the norm with hospice nursing?
There are many inpatient facilities! You could totally do that! I know for my agency we have both, but we hire nurses specifically for the hospice houses who work full time or part time there.
Just curious why is there a concern with germs. I understand that if you have to give a catheter and wear gloves, but do the patients have infectious diseases? I thought that most patient in hospice had cancer.
That is actually incorrect; while we do have a lot of patients with cancer we have many with a variety of terminal illnesses, we actually have a lot of dementia/Alzheimer’s. Every facility and home has their own “germs” and we don’t want to spread Any of them to other patients; we have to be very mindful of cross contamination. We go into long term care, assisted livings, and homes and while our patients are terminally ill, that doesn’t stop any of them from getting common things like the flu or colds. Their terminal status also makes them more at risk for serious sides effects from these things as well. We also can have patients with MRSA or CDIFF. As providers we do not want to spread infectious diseases to our patients, which may live on surfaces, and we also want to stay healthy ourselves. Great question!
What was your toughest case? Do you ever become friends with your patients. Your work is much more diff. than a funeral worker because you actually see the patient go through everything
I have become close with patients and families for sure, it’s hard not to because we meet so many amazing people and it is such a blessing for us to be a part of it. I think my toughest cases are those who are young and got a diagnosis that they weren’t expecting and they have little ones. It is always sad with each patient but for me when parents have to leave little ones behind it breaks my heart knowing they’ll never get their dad to walk them down the aisle or see them graduate.
It depends. Usually they want about 1-2 years experience in hospice/home health/ or any other bedside position. We have had nurses come from many different specialties such as maternity, pedi, oncology, dialysis, ED and the list goes on.
love this! I just sat with my grandmother while she passed away, I was her main caregiver for 2 years as she declined. The last month was the worst and I gave her all of her meds and changed her and all of the end of life stuff. I have had difficulty ever since graduating high school (7 years ago lol) figuring out what I want to do and taking care of her I realized I want to be a hospice nurse. Me and my grandmother loved eachother a lot however sometimes it was very tumultuous and we fought a lot (a little because we were very much alike but her way was her way and mine was mine and because I struggled watching the woman who raised me slowly die) but there was never a minute that went by we didnt know how much we loved eachother and I just want more people to feel that type of love and compassion when they are in their own end of life.
Thank you for sharing your story! Being a caregiver is a tremendous undertaking and I give you so much credit for doing all of that- I know it can be hard at times, especially watching a loved one decline- it’s takes physical and emotional toll on you. I know she greatly appreciated having you there though- you’re an a amazing person and I think you’ll be great in hospice- you’ve got the heart ❤️ it is never too late to start working towards your passion- the time will pass regardless so you might as well do something with it ☺️ good luck with your journey! I’d love to hear back from you on how it’s going 🥰
I have been a nurse for 5 years, and in that time I have done many things. I have been a support person on the other end of hospice with family. I have accepted a hospice position within my area! I start next Monday! I am excited about this new adventure!
I am so excited for you! Congratulations !! 🎉🎉
@@HospiceNurseAllie Thank you!
I am Med/Surg Trauma nurse, and I have so much respect for the work you'll do.
I worked hospice for a year I freaking loved it..this was a good video. It really is like that. A lot of the stuff yiu did I did too. It's an amazing job and experience. God bless you .
So happy to hear you loved it too! It really is a blessing to work in this speciality and thank you so much for your thoughtful and kind comment!
How did you become one?
I just got hired for mon Thru fri 8am to 5 pm for a hospice company doing home health. A little anxious. Start on Monday.
Do they let you do family friendly hours ( like only seeing patients 930 -3 then do chartint later ?
I didn’t know ppl still used mapquest! Haven’t heard that word in forever. Great video!
oh ya I do! I don’t have to print them out like I used to tho 😂
And thank you for watching!
I’m a new registered nurse as of August 2020 and I was offered a job as a case manager hospice nurse, and I must say this was soooo helpful. Thank you so much for taking the time to share these valuable tips and tricks.
