Why this nurse left the intensive care unit to go into hospice

Earlier this year, I made an announcement that may have made a few people think I was half a bubble off level.  I’m leaving CCU.

I’ve worked in CCU (and CVICU) for 14 years.  5 years ago I had a baby, and reduced my hours to one day per week.

It took me just about all of those 5 years to fully comprehend that one just can’t keep up with all there is to learn working only one day a week in CCU.  The basics come back to you if you have enough experience with them (ventriculostomies, for example) but the new stuff is coming in droves and is being implemented constantly – new therapies, new monitoring machines, new procedures.  When you can’t make the in-services given during the week, it falls to the weekend coworkers to bring you up to speed, and I was feeling very guilty about that.

“Why not just put the kids in daycare and work more?” one could ask.  And one would have a point.  But …

I recently had a patient that almost any CCU nurse would thrive on – unstable, many drips, lots of titrating.  In years past, I enjoyed the dance we do when trying to stabilize a patient, my brain happily bathed in adrenalin.  But this time, although my brain was still bathed in adrenalin, I found the dance … boring.  Tedious even.  Now that is an interesting feeling – all jazzed up and bored about it.

Thinking about it later, I realized that although my last several employee reviews were good, I could never come up with “new goals for the next year.”  I had no desire to be an open heart nurse, take care of patients on balloon pumps, get my CCRN, or learn anything else, really.  Although I have plenty of skills, I just didn’t want to learn any more about critical care.

So although I had a great-paying job with great flexibility and seniority, I found myself contemplating leaving it all behind.  But to do what?

Over the course of my career, I realized that I enjoy working with the patients that are close to having or are having life support removed.

Why?  I’m not sure.  Why does anyone like anything?  All I know is that I felt a great deal of satisfaction when I was able to see a patient through to passing peacefully.  You form an almost instant bond with others when in that situation, and not just the patient, who was usually unconscious by that point.  I have always enjoyed working with family members.

So I decided to become a hospice nurse, and there was a company out there nice enough to hire me despite my total lack of any actual hospice experience.

When you tell someone you’re a nurse, they usually ask “what kind; what do you do?”  When I would respond, “critical care,” they’d say, “Oh! Wow.”  When I told my coworkers I was leaving to become a hospice nurse, I got a few “Oh … uh, interesting …” and lots of “oh, you’ll be great at that.”  But the prize for best answer goes to one particular doc:

Me: “This is my last weekend.”

Doc:  “Oh, why?”

Me:  “I’m going to hospice.”

Doc: “… but you don’t look sick.”

Ah, hospice humor.

I have nothing but the highest respect for my former employer and my former coworkers.  They are a huge reason why I stayed so long and I consider several of them family.  But every time I think of the new direction I decided to go in, I feel a little thrill of excitement to learn something completely new.  Hopefully with enough tweaking and HIPAA-nating, I can share some of my experiences with you all.

“Gina” is a hospice nurse who blogs at code blog – tales of a nurse.

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