 Welcome to nursing school explain and this interview series with a first time here we have today a hospice nurse named Jocelyn who's been doing hospice nursing since she graduated from nursing school hi Jocelyn. Hi Professor bills thanks for having me. It's so good to see you I am so proud of you and all that you have accomplished. So when did you graduate. So I graduated, we finished in September of 2020. We were, we got kind of delayed because of COVID but luckily we still finished in the same year. So it's been about a year and a half then for you. And right, other than hospice right away so tell me how did that all happen or come about. Well, I was really fortunate to be able to do hospice with as for my preceptorship. And so I did that for a few weeks, and not long after I finished my preceptorship hospice or COVID started coming around and the shutdown ended and so when school was postponed, I called them back and asked them if I could volunteer or shadow or just get some experience while I was off schooled me, offered me a job on the spot and so I worked for them part time. And so I went out the end of nursing school and then as soon as we graduated, I came aboard full time and took the NCLEX and just started working right away. That's excellent so these connections that you're making through preceptorship and clinical assignments really tend to pay off and in your case it sure did. Yeah, I did. And I'm so glad I just I'm very fortunate that we had a preceptorship in hospice because I always liked that field and I just got, you know, got really lucky with that. And you said you work there while you were still in school. What exactly was your job description or what did you do during that time. I was working part time at the office I was helping basically answer phones, helping the nurses support the nurses with triage calls and ordering equipment. I was just watching and seeing how it worked around the office so I got a good idea of how the business was ran and I kind of got it to see that perspective. In addition to the clinical side so it was really beneficial for me to just even be in that atmosphere and kind of soak in everything that I could. It sounds like there was a lot more administrative tasks that you got to do initially that kind of got you started on that journey. So, and I know that you've said this from the beginning that you always liked kind of like the out of the hospital nursing aspect more than in hospital acute care. What is it that drew you to that setting. So, I've always had I've always wanted to work in the medical field, but what I really like about hospice is just the holistic approach to treatment and how their philosophies are treating like patients based on their individual environment, meaning what their home is like what their lifestyles like what their family life is like, and being able to cater your treatment and therapy to each individual is just really special to me and I think that I love people in general so it's very, very much particularly I guess, in terms of, get you know adapting to other people and kind of making just treating people based on their own individual needs. And make such a big difference if you actually see them in their natural environment in their home surrounded by their family members, rather than the acute care setting where everything is like the hospital dictates how their day to day goes but at home really the patient kind of dictates more of how that day to day goes and you're able to support them there. Can you kind of walk me through a day of a hospice nurse so what does your typical day look like. The beginning of your day starts with looking at who your patients are going to be for the day, giving them kind of setting a schedule, a window a time window for each patient, usually I give them a two hour window so I'll make phone calls to my patients. Good morning, and let them know I'm going to be there between 10 and 12 or, and I'll tell the other patients different gaps that way I have some sort of leeway depending on how long I take at each person's house. So I pack up all my materials, and then I head out and drive to their houses. When I go to do a visit I come in and see the patient take their vital signs and kind of get a brief overview on how they're, how they've been doing over the, like since I last saw them. And if their medications are working if their pain is being managed. If there's any changes that have been happening how they're sleeping how they're eating, and just basically checking on the family to how they're handling it if everything's going alright if they need any extra support. You know, a lot of times it's, it's hard to my guilty pleasure is kind of, you know, engaging a lot of conversations with families because you get close to people, and you get to know them and I have to like remind myself to, to move on and get on to the next patient but it's really just helping people manage their own, helping family members manage taking care of their loved ones, especially during this hard time for them it's it's it's a hard time. People are not usually prepared for the end of life and I think it's a, it's rewarding to just relieve a lot of stress that families face. Sounds very interesting. And then you said you have a certain caseload so you see the same patients over and over again on a pretty regular interval or how does that typically work. So as a case manager, right now I'm per diem but when I was working as a case manager, you usually have a caseload between 12 to like 15 patients, and you'll spread them out throughout the week so some patients are once a week some patients are twice a week. And when you plan it out nicely, you can see patients on the same, you know, you see the same patients on the same days of the week. So on this on Tuesdays and Thursdays you see these certain patients and vice versa. And so you have to schedule it that way and then in between, you know you handle all of your administrative duties such as, you know, ordering refills, talking to the doctor, making medication changes on communicating with your chaplain and your social worker because it's a whole team aspect for each individual patient. Absolutely I think I mean everywhere right nursing is a team effort but in hospice even more so because you really rely on these. Other disciplines to help you support the patient as best as they can in this very important phase of their life. Well sounds like it's a it's a really good fit for you and you found your your way right out of nursing school and sinking back now and I know that the, the time that you graduated was very special let's say that because of covert and everything and so you certainly showed a lot of flexibility there with along with all your, your classmates, but looking back at now the transition from graduating and then into the professional nursing. What advice do you have for new grads what would you tell them that you know now that you didn't