Aww thank you for watching! I’m so glad I could help! Best of luck in your journey- you’re going to rock it
Nurse Allie that is so sweet of you to say!! I sure hope so! I just want to be the best I can be for this amazing population of people. 👩🏽⚕️
You will! It’s truly a calling and a blessing to work with hospice patients and I think that our patients make us better nurses and people. And if you applied for the job you already have the heart for it, the knowledge will come as you grow in your career. I read a lot of my fellow nurses notes to learn how to “chart towards the decline”- and you’ll always have your team to call if you need to!
Nurse Allie great advice. Thanks so much. New subscriber here.
Hi Allie-could you give me a list of skills that are included in hospice? Such as IVs, caths, Trach etc? This would be helpful for me. Thank you for this super helpful video🥰
Such a good idea!! Definitely making that one this week!
I’ve thought about doing this but seeing as it’s not a glamorous career I haven’t but I’m so glad to see someone talk about hospice ❤️ and such good tips !!!
(I enjoy working in hospice but it’s difficult for people to listen about my work day)
I am not a nurse. I have just had five friends die in the last six months. No, I am not killing them! I have witnessed the work you do and I am totally amazed. I am a senior so I am not looking for a job but I am seriously thinking of volunteering. Second thought...the prep in your work reminds me of my work....banking. People think that you just walk in and start serving them. No, you have to be organized. And you made me think of my cleaning habits in my work area. Wash my desk and common equipment like pens and phones. I rarely got sick. Very interesting and informative video. Thank you.
Thank you so much! I truly admire my patients loved ones who rally behind them during that time. it is so much harder to watch someone you care about pass away, but also know that you gave them choice to pass away under their terms. I absolutely recommend volunteering! It is incredibly rewarding and our patients are so grateful for having someone with them. Also, I had many friends that worked in banks and it is a lot of prep work that people dont even realize.
What an excellent overview of Hospice!!
Thank you! 🤗
I am literally going into hospice as an hha...this was beyond helpful
Y’all are the heartbeat of our team! Thank you for what you do! You’re going to be great!
This is very informative. Thank you for sharing! I’ve been in blood banking for 18 years and have never worked in a hospital or SNF. Hospice nursing has recently interested me but I’m afraid my lack of med/surg experience will prevent me from being hired as a hospice nurse.
I don’t think that’s the case! If anything Homehealth or SNF background is more preferred but we have nurses from all different backgrounds!
Excellent video!! New grad RN here strongly considering hospice nursing. This video is exactly what I was looking for!
So happy to what that! Love that you’re considering hospice nursing as well! It’s a hidden gem of the nursing field IMO. Good luck hunny buns! You’re going to do great things ❤️
ua-cam.com/video/kL4CgifiYe0/v-deo.html
I love this. And you. I'm a 2nd year nursing student and this is what I want to do. Thank you
That’s amazing! It’s so rare to hear anyone wants to go into hospice
Wow! I love your organization and suggestions. I am an "older" nursing student and want to work in Hospice. My mom was one of the first Hospice nurses in St. Louis, she even got her picture in the news paper! I will continue to follow you! I'll be looking for a good company or hospital to look for. Please let me know of recommendations. I'm in Florida, willing to travel. Thank you!
I definitely will! There’s so many good ones out there. I started at a smaller agency which was nice! But the larger one I’m at has so many more resources. There are benefits to both
Did you graduate? I’m an old “new grad” and am having problems finding a job. I’ve been working in aesthetic dermatology for 3 years and now I can’t find a job in a hospital or any kind of bedside nursing.
Thank you! I'm trying to decide if I want to go into nursing from school counseling. I have a heart for hospice.
Wonderful video! I have been a pediatric nurse for 20+ years and I am transitioning into hospice nurse. This was valuable information!
Thank you! And congratulations!! Pediatrics is so tough, thank you for working with them and being there. Those nurses helped me and my little through some rough nights.
Me too! I've been a pediatric nurse for 12 years, and I'm making the transition to hospice as well.
Wow from the beginning to end . That's beautiful! How is hospice treating you?
Thanks so much for this video! I am a new nurse - started with MedSurg but it's definitely not a good fit for me so I am considering hospice!
I feel like a lot of nurses feel their only options as nurses are hospitals or SNFs. Everyone has their niche and hospice is definitely worth looking into! Thank you so much for watching ❤️
@@HospiceNurseAllie Yes, that is definitely true! Hospitals are very loud, busy, and crazy which is hard for an introvert like me - I have an interview for hospice this coming week so I'm hoping for the best!
