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If you’re a new hospice nurse, you might feel overwhelmed. You may also wonder if your prior nursing experience is enough. Before you settle into those feelings too much, you might want to explore these 5 tips to help you stop feeling incompetent as a new hospice nurse.
First and most importantly, there’s a learning curve with all jobs! Just because you were an expert in the intensive care unit doesn’t mean you will know everything about hospice.
To put it into perspective, nurses who work in inpatient hospice units have different responsibilities than outpatient hospice nurses.
My point, it takes time to get used to any new role regardless of your prior nursing experience.
Common Feelings of New Hospice Nurses
So, you landed your dream hospice job and now you’re feeling like a fish out of water. Your preceptor always seems to know what to say and you keep asking yourself if you made the right decision.
You might be feeling:
- Overwhelmed and wonder how will you ever learn all of the acronyms and hospice terms
- Stressed about charting
- Incompetent to handle your patient’s symptoms
- Lost at the interdisciplinary group (IDG) meeting- this was hard for me initially
- You might worry about how you’ll handle your first patient death by yourself
- Disconnected from your own family
You are not alone! In fact, most nurses feel overwhelmed and stressed when they start in hospice.
5 Tips To Stop Feeling Incompetent
1. Ask Questions
This sounds simple yet many new hospice nurses feel like they ask too many questions. It’s not uncommon for nurses to think they need to know everything. After all, nursing school beat this into all of us.
Well, I beg to differ. You don’t need to know everything and it doesn’t benefit you to pretend that you do.
Seriously, ask as many questions as you need to feel confident both during and after orientation.
PRO PRECEPTOR TIP: Keep a list of commonly asked questions during orientation and make sure to address them during orientation.
Another thing to consider is that you are on your own a lot as a hospice nurse, so take advantage of time with your preceptor and ask questions.
2. Get To Know the Hospice Team
First and foremost, you will not make it in hospice without your team. The Hospice IDG are the members of the team that also provide care and support to the patient and their families.
Try to think back to your first nursing job. I’m sure you can recall different types and styles within the team. The same is true in hospice.
For instance, you’ll find there are informal and formal leaders, easygoing nurses, overwhelmed nurses, and everything in between.
You will also find that you tend to gravitate to certain people. When this happens, make small talk and eventually see if they are willing to be your contact person once you are off orientation.
Now, let’s get back to IDG. Here’s what you need to know.
Members of the IDG meet no less than every 15 days to discuss the patient’s plan of care and are an essential regulatory component of hospice.
RELATED ARTICLE: Hospice IDG: Top Time Wasters and How to Avoid Them
Members of the IDG include:
- Medical Director
- Physicians
- Nurses (RNs and LPNs)
- Home Hospice aides
- Medical Social Workers
- Chaplains
- Bereavement
- Therapists (speech, occupation, physical)
- Volunteer Coordinator and Volunteers
- Patient and Family (are not required to attend meetings)
The bottom line is that you want to get to know your team, their role, and how you can work with them to meet the patient’s needs (and yours).
3. Learn the Lingo
Now you might be asking yourself how you’ll ever learn all of the acronyms that are being thrown around.
To begin, unlike other areas of nursing, many of the acronyms used in hospice are 100% necessary for patients to meet hospice eligibility criteria. In fact, your words can be the difference between your patient qualifying for admission and your agency being reimbursed.
I’ll be the first to admit as a nurse, it’s hard to get excited about reimbursement when all you really want to do is take care of patients.
Well, if your agency doesn’t get reimbursed, they can’t provide supplies to patients or a paycheck to you!
As a new nurse, here are some commonly used terms and scales that you should get familiarized with.
4. Develop Your Hospice Persona
Before you call me crazy, hear me out. If you’re like most people, you have one of those emojis that you like to use when you send messages.
You probably also have a style when you work, right! Whether you’re upbeat or serious, you know what works for you when you take care of patients.
Personally, I like to see if I can make my patients smile by the end of my visit. So, I am serious, compassionate, and a little silly. My persona is the nurse that takes their time and gets things done, but not without a little humor.
Also, start listening for key phrases that your preceptor uses and implement them using your own style.
For instance, do you want to come in and sit with the patient and talk before you start your assessment? Or perhaps, you come into the home with a certain rhythm and energy.
Whatever you decide, it will only work if you truly believe it.
Phrases You Can Use to Stop Feeling Incompetent
- How have things been since my last visit?
- I noticed you called the after-hours nurse, tell me more about what happened?
- How’s my favorite patient? (Don’t try this one if you can’t pull it off!)
- What’s most important to you today?
- You’re doing a great job taking care of your loved one (father, mother, etc.).
5. Be Prepared BEFORE You Call the Doctor
First, if you have ever worked as a nurse, you already know this. It’s so important that you get your facts straight before you call the doctor.
I’m gonna keep it real with you. Be prepared to answer the question, “What do you want me to order?”
You are the expert and this can be a little intimidating. So make sure you gather the facts and be prepared to tell the doctor what you want them to order.
While this isn’t always the case, you don’t want to sound incompetent when they ask for your suggestions.
You will want to have the following information available:
- Patient diagnosis
- Symptoms plus duration
- Medications – what’s working or not working and any recent adjustments
- Vital signs
- What you’d like to see happen (orders, tests, etc.)
You can also use the SBAR format when you call the physician. This will ensure that you are only providing relevant information and facts. Avoid being overly emotional as this can lead to confusion.
What does SBAR stand for?
RECOMMENDED ARTICLE: How to Survive Your First Year as a Hospice Nurse
CONCLUSION
If you made it to the end of this article, pat yourself on the back! I can’t promise that it will get easier, but I can promise that you’ll get more confident each day if you use these tips.
If you want to stop feeling incompetent, you have to understand that you have what it takes to do the job.
My next point is something that I believe wholeheartedly!
You will get there but for now, the most important lesson you can learn is to be in the moment with your patients. They don’t need you to know everything, they need to know that you care.
Maya Angelou said it best:
So, let’s re-cap.
5 Tips to Stop Feeling Incompetent for New Hospice Nurses
- Ask Questions
- Get to Know the Hospice Team
- Learn the Lingo
- Develop Your Persona
- Be Prepared BEFORE You Call the Doctor
If you apply these simple tips, you will develop the confidence you need to succeed as a hospice nurse.