James worked on-and-off as an LPN for over 20 years. In 2014 he completed a bridge program and became an RN. James became a hospice nurse in January 2015. He lives in the Kansas City area with his wife of over 30 years, 4 daughters and 2 sons in law.
In this episode I explore the frequent, maybe even normal, conflict that can arise between sales and clinical.
I review what I believe the clinical team needs to do to be more accommodating and show the sales team we are serious about growth.
I also review some things that the sales team can do to help lessen some of the stress they can inadvertently place on the clinical team.
I review the fact that our patients can, at times, misrepresent what the sales team has said or promised to them. The same thing can happen when our patients or referral sources misrepresent what the clinical team has said or done.
In the end we are all a team, and we are all on the same side.
As always, don’t forget to call, text or email to leave feedback! I would love to hear from you!
In this episode I review some of the challenges we can face when caring for patients with a long history of substance abuse.
During the show I review the psychosocial reasons we will find ways to not admit people who need hospice.
I also discuss how we can easily complicate the qualifications for hospice when we interject our own feelings and fears into the situation.
At the end of the show I share the story of a heart failure patient with special needs, and how we adjusted our plan of care to make sure this patient got the care he needed.
As always, don’t forget to call, text or email to leave feedback! I would love to hear from you!
In this episode I explore the realization that, if we are honest, we all have feelings of insecurity and inadequacy.
Imposter syndrome is something that we all will face at times in our lives. We will especially face imposter syndrome when we are adventurous and are willing to take on new challenges.
In this episode I review many of the different ways we can experience imposter syndrome and why we might experience it.
I mention a recent article where I explain why hospice nurses are not trying to kill their patients. You can access that article HERE.
I also review a strategy on how to avoid imposter syndrome. Do you want a hint? You can’t avoid imposter syndrome if you are going to engage life!
It has been just about 30 years ago that my wife and I decided to start a family. Our oldest daughter just turned 25. If you do the math, you can figure out that things did not start out as we had planned.
We struggled greatly with infertility. Eventually, we decided to become foster parents with the goal of adoption.
Through many trials and tribulations, that I don’t have the time or space to fully explain, we eventually adopted 2 amazing daughters, and then had 2 (surprise) bio babies. Things did not happen the way we planned, but we would do it all a million times again to have the family we have now.
Mother’s Day reminds me as much about loss as it does anything else. During the 3 full years we tried to start a family the “natural” way, Mother’s Day became something we did not enjoy.
For some reason, that I can’t fully explain, infertility causes feelings of loss. With every passing month, our inability to become pregnant just started to hurt more. Eventually, we just couldn’t go to church on Mother’s Day. It was just a painful reminder that my wife just couldn’t be a mom. My aunt Joyce lost her son when he was just 17 years old, so she didn’t go to church on Mother’s Day either. It just hurt too much.
Now I do hospice for a living. On Mother’s Day I just can’t fully clear my mind of loss. I’ve just cared for too many moms over the years. I am painfully aware of all the families who have lost their moms, and will spend today in mourning wishing for just one more day with their mom.
For those families, please know that I am thinking of you today. My profession puts me right in the middle of watching sons and daughters lose their moms to unrelenting disease.
Today is not an easy day for those who have lost their mom. Most of you will spend the day with your own family in celebration, but deep down inside you are thinking of your own mom, and how you have to get through today without her.
May today be filled with God’s grace and mercy as you feel joy and sorrow. Joy with the family you started, and sorrow for the family you have lost.
In this episode I welcome veteran hospice nurse, Michelle Ery.
During the show, Michelle shares with us how she obsessed over her patients to the point that she started using substances to manage the anxiety and obsession.
Michelle shares with us what happened to her on Memorial Day of 2020, and how this event was the catalyst that ended up changing her life forever.
Michelle covers her experience in a thirty-day addiction treatment center. She shares with us how this experience effected her nursing license. She also details how her place of employment handled everything that happened.
At the end of the episode, Michelle encourages any listeners who feel like they are struggling with addiction to contact her via her personal facebook page.
I cover several issues that I have observed causing major burnout for hospice nurses.
Are you waiting for hospice to get easier?
Are you unwilling to work an 8 hour day?
Do you struggle with autonomy?
Are you unwilling to turn off your work phone after hours?
Are you unwilling to learn to chart at the bedside?
Do you have to always be right?
Do you have to fix every problem?
Is it you or your agency causing you to consider leaving hospice?
During this episode I don’t pull any punches. The issues above are what I have seen be the leading cause of burnout for hospice nurses. If we are unable to master the list above, this work may not be what we should be doing.
I don’t want anyone listening to this episode to quit being a hospice nurse. Still, this work is not for everyone. It’s okay to realize that hospice is not for you.
At the end of this episode I spend some time discussing The Hospice Nursing Community. This community has a private group dedicated to hospice leadership.
In the last week I have taken a hospice administrator position here in the Kansas City area. I will be sharing some of my experiences in the private group for hospice leadership.
I also share that I have made a change to the pricing structure. The monthly subscription is now $19.99 and there is also an option to pay $199.00 for a lifetime membership that does not expire.
As always, don’t forget to call, text or email to leave feedback! I would love to hear from you!