Great organizational advice Allie! That's the key to a good day. Nursing is stressful enough. 😊👍
Thank you! I absolutely agree 😁
A day in the life of a hospice nurse is 14-16 hour days... Every day!! It is holding your pee for hours on end because they aren't supposed to go at the patients house and there isn't always a safe, clean restroom in the hood where some patients live. It is not having any time to even eat lunch. I used to pack her lunches but they kept coming home uneaten. I'm like "why not nibble through the day while your going from one patient to the next?" Her answer "because while I'm driving I'm on the phone either placing med orders, calling the doctor, coordinating with others who don't know wtf they are doing, or fixing wounds ignored by slackers because they know the next nurse will catch it on the next visit"
When a hospice nurse does finally get home about 7:30-8:00 (so already a 12 hour day) they get to scarf down some random food and then do documentation of their day on the tablet for several hours more. All the while a steady stream of venting to colleagues via text or call.
Finally at 11 if she's lucky she can head to bed. No interaction with the kids, no real interaction with me, no time for friends, no time for anything.
On her 1 day off every 14 days or so she is so worn down all she can do is sleep all day trying to recharge for the next long string of craziness.
7-8 patients per day.
Definitely depends on the agency. Our weekday crew doesn’t tend the work too late because actually have nurses who work evening shifts. Not all hospices have that so case managers need to get every visit done, even PRNs. But usually when I work weekends this is what my day is. It is tiring. And the bathroom situation has gotten worse since covid since restaurants won’t allow you to use their facilities. One boundary I have managed to set is to not talk on the phone while driving, we legally can’t in our state so we put up our “away” messages while driving. It’s not easy!
It definitely sounds like they need more supplementary staff. Most people do document some after work but it shouldn’t be hours. Seems like they may be stretching her thin. I wish your loved one the best and hopefully she can find a better work/life balance.
I graduated H.S in 2015 never went to college.5 years later and I just applied for the 2021 spring semester to get my nursing degree in hope to work in hospice.
I spent a year working with seniors and got close with the residents. I wanted to be able to play a bigger role in their end of life and just their care in general.
Glad you've made these videos because it is just strengthening my goal to become a hospice worker.
You’ve got this!! I love hearing that you’re interested in working with the geriatric population- we need more passionate caregivers in this field like you! You’re going to do great ❤️ I am so happy you made the decision to start school- it seems like it will be a great fit!
thank you so much for this video! I will be a new grad nurse in December of this year and I have a passion for hospice/palliative care nursing. Is an RN case manager and a hospice RN the same role? Is this a good job for a new grad nurse? I am nervous about it because people keep telling me that I need a year of med surg., but I know that's not where I want to be.
There is many roles in hospice for an RN not just case managing. You can do admissions, pre admission, Baylor weekends, or oncall if you want to stick with bedside nursing. I would say if your independent assessment skills are strong then yes, it also depends on what your background is (I.e. CNA). I would definitely check around to see if hospices near you have any new grad orientation programs or residency programs! Those are wonderful to transition new grads into becoming great hospice nurses. But you DO NOT have to start in med surg.
Working for hospice is hard enough and you still do those everyday? So sorry your company does not seem to supply you with anything. Mine oversupplies...lol! Chux, ziplocks, paper towels, hand sanitizer, pens, papers, stickies, etc...
We use small tablets to chart (I still remember the time when we used laptops and bring printers) and my trunk is basically my supply room. I don't bring anything as much as possible inside the car.
Here is a trick I use to wash. Know those $5 jug sprayer at Walmart they use to spray weeds with? I use that to spray water on my hands and I have liquid soap supplied by my hospice company.
We even use the same saniwipes...
Ooo that’s smart! I have a system now that uses a water pump too! $12 For the pump and it uses those Poland spring water containers (I Jsut refill it). Mine does supply me with sani, pp towels etc, but I do always like to carry my own extra just in case.
Our father’s hospice nurse walks into our home barely acknowledging us because she is busy talking on her cellphone. Then she asks if we need refills on his med - which they have almost entirely stripped away - measures his heart rate, and leaves in about 2 minutes. I would rather personally die alone without hospice involved if that is the extent of medical attention.
