hello and welcome my name is holly and today i'm going to be answering some frequently asked questions about hospice nursing so if you are interested in becoming a hospice nurse or if you're interested in the field of hospice nursing then this is the video for you all right so the first question is how do you become a hospice nurse well the first thing that you have to do is become honors so you will go to an accredited school of nursing and either obtain your associate's degree in nursing or your bachelor's of science in nursing and then of course you will take your licensure examination and become an rn and then typically hospice agencies will want you to have like one to two years of experience so typically they won't hire straight out of nursing school i have known for it to happen we have some people that we work with who were hired straight out of nursing school but typically they will want you to have one to two years of experience and the experience that you can have can vary widely you can have worked in the icu er med search telemetry you name it as long as you have that one to two years of experience then you can pretty much apply for any hospice position so you don't need any sort of certification prior to becoming a hospice nurse so like i said you just need your nursing license and then one to two years of experience as a nurse but after you have worked as a hospice nurse for over a year you're actually eligible to become a certified hospice and palliative care nurse if you choose to do so the next question is how much money do hospice nurses make or what is the annual salary of a hospice nurse and the answer to that question is that it's going to vary depending on where you live how much experience you have etc so the national average that i found was about seventy five thousand dollars but like i said that's really going to vary depending on where you live so i will link down below a website that you can go so that you can look to see what the average salary or the average hourly rate is for a nurse in your area the next question is what do hospice nurses do well hospice nurses can work either in a home care or a home health setting or they can work in an inpatient facility and if you've watched any of my hospice videos and you will know that i work at an inpatient facility but hospice nurses care for patients who have been given a terminal diagnosis so they have a prognosis of less than six months to live so these are end of life care patients now some patients can't actually graduate from hospice services so just because a patient comes onto services doesn't mean that they will die within six months sometimes people come on and they graduate and so they aren't on hospice anymore some people can stay on hospice but they will live longer so they can live like a year two years but they can stay on hospice as long as they are showing signs of decline so it really kind of varies but to be eligible for hospice of course you do have to have the less than six months to live so like i said these are terminally ill patients that we're taking care of in the home care setting the nurses are case managers and so they will manage a caseload of patients depending on where you work depends on what your case load will be but they go to the patient's houses wherever that may be or their residents so if they live at home in an apartment at a nursing facility you know we've had patients that live in a car wherever it is that they live the home care nurses go to visit the patients they have scheduled visits that they do throughout the week and then they have prn visits that they can make and it's a lot of symptom management making sure that the patients are comfortable one of the big things that we see in hospice is pain shortness of breath anxiety things of that nature so we're doing a lot of medication adjustment to make sure that the patient's comfortable and we can manage their symptoms now the agency that i work for like i said we have an inpatient facility and that's where i work so if we have a home care patient and their symptoms are not being controlled then they can actually come to the inpatient facility and we can keep a closer watch on them so they can come to our facility and we can fine-tune their medications make sure that we're comfortable and we're managing their symptoms so the work that an inpatient facility hospice nurse does can be comparable to what is what it's like in the hospital setting because it's you know we we have 12-hour shifts we're monitoring the patient making sure that we manage their symptoms and so on and so forth so there are the two sides typically though hospice nurses are home care hospice nurses so they're actually going into the patient's homes and since i don't have as much experience in that department i don't want to speak too much on that because i don't want to say anything wrong but like i said they're making visits to the patient's home making sure that the symptoms are under control and addressing any other problems that might arise the next question is is hospice nursing stressful and my answer to that would probably be yes but i think pretty much all jobs and nursing can be stressful from time to time or are stressful most of the time i would say that i have had more positive experiences than i have had negative but there are some recurrent problems that you will face as a hospice nurse and one of those is the tension between family whether it's with the patient or with the staff or you know sometimes the family is not all on board with the plan and that can cause issues so sometimes you have some family members that want the patient to try to continue to fight and you know they want them to try to cure whatever it is that might be ailing them and that can cause for some issues it mostly causes the nurse to have to do a lot of education which can be difficult whenever the family members aren't really willing to receive that education so that i would say is one of the most stressful parts and then of course all the death you know all the death can sometimes be stressful but i think after a certain point not that you become desensitized to it but you kind of just get adjusted to the fact that that's part of your job and you find different ways to cope with it whether they're through humor or you know just repressing the emotions you know because you know that's real healthy but you just kind of have to get through it like you would at any other job you just have to if you're interested in hospice nursing realize that there is going to be a lot of death and if that's going to be something that you're going to be okay with you know you'll have to make that decision for yourself kind of in a similar vein we have is it hard to be a hospice nurse and again i would depend you know on the day some days it's not that bad it's not that hard you know you're just monitoring your patients symptom management keeping them comfortable you know maybe you don't have too much tension with family members and then other days you have like really sad family stories really sad patients and it's just really bad so so it does kind of vary but i would say that the actual job of being a hospice nurse is not difficult it's everything that goes around with it so it's the dynamics like i was talking about with the family and the patients and just the fact that sometimes you have really young individuals who are taken way too early and things like that that really make it hard and difficult but a lot of times you know we'll see like older patients and although it's always difficult to see someone pass and having to see their family lose that loved