I’m back behind the microphone as I return from a month-long break from the show.
In this episode I take on the challenge of discussing hospice leadership.
I review some of my own challenges in my leadership experience. I also spend some time discussing the last 7 months I have spent in the field, and how much stress and emotion is involved.
I also mention that I would share some of my favorite leadership books here in the show notes.
I discuss some of the behaviors by hospice leadership that I think can be very toxic. I also share my thoughts on how leadership should handle staff members who are struggling.
Ultimately, I believe that the success of any hospice agency should be attributed to the field staff. Failures by the agency should first be examined by leadership to make sure the problem isn’t process related.
Your are reading Part 11 of my series, “What to expect from your hospice nurse.” To gain full perspective, I encourage you to start from the beginning by visiting the series landing page HERE.
in the world of hospice care, there really are very few expectations on the patient. I think that is one of the reasons I love bing a hospice nurse. Hospice is very patient centric. For the most part, whatever the patient wants, the patient gets.
Hospitals are pushy. They don’t have much of a choice. Insurance companies are calling the shots. The patient is expected to only have so many days for whatever procedure or illness.
I can’t sit here and tell you I know everything about hospitals and insurance. Still, I’ve been in medicine for most of my life, and I can tell you that there is plenty of pressure to get people in and out of the hospital as quickly as possible.
All of that goes away when you enter hospice care. At least, it should all go away. If you are anywhere near me it does go away, because I don’t believe in it.
This is your story
I love hospice because it’s all about the patient. You, as the hospice patient, don’t have to do anything you don’t want to do.
Isn’t that freeing? Aren’t you fed up with being told what to do by doctors and nurses? Aren’t you ready to just live the way you want to live?
If you have a terminal disease, and you’ve done everything possible to extend your life, don’t you want the last few months of your life to be the way you want?
Do you want healthcare that is dedicated to your comfort based on what you find important?
At its very core, that is what hospice is supposed to be. If you are on hospice care, the only thing that can be expected of you is that you allow your RN Case Manager visit you and complete a comprehensive assessment weekly. Technically you don’t have to see your hospice nurse more often than every 14 days, but that can be a hardship on the hospice agency. Let’s not do that. Otherwise, it’s your show!
Your hospice nurse should never argue with you
Nurses like to fix things. It is what we are taught in nursing school. Find a problem and fix it. Even if the patient doesn’t want it fixed, fix it anyway.
Because of this, we get pushy. Sometimes, unfortunately, we will get pushy and try to impose our will upon our patients. We don’t mean to do it.
Don’t be afraid to have things your way. If you want every unpleasant feeling reduced and controlled, then that is what you should get. If you are into all natural, and you want to refuse all controlled medications, then make sure to tell your nurse.
If your nurse can’t seem to understand that you want things a certain way, don’t be afraid to contact the agency office and request a replacement. It isn’t rude or mean. Some nurses and patients just can’t figure things out. It has happened to all hospice nurses.
Many nurses (I’m the worst) have a hero complex. How can we not have a hero complex? Over the last three years (COVID-19) that’s all we have been told. Yay first responders! We are special!
Well, I think first responders are special, but when it comes to your hospice experience, we are not the hero in your story.
Your caregiver is the hero in your story. As I mentioned in part 4 of this series, you will have a family member or friend who will be by your side when you take your last breath. As important as your hospice nurse is, nobody is more important than your caregiver.
Your caregiver will go through the gauntlet with you. He or she will do the exhausting work of caring for a dying person. It is a monumental task, and only death itself is more grueling.
I was recently reminded of my place in a hospice patient’s story
I was working the weekend on call. I had been at the patient’s side several times over the weekend to help manage symptoms and assist family. During my last visit, I noticed the patient starting to breathe shallowly. I stood up and got the attention of the daughter in the room.
“Is his breathing becoming more shallow?” I asked.
“Yes,” was her reply. “Should I go and get my sister?”
“Yes I think so,” I replied.
Everyone came into the room. I was standing at the foot of the bed. As the room filled up, one of the daughters motioned everyone to give me some room. This instantly felt uncomfortable to be.
“This isn’t about me,” I thought to myself.
I quickly moved away from the bed and motioned for everyone else to get in close to the patient. They stood by his side as he took his final breaths. I could not even see his face, so I could know when he passed , and it didn’t matter. I would do my part to get the time of death once everyone was ready to do so. It didn’t matter the exact time he passed from this world to the next.
What was important is that his family could all be close to him and take in the moment. I had no business being accommodated during such an emotional and intimate moment.
Hospice is about you and your family
As I draw this series to a close, I want you to understand that hospice is about you. Hospice is about what you want the last days, weeks or months of your life to look like.
Hospice exists to help you navigate this time, but as I have mentioned before, this is your experience. This is your care plan. This means that hospice is supposed to respect and honor your wishes no matter what they might look like. It doesn’t even matter if your hospice nurse agrees with your decisions.
At the end of your life, I want you to choose hospice to be there to help you, and your family, navigate the most difficult event you will ever face.
Ultimately this is your story, and it is up to hospice to make sure your story ends the way you want it to end. I hope this series has helped you understand what to expect from your hospice nurse and the agency she represents.
