Hospice Nurse Question:

A typical day generally runs from 5:00 p.m. till 8:00 a.m. and, on weekends, from 5:00 p.m. Friday to 8:00 am Monday. I receive reports by voicemail or email. Calls come to me from the answering service and, unless I am on another call, the service will patch the caller through to me. The call may involve a patient's symptoms, equipment, supplies, or medication. I often need to refer to specific patient information via internet or a detailed printed census that has been faxed or emailed to me. Based upon the problem, I may suggest a course of action, or I may offer to send out the nurse, the DME technician, or a social worker. On weekends, I often have the option of sending a CNA if that would be helpful.

Sometimes the call is as simple as a medication refill. Sometimes it is a change in condition that results in significant discomfort for the patient and/or family. A considerable amount of teaching is often involved.

Death calls present an interesting dynamic. Since hospice staff must attend all home deaths, we instruct families and caregivers to call us first. Many find it difficult to say “dead.” They might say, “He hasn’t been breathing for 10 minutes and I can’t wake him up,” or “I think he might be gone, but I’m not sure.” I have to be able to read the caller’s response, find the right words, and prioritize the visit. Sometimes the family wants a little private time and other times they need someone there as quickly as possible.