Monday, September 1, 2008

A Little About The Job... ('Cause It's Labor Day!)

Please remember, as you read this, that I can only speak of my own job as assigned by my hospice. Hospices, throughout the country, handle their "after hours" emergency cases in many, different ways...

Many hospices rotate their day shift nurses to be "on call" at night.
Thankfully, my hospice has nurses that are dedicated only to the night shift. It's a staffing "plus" that allows the day shift nurses a full night's sleep thus allowing them to fully tend to their patients during the ususal 8A-5P hours. I truly believe that having dedicated night nurses contributes greatly to staff retention. A nurse that has devoted a full day to tending his/her patients and then has to be repeatedly "on call" during the night rapidly becomes an unhappy nurse. Unhappy nurses will soon look for work elsewhere.

I work alone, from home, and am responsible for approximately 180 patients scattered within an area of at least 1,500 square miles. At night, an on-call hospice physician and nursing supervisor are available if I should need them. They, of course, have also worked a long day and are surely hoping that I don't need to wake them up. I take great pride in that I rarely ever have to disturb anyone's sleep.

Some hospices assign a "back-up" to the night nurse. This nurse, from the day shift, is to assist in the event that multiple emergencies happen simultaneously. I don't have a "back-up". When all hell breaks loose, I take a deep breath, mentally triage the events and just "do it". I also very carefully explain the situation to the caregivers and assure them that they will be seen as quickly as possible. Caregivers are almost always very understanding in these situations. They also understand that the needs of the living patient will always override the needs of the dead.

Emergencies are as varied as the patients. Intractable pain, terminal restlessness,respiratory distress, malfunctioning equipment, occluded Foley caths, family "freak outs" ... the list is endless. Unfortunately, some caregivers are disappointed in my reluctance to respond. Linen changes, dirty diapers and constipation will almost never warrant a visit from an emergency night nurse.

It's a lonely and sometimes, dangerous job; but the rewards are beyond compare. The caregivers are very appreciative and relieved when I walk into their home and I'm happy to be there... because I know that I can help. I am one of the lucky few that can say, "I love my job."


Steve & Brandy said...

Hello - I came across your blog looking for an after hours hospice nurse job. I enjoyed reading a little more about what you do. I only have hospital experience & I am wondering if you can tell me what my chances of landing an on call hospice nurse job would be? Also, I am wondering if you can tell me about how many people you end up visiting during a given 8 hour shift? Any more information and insight you can provide would help me out so much, thank you!

dethmama said...

@ brandy... Very few hospices, that I know of, will accept a new grad. So your hospital experience will be to your advantage.

My shift actually encompasses a 16 hour block of time. 5PM to 8AM. However, many is the time that I've come home after 10 in the morning. My job requires that I am able to find plenty of opportunity to catch up on sleep so I'm refreshed for the next night. I would not really recommend this job for anyone with small children that may need your attention or interrupt your precious rest during the daytime.

I really can't give you an idea about how many visits I make per night. Every night is a "crap shoot".

Gail Rae said...

Your scheduling set up is exactly how my mother's Hospice company works. From a caregiver's perspective, I like knowing that, if I should need to make a call (so far, in five months, I've needed to contact the on call RN twice) the nurse will be relatively fresh.