A Tale of Entry Level Hospice Nursing.

2016 was the year I finally broke into hospice nursing. I had taken a 6 year hiatus from nursing, in order to stay at home with my kids. I honestly wasn’t even sure if I wanted to keep being a nurse. But other job prospects seemed non-existent. The twins were in kindergarten. I had just completed my nurse refresher course and was starting my job hunt. I was reluctantly ready to be a nurse again. This is a story of how I got my first entry level hospice nursing job.

As early as 2006 I knew I wanted to pursue hospice nursing, and I have this blog post to prove it. It took me long enough to get there. Not many organizations were willing to hire a nurse with such a big lapse in experience, but eventually a hospice organization was willing to take a chance on me.

Hospice Nurse from the 1970s

Becoming a Case Manager

They hired me to be case manager for home care patients. Basically I had a case load of around 16 patients, and I visited them each at least once a week. This particular hospice was not big on training. They were pretty much like, “Get out there, you can do it! We believe in you! You have a Hospice Heart!” This was difficult for me as I have trouble feeling confident in a new job without proper training. Fortunately (and I think some might disagree with this statement,) but the nuts and bolts of learning hospice aren’t that difficult. It basically boils down to 2 important things: Learning symptom management (pain, nausea, dyspnea, constipation – those are the big ones) and learning how the hospice medicare benefit is structured. As a case manager you will get a lot of questions about what is and isn’t covered in hospice. Once you master these 2 things and you have a “hospice heart,” you can basically go out there and do the thing.

The MICU makes good Hospice Nurses

I spent 6 months as a case manager and it had a good side and bad side. My experience in the MICU really helped me to relate to the patients that had chosen hospice, because I knew what the alternative was. In the MICU I had taken care of plenty of cancer patients that oncology had given up on, and I had performed useless CPR on quite a few patients. I felt much respect for the patients that had the courage to choose hospice, and I felt honored to take care of them. I loved going into people’s homes and earning their trust, educating them, giving emotional support. These are all things you think you’re going to do when you’re in nursing school, but get to the hospital and it’s a different story.

On the other hand there were the homes that I feared going into. The ones that you knew a family member of the patient was going to talk your ear off about their own personal drama that had nothing to do with the patient and so you had to have an exit strategy. There were the ones that didn’t want you there in the first place. And yes, there were the homes that just plain smelled bad. Like, really bad. All stories for another time.

Entry Level Hospice Nursing is within reach

At any rate, if you want to an entry level hospice position, and you have recent clinical experience, there are jobs out there for you. But it’s important to find the right organization, and the right type of job. Training is important and you need to know what you are getting yourself into. But if hospice is truly your calling, a job will not be difficult to find.