Just know that not all hospices operate this way and also all hospices shouldn’t be put under an umbrella due to one experience. I’m very sorry you experienced this, we tend to spend about an hour or more with patients at visits depending on the need of the patient. I’ve spend over two hours with patients at times. What you experienced is an exception to the standard of hospice most give. There are definitely hospices that need improvement and it sounds like the nurse needed some bedside manor education.
I’ve run into patients families after passing and often we receive letters and phone calls with gratitude towards our exceptional care for their loved one and family during their time on our services. It seems your loved one didn’t get the level of care and attention they truly deserved at such a tender time. I’m very sorry for your loss and I hope in the future you’ll give hospice a chance if it is indicated.
Report her
you need a new hospice nurse!!! most hospice nurses are amazing
Nicole3900 I agree! Usually you hear nothing but good things in regards to hospice nurses.
I need help from a case Manager perspective because OH BOY I’m overwhelmed like crazy with about 25 patients five of which I won’t have in a couple weeks. I’m thinking I need a change. I’m up till 1-4am charting
I’m so stressed out!!!
Wow that’s a lot of patients even with 5 less and you shouldn’t have to be charting at home that much my dear! It’s not you, it’s the company you work for giving you too much to manage. That’s unrealistic.
Oh my gosh , you have helped me so much ! Thank you !
That’s awesome! Thank you for watching, I’m so glad you gained something out of my video!
I am really enjoying your videos, thank much for all the tricks 😊
Awesome video! Thank you
Haha I would put covers on my car too 😜 I already thought of that and I’m in nursing school - I’m the same wiping shit down all the time haha
Really enjoyed your video! Thank you 😊 for sharing! ❤️❤️❤️
Wait... they sometimes refuse people who are dying pain medication if they have a history of opioid abuse? They're dying... I dont get that..
They do not and should not. Sometimes families or even the patient is worried about breaking their sobriety. We always work out a plan for when the time comes in regards to using pain medications so that we don’t have delay care. It’s absolutely heartbreaking when someone denies comfort medications for fear of a stigma.
@@HospiceNurseAllie I mean honestly.. how could they. Thank you for being an angel.
I just got a hospice job and will start in oct. I'm excited! Thanks for the tips I plan on watching more of your videos. I'm suppose to see 6 patients a day is that a good amount?
That does seem like a lot! It does depend on the complexity of the patient so I would def feel it out and do your best!
*Questions: First, most patients visited at home 2-3/week? Second, does it sound right that Medicaid pays the hospice company $190/day for any day that he nurse visits a patient’s home for a one hour visit?*
I know nurses don’t deal with the billing, I just wonder if that sounds about right. I looked up online for Medicaid reimbursement and that’s the number I found. It actually didn’t say it was for a one hour appointment, but it did list to home health care line items, one was just listed as home health care and the other was listed as 24 hour healthcare. $190 for one hour seems like a huge amount. I don’t care so much about the reimbursement rate, I just wonder where all the money is going since I don’t think it’s going to the RN staff. I feel like it’s a lot of money but I also know that Medicaid is not known for big reimbursements to providers, so that in itself makes me doubt that $180 number is really as big as I think. Or I could just be mistaken about the reimbursement rate in some other way.
So as far as visits- nurses visit patients anywhere from once a week to daily. Nurses are only required to be in the home for 20 min (at least) but we often do spend more time. As far as reimbursement I am not sure. But the hospice is paying for more than just the nurses hourly pay rate. It’s also for mileage reimbursement, equipment for the nurses, supplies for nursing staff, etc. When it comes down to it, that really isn’t an extensive amount considering hospices are not for profit and really do pay for a lot more than what people realize.
@@HospiceNurseAllie - Okay, thanks for the information.
I have an interview on Monday for a HH Hospice position. I’m kind of having 2nd thoughts. M-F 8am-6pm. They expect you to see 25 pts. a week (I heard that’s a lot and that 15-20 is more doable), be on call one weekend a month, and you can be still be called at midnight to pronounce a death at any time. I would feel like I’m never off! Ugh, I have 10 years of acute care experience and had high hopes for hospice nursing. Do you still recommend it?
