In the latest episode of myRNpodast, Shelly Baas, RN, discusses her career choice to work in Hospice Care. Click here to listen to Episode 4.
Shelly Baas took an unconventional path to nursing. She focused on pre-pharmacy which was heavy on biology and chemistry. Then she switched to English, but as the debts began to mount she knew she just had to finish with a degree. She had all the prerequisite courses for the nursing program, applied and was accepted. “The majority of nurses know from an early age they want to be nurses,” explained Shelly. “But I went in the backdoor and it has worked great!”
“Nursing is a great career. It offers so many different settings and jobs and tremendous flexibility. In my 22 year career, I have been full time, part-time, per diem, and on-call. It has been amazing!”
Currently working in hospice, she started her career in subacute rehabilitation and then moved to public health with prenatal and infant care. She says, “If I had to do it all over again, I would like to try the hospital setting. It may have better prepared me for hospice.”
The Challenges of Hospice Care
First, be aware that this is an emotionally heavy job. Your patients and families are navigating a stormy path of difficult diagnoses, decline of health, relationship strain, and grief.
Second, if you are working full time know that this job is not shift work with defined and controlled hours 7 am- 3:30 pm. If you start your patient at 3:00 you may encounter a crisis that requires you to stay til 4:30 pm.
Third, you are overseeing all the required needs of the patient. You will be required to manage documentation, equipment, supplies, patient education and complete it all with compassion. You also quarterback the communication with physicians, home health aides, chaplains, and social workers.
Fourth, hospice nurses also provide patients’ families with education and support because the family will remain the primary caregiver. At the initial visit, it is vital to establish a rapport that facilitates trust and compassion.
The Rewards of Hospice Care
Hospice offers so many opportunities to build trusting compassionate relationships with the patient and the family. As you educate, treat, and provide support, you are making a huge impact on the comfort, the load and the symptoms of the patient and the family. You have the opportunity to be a guide on a very difficult, and at times, dark journey. The care and guidance you provide can make a tremendous positive impact on the patient and family.
Who is a Match for Hospice?
Shelly has met so many different personalities and they all bring different strengths to hospice nursing. “I think anyone can find a role in hospice nursing. It is not all ‘touchy–huggy’ type of nursing. Some patients don’t want to be coddled, in fact, some just want the facts and practicality.” She reflected and added, “maybe the only thing that might not be a fit is a nurse that prefers a controlled environment.” Hospice nursing is much more unpredictable than hospital shift work.
What to expect your first 6 months
Shelly says, “Be patient with yourself!” Typically a nurse will start as a case manager before moving on to different roles. This role requires managing information, services, as well as completing the required documentation.” Shelly continued, “Don’t underestimate the time required to communicate with other staff members, patients, and their families. Be prepared to develop your own management system to organize the different aspects of the day. Manage your expectations for your admissions. At times the patients and their families will require you to listen and that will require more time in the home.” Shelly continued, “Orientation differs between organizations, but usually lasts about 2-3 weeks. However, I believe it takes a year to really master hospice nursing, so again- be patient with yourself.”
How will I know if I’m ready for hospice?
Shelly has observed nurses with ICU, ER, and trauma experience transition well to hospice. The ICU, ER, and trauma all have a bit of unpredictability, quick decision making and technical experience that prepares you well for hospice nursing.
Hospice can be a challenging but fulfilling career option! Just be patient with yourself and give it a try!
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