one we kind of try to have a positive outlook on the fact that they they've lived a good life and you know you just kind of like i said have to find your own ways of reasoning with it and coping with it so next up is what makes a good hospice nurse well the first thing that i will tell you is that hospice is for sure a passion not every body is going to be suited for hospice just like there are some nurses that are not going to kick butt in the icu or in the er or in the or there are going to be nurses that just aren't suited for hospice and that's okay we all have different strengths and weaknesses and just because hospice is not for you doesn't mean that you wouldn't find your passion somewhere else but hospice is a passion there are nurses that come through sometimes who think oh you know this might be cool and then they get in and they're like no this is not for me this is not my passion so first and foremost i think that a good hospice nurse will have a passion for a hospice one of the other some of the other characteristics is that of course they have to be compassionate they have to be caring they have to be willing to really take time to talk to family members to educate them to be patient sometimes it's easy to become impatient like you know why don't you see this why don't you see that it's bad to force feed your family member when they are hours away from death as a nurse as a hospice nurse you have to be willing to take a step back be patient and educate that family and know that that family member is going through their own internal struggles and as hospice nurses we are not there to judge their internal struggles we are just there to educate them and to try to make sure that the death of the family member is peaceful and that the family that witnesses that death has as peaceful as a process as possible a good hospice nurse will of course know the progression of death kind of what to expect the pathophysiology of that that sounds very like academic but you do have to understand those things because like i said you're going to be doing a lot of educating for the family so you kind of need to know the dying process inside and out so that you can educate them so if you want to become a hospice nurse make sure that you actually understand what's going on whenever patients are dying when they're going through that dying process because you will have family members that are questioning you and they want to know why is this happening why is that happening so you're going to have to be able to answer their question hospice nurses should obviously know that we're not trying to cure the patient of whatever it is that is causing them to have their terminal diagnosis our goal is to help keep them comfortable while they are still alive no matter what the length of time that is like i said they could last a year after being on hospice and that's okay but during that time we're keeping them comfortable we're making sure that we're managing their symptoms and we're making sure that if anything comes up that we're addressing it but we are not trying to cure them so we're not going to tell them well you know i think maybe you should go get that chemo and that radiation for your cancer that's not part of our job you can't do that so you have to understand that these patients are terminal and that we're just trying to keep them comfortable another really important characteristic for hospice nurse to have is that they have to be a good team player because hospice is all about teamwork if you have watched some of my other videos you will know that hospice is really big on teamwork you're working with a lot of other individuals in different areas that all come together to help the patient during this process the patient and their family during this process you have to work well with others in order to best serve your patients finally hospice nurses should be able to set good boundaries with their patients and the patient's families this is a really big deal in hospice actually we have a lot of training about this making sure that you're setting boundaries with your patients because when you're a home care hospice nurse you are in the homes of the family and the patient so you become very close with them you're going to know them their lives what's going on with them and they're going to want to know you a lot of times maybe not always but sometimes you're going to have those families that you know they're very thankful that you're taking care of their family member and the patient and the family want to express gratitude towards you sometimes by offering you gifts or inviting you to go do things and you have to set boundaries and let them know that although you care for them and you're their nurse you're their nurse you know we're not trying to what am i doing here we're not trying to mesh your work life and your personal life with your patients you know you have to set boundaries and you have to remain professional and also it's really important for you to set boundaries so that when the inevitable happens and that patient passes it's not a big process for you and you don't have to go through this big grief process obviously of course you will grieve that individual because it was someone that you were caring for but if you really get involved and you get too much into their business then it's going to be really difficult for you and if you have a caseload of like 10 patients you know you don't want to be going through that grieving process for 10 different patients so you got to make sure that you set good boundaries another question is what do i love about hospice well there are many things that i love about hospice but i would say that probably my favorite thing is the holistic care that the hospice team provides so whenever i was in nursing school i would hear this thing about holistic care you know the holistic care model i was like man that's so beautiful i love that but then when i started working in the hospital i quickly found out that i'm like you know they're not really doing that that was really disappointing but in hospice they've got that down and i love that about hospice like i said we're working as a team we have all of our members of the interdisciplinary team that are working to serve the patient and their family and it's just really a beautiful thing and i wouldn't have known that it existed until i came into hospice like i said working in the hospital you don't see a lot of holistic care so it was a very welcome surprise whenever i started working in hospice so the last question that i was going to go over was what are some tips for new hospice nurses but i think i will actually make that into a totally different video so that i can actually come up with some more tips because i'm going to be linking the original blog post where i went over this information i think i only have like three or four tips on there so i want to make a more in-depth video for maybe some of you new hospice nurses out there you know would you like that and also if you have some hospice nursing questions that you would like me to answer please comment them down below i got all these questions off of google okay like nobody actually asked me these questions so if you have a question about hospice nursing or hospice in general and you would like for me to cover in a future video then please comment that down below and i will for sure do that but like i said i think that i will do the hospice nurse tips in a separate video so be on the look for that if you're into all things hospice but that's going to wrap things up thank you so much for watching and until next time happy nursing