Just keep in mind not all hospice agencies are not the same- but most do require some on call (or at least to be oncall back up on a weekends two.) it is not unheard of to be called out at any hour to pronounce or for an emergency when on call. But...8-6 seems like a really long day especially for a 5 day week though. And the caseload is a bit higher then most I’ve seen. If you are second guessing it then it may not be the right fit. There are hospices out there that don’t require 10 hour days (I’ve worked for two and neither had days that long) Hospice case management can be a commitment- I know some case managers who catch up on charting at home and struggle with a work/life balance but there are others who manage it all well. You need to find an agency that fits you and makes you feel comfortable. A few things to keep in mind if you do move on to another agency are the required on-call, what happens if the census becomes high (do they hire agency or expect you take on more patients?), reimbursement for mileage, how large the territory is you will be covering, and typical case load. You want to love your job, and while all jobs have their stressors, you do not want to feel overwhelmed. Don’t settle! I hope this helps!
@@HospiceNurseAllie thank you so much for all you do and your informative YT vids! I think I’m going to look elsewhere. Would a regular home health (not hospice) be more manageable? Or are they both pretty much the same? I’m also interested in case management and/or utilization review. I’ve been applying to these positions, but they are hard to come by. I am so burnt out at the bedside after 10 years.
I totally understand the burnout. I definitely think hospice is more manageable but I’ve only done a few home health visits before. I know nurses who work in HH and typically they get paid per visit and need to do a certain amount of visits per day (I believe it’s 5) in order to be considered full time. The acuity of homehealth patients is usually higher as well, so the charting may be more extensive. I definitely prefer doing my hospice charting over home health charting any day. I would also check out contact tracing jobs for nurses- usually work from home or an office- and you basically get reports from contact tracers daily. Hospice defiantly is bedside nursing, we do wound care, Foleys, pericare etc, but it is not as strenuous as working medsurg or working in a s SNF for sure.
Thank you Allie for this video and all the tips! I enjoyed your humor too :) I applied to a weekend only hospice position, this would be my first home health job. Silly question, but why do weekend nurses see the most patients? I'm not complaining.
For some reason, probably Murphy’s law, things tend to go south on the weekend 😬 also there is not usually as much staff on (depending on the agency). At my job we have quite a few nurses on weekends and still get calls rolling in. You’ll do routine visits (for wound care etc. and also PRN visits on top of those. I’m so excited for you and I hope you love working weekends! It’s a blast and welcome to the rock show 🤘
And definitely not a silly question!
Thank you so much for your amazing videos!!!
Thank you for watching and for your comment! I love hearing feedback!
Do they let you see patients later like 930 AM , do they patrol what time you do your first visit ?
Sometimes! It depends on the day and how many visits there are and what time patients need or want to be seen. I like to start on time just so I get out earlier though.
Im thinking of applying as a hospice nurse. Im not good at parking. Is it challenging to look for parking when visiting patients?
It depends on the area. If I’m downtown it can be challenging. Usually there is off street parking in most areas I cover. It is good to figure out the parking situation before the visit.
Sometimes I ask the families where they’d like me to park when I call them to set up a visits The case managers know their areas so parking usually isn’t too much of an issue for them whereas I do mostly PRN visits and am not familiar with the areas as much. I totally feel you on the parking thing, I get anxiety about it sometimes, but in the end it ends up working out somehow.
@@HospiceNurseAllie thanks :)
Anytime! 😊
So helpful. Thank you.
Thank you for posting this video. The papers with the patient info, do you keep them for future reference, or do you shred them?
I toss em in my company’s medical info shred bin, and on my days off it stays in the same locked compartment of my work back as my laptop. I don’t play around with when it comes to my patient’s info 😉
Work bag* 🤦♀️
@@HospiceNurseAllie Thank you.
They tell us we hit the Wall while they hit Hospice!
Thanks for making this video.
