7 Simple Ways to Get Organized for Hospice Nurses

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Being a hospice nurse can leave you feeling exhausted and overwhelmed. Sound familiar? If so, then you need these 7 simple ways to get organized for hospice nurses.

Unlike working at a hospital or nursing home, you don’t just get to pop back into your patients’ rooms after you leave.

As a hospice nurse, you will encounter a variety of situations and it’s imperative that you get organized as soon as possible.

Below, I’ll share the top 7 ways to get organized as a hospice nurse.

Whether you are new to hospice or have been doing it for a long time, these tips apply.

7 Ways to Get Organized

1. Prep Ahead of Time

If you’ve ever worked at a hospital, you probably had some kind of report before you started your day.

This ensured that you knew what was going on with your patients and helped you figure out who to see first and what their needs were.

Unfortunately, in hospice, you don’t get a well-packaged report each day. You are responsible for knowing who is on your schedule and why they need to be seen.

Now you might be thinking, “everyone is dying so that’s why they are being seen.”

Well not so fast. Just because your patient is dying, it doesn’t mean that they don’t have other needs.

Allow me to break this down a little more for you.

For example, hospice patients may need medications, supplies, catheter placement, or recertification, etc. And the list goes on.

By reviewing their chart ahead of time, you can be prepared for what might come up during your visit.

How to Plan Ahead in Hospice

Call the day/night before your visit to confirm your patients’ appointment
Sync your tablet/visits if you have an electronic medical record system (do this several times a day)
Know your travel route and which patients you will see first and last
Restock your trunk supplies

2. Document at the Bedside

As it turns out, this happens to be one of the biggest challenges for hospice nurses.

Just like a broken record, I keep repeating this simple way to get organized in almost every article I write.

If you don’t want to spend hours at home charting, you have to master the art of real-time charting.

In the rare instances where your patient won’t allow you to document at the bedside, then you should go to your car and complete your charting.

EXPERT TIP: Use a notebook or visit brain sheet to make sure you don’t miss any details.

3. Ask for Help

Don’t be afraid to ask for help!

Being a hospice nurse can feel lonely because you don’t have your nurse homies to turn to in a pinch. However, you should remember, you are NOT alone!

It is important to understand the roles of the members of your team and take advantage of their knowledge and expertise.

In hospice, you will work with the hospice interdisciplinary team (IDT) to provide care.

According to CMS guidelines, all hospices must have an IDT. This is a condition of participation or COP.

COP §418.56 pertains to the Interdisciplinary Group, Care Planning, and the Coordination of Services.

For instance, if you have a patient with a lot of family “drama,” you might want to get the social worker involved so you can focus on providing nursing care while the social worker focuses on social issues.

Members of the IDT include:

Medical Director
Registered Nurse
Nurse Practitioner
Social Worker
Chaplain
Bereavement Coordinator
Home Hospice Aide
Volunteer Coordinator
LPN

Honestly, you have a team on hospice for a reason so always include them in the care plan when appropriate.

Another time that you might need help is when you get stuck at a patient’s home for an extended period of time.

When this happens, you should reach out to your supervisor and let them know so they can get other patients rescheduled or seen by another nurse.

They can also help with notifying your patients if you are going to be late.

I think of it like waiting on the cable guy (I might be dating myself with this one). If your patient is waiting and you don’t show up, they might get angry or frustrated so take the time to give them a heads up if your schedule changes.

Otherwise, you run the risk of having unhappy patients and your own personal burn-out.

4. Keep back up supplies

Have you ever splashed urine or blood on yourself while providing patient care? Perhaps, you’ve cleaned the colossal poop and ended up wearing some of it!

Well if you can’t relate, good for you. Sadly, I can relate because this has happened to me before.

Fortunately, I was working at the hospital at the time when I forgot to close the clamp before spiking blood for a transfusion and I was able to get a pair of replacement scrubs from surgery.

You won’t have the same luxury as a home hospice nurse so keep a backup pair of scrubs in your trunk!

Supplies: Ways to Get Organized

Supplies You Need

Adult Diapers
Wipes
Foley Catheters
Barrier Cream
Gloves
Masks
Bedpan/Urinal
Wound Supplies

Paperwork: Ways to Get Organized

Even if your agency is electronic, you might need paper forms from time to time. This can add time to your or others’ schedule to come back at a later time for signatures.

Revocation forms
Advanced beneficiary notice
Start-of-care booklets
Caregiver resource books (like “Gone From My Sight”)

5. Know the Visit Type

If you are new to hospice, learning the various visit types and levels of care can be tricky. Therefore, it’s important to understand the visit types and to know what type of visit you are supposed to complete.

For instance, if your patient is at the end of the benefit period, they may need a recertification visit instead of a routine visit.

Patients get recertified every 90 days for the first two benefit periods and then every 60 days thereafter. This can be confusing and challenging to keep up with so make sure you know the dates of your patients’ recertification period.

You can also find recertification calculators online.

6. Keep a Daily To-do list

As a hospice nurse, you will have a laundry list of tasks to keep up with each day. One way to stay organized is to keep a running list of tasks that you need to complete and refer to them throughout the day.

It’s also helpful to use your drive time to make phone calls to family members and to get orders.

Additionally, using a list can reduce the likelihood of missing something.

The last thing you want to do is provide poor care and let your patients and families down.

Even worse, you don’t want the on-call nurse to get a request for diapers in the middle of the night.

PRO-TIP: Always verify supplies and meds with your own eyes. I’ve had patients tell me they have enough pain medications only to find they only have enough for two doses when I verified.

If you are not going to be back for several days, make sure your patients have enough supplies and medications until your next visit. It’s also a good idea to get on a regular schedule with ordering medications and supplies.

7. Know the Facts Before Calling the Doctor

This organization tip applies to all nurses, and not just hospice nurses!

Get your facts straight before you call the doctor for orders.

The best way to prepare to call for orders is to use the SBAR format.

Situation
Background
Assessment
Request

An example of this could be when you are calling to report uncontrolled pain in your patient.

First, you will want to explain the situation and background to the physician. This may include the patient’s name, admitting dx, and what you observed during your visit.

Next, remember to ask for what you need, and don’t be surprised if the doctor asks for your input.

As a hospice nurse, you will want to be familiar with opioid conversions and other pain and symptom management therapies.

Additionally, you should always keep a list of pharmacies in your area along with their phone and fax numbers.

This organizational tip can be the rural nurses’ lifesaver. It was certainly mine!

Also, you don’t have to remember everything so use cheat sheets and other tools when you can.

Another bit of information to keep in mind is to collect appropriate death information for reporting back to the physician who’s signing the death certification.

For example, this includes the time of death, smoking history, next of kin, etc.

Summary

Lastly, the difference between surviving and thriving as a hospice nurse comes down to organization. Ultimately, it is up to you to find a system that works for you. My best advice is to document in real-time and use the tools that I have shared with you. Yes, you can do the things you love and still be an amazing hospice nurse.