I’m surprised at all of your cleaning process b/c I wouldnt think there really are harmful germs that need to be cleaned off. So I assume she is germaphobic. Maybe I’m wrong, but that’s what I’m thinking. It’s not like these people have the Black Plague. But I would say there’s nothing wrong with her taking strict steps to sanitize things. No I will say that currently because of coronavirus I think it does make sense to clean equipment. Doesn’t seem like it’s a big deal normally because it seems like COVID-19 is transmitted through aerosol droplets much more than touching a surface and then touching our face. That doesn’t mean touching one’s face/eyes/nose/ears/mouth is safe regarding coronavirus, it just seems like it’s not a big issue normally. But my household actually use the sanitizing wipes to clean off anything that comes outside the house inside the house. This includes groceries, purses/wallets that were touched, and we definitely clean our hands and phones anytime we come home. I even clean my glasses because I could’ve touched my glasses instinctively without thinking about it or even remembering it. It does get old, but it’s a safe thing to do. We go on and live our lives like normal so we’re not petrified of the coronavirus, but we wear masks and try to practice social distancing and clean off items coming inside.
Nope! This is required by state! We go into peoples homes not knowing what has been on the surfaces. It is to prevent cross contamination between patients since we are working with a very high risk population. We go into patients homes as well as many nursing facilities with many different diseases as well as precaution rooms, and every patient has a different level of hygiene. but she is me, and I try and read most of my comments. I do have a family to protect and patients and there is a possibility of germs from any surface being crossed to a person. I’m sure if you had to do it everyday you would do just the same. But per state we clean down all our equipment after each patient, just like they do in a hospital.
@@HospiceNurseAllie - OK thanks for telling me about the state requirements. I thought you were probably just over cautious. Thanks.
I’ve seriously thought about hospice, but feel like I would want to be inpatient only. Idk about all the driving. Do some facilities let you do that? Or are home visits pretty much the norm with hospice nursing?
There are many inpatient facilities! You could totally do that! I know for my agency we have both, but we hire nurses specifically for the hospice houses who work full time or part time there.
Hey!! I’m a Hospice Nurse in Mass too!! What’s area do you work in?
Literally all Ofer the place from the north shore through the greater Boston area 🤪
Sweet! I’m from Beverly but live on south shore now.
I grew up in Wilmington, MA
thank you love your videos
Thank you for watching
Unfortunately I’m going to need Hospice for I have ALS.
I’m so very sorry to hear that. I hope you have an amazing team. Keeping you in my thoughts hun and sending you hugs.
This video is SO helpful! Thank you!❣️
what city are you located...make of these include charting tips too thanks so much
So I work in Massachusetts all over the place! That’s a great idea for a video! Thank you so much for the suggestion!
Just curious why is there a concern with germs. I understand that if you have to give a catheter and wear gloves, but do the patients have infectious diseases? I thought that most patient in hospice had cancer.
That is actually incorrect; while we do have a lot of patients with cancer we have many with a variety of terminal illnesses, we actually have a lot of dementia/Alzheimer’s. Every facility and home has their own “germs” and we don’t want to spread Any of them to other patients; we have to be very mindful of cross contamination. We go into long term care, assisted livings, and homes and while our patients are terminally ill, that doesn’t stop any of them from getting common things like the flu or colds. Their terminal status also makes them more at risk for serious sides effects from these things as well. We also can have patients with MRSA or CDIFF. As providers we do not want to spread infectious diseases to our patients, which may live on surfaces, and we also want to stay healthy ourselves. Great question!
I hoped I explained that well! May have over explained😆
What was your toughest case? Do you ever become friends with your patients. Your work is much more diff. than a funeral worker because you actually see the patient go through everything
I have become close with patients and families for sure, it’s hard not to because we meet so many amazing people and it is such a blessing for us to be a part of it. I think my toughest cases are those who are young and got a diagnosis that they weren’t expecting and they have little ones. It is always sad with each patient but for me when parents have to leave little ones behind it breaks my heart knowing they’ll never get their dad to walk them down the aisle or see them graduate.
yay! First!!
😘 love you!!!
What are requirements to become a hospices nurse?
It depends. Usually they want about 1-2 years experience in hospice/home health/ or any other bedside position. We have had nurses come from many different specialties such as maternity, pedi, oncology, dialysis, ED and the list goes on.
i was looking at that thumb you caught me lol
😂 I can’t blame ya
Does all that hair get in the way
Nope. Prior to covid I always wore it up and out of the way. Now I wear scrub caps with buttons to save my ears.