know back when you were in school. You know, I just, I feel this is, you know, during nursing school there just tends to be a lot of anxiety, negative talk that just kind of lingers around. And it's natural because nursing school is tough right for for everyone and I think sometimes that carries on to after nursing school and if I could just make a recommendation to people is to just kind of tune out. And just kind of talk or self doubt and really just go for it because as a new grad you really have nothing to lose so just putting yourself out there is the best you could do to advocate for yourself. Definitely. And just, you know, not being afraid to not letting other people's opinions or fears scare you out of jumping on opportunities to just get yourself out there and just get experienced basically. And I think that really pays off no matter if you find a job. If you already have a job let's say during nursing school or if you get a job like you did you just kind of you were very proactive right you just searched out the opportunity because you really like the environment. And if you found your niche, I think it's very important to kind of pursue that meet people and put yourself out there and introduce yourself and then they see how they see how in each you are and that really benefits you in the long run. I don't know how many students in the past have actually worked at, mostly for me that the experience has been in the hospital setting. They get to know the managers and the charge nurses, and maybe a supervisor and then they get to know how they work so they know their work ethic and that they're on time and they're a team player and if you can really show that before you have that license, it's much more likely to get a job, no matter what setting it is that you that you really want to be in. So I think that worked out really well and I commend you to do in a good job because Kobe times were not easy for anybody and especially not for nursing students with all the constant changes that we had. So great. Thank you. It was definitely tough. One thing about hospice nursing that's a little different is you're very much on your own. I think I had, you know, when I finally, when I passed my NCLEX and started working full time I think I had two weeks with the nurse. And then I was on my own and I had my own caseload and of course at that time you really don't know. There's still a lot that you don't know and knowing how to be a good communicator and knowing what resources you have at hand are so important because there were so many times where I didn't know what to do and I had to call my lifelines but if you're, you know, if you're brave and independent then it goes a long way because there's just definitely a lot of autonomy with hospice nursing which I love, but it definitely takes a lot of good communication in order to even get things done and give the best care that you could possibly give. Absolutely. And I think the, the piece that you brought up about communication is important in every kind of nursing, because nobody knows everything right I still have questions I've been doing this for a long time and sometimes I still have questions I don't know what's going on so the ability to not be afraid to ask questions that's super important and just to know that it's okay not to know everything. That's why you have a healthcare team right that's why you have your physicians and your social workers and in your case the chaplains, because they might know something about the patient or what might work for them that you just don't and so being able to communicate those things among the team members and of course also with your patients is just super important and don't ever be afraid to ask for help that's that's really one of the most important takeaways I think. Definitely. So then it sounds like you know this is a very special kind of nursing that you do, but I'm sure that you have that one patient interaction that one patient that sticks in your mind. And without revealing too much information of course with HIPAA, but can you tell me about this your most memorable patient interaction. It's hard because there's so many but I'll just narrow it down to one that sticks out with me I had a patient he was one of my first patients he was a cancer patient that had was dealing with a lot of chronic pain and so when I took over his case it was it was a lot of a difficult task and getting to manage his pain medication regimen, but once we got that figured out, he went from being a very negative, you know pessimistic type of personality to person to being very pleasant and hopeful and would carving work around his house because he, you know had managed pain and I'll never forget when he told me he said you know my life has gone so much better since you came into my life because he was just able to live again and for the rest of the time and oddly enough you know I didn't end up being his nurse when when he passed away but I had established such a close bond with him and his wife, and leaving them was hard and I went to a different hospice and months later, so crazy I was driving and I just, he came to my mind, and I don't know why I just had this itch to, to message the wife and ask her. How have you guys been how's everything going, and she responded to me like oh my gosh it's so bad I wish she were here. It's like oh my gosh what's going on so I called her and she, she asked me to come over because in a state of panic and I mean I was close to them so I didn't mind it. Even though it wasn't his nurse but we were just so close and he died maybe a minute or two before I walked in that door and I feel that he, like his spirit like some and me or something to just be there for her big so it just goes to show how much hospice nursing is more just being human at the same time and I think it's, it's meaningful I think I actually saved he like carved this for me, this little like nursing hat with a like signed in put some. I'm not really religious but he put some, I think scripture down there but yeah just reminds me of like why I do what I do so it's awesome. Wow, thanks for sharing the story this is very powerful, and you know you kind of build a very special relationship with these patients and the family, and then having that strong, you know connection really helped you to be there. If not for him then for his wife when she needed you so that was going way above and beyond so I'm getting a little teary eyed over here that's a that's a very nice story thanks for sharing that. So no, I, it's, it's unexplainable just kind of right so it just goes to show just being hospice nursing is also just being human, you know. Absolutely yeah it takes it takes a special person I think to be able to do that because this is always there. But how it occurs, you can you have an influence on that right you can you can accompany the patients through this in a much better way than maybe they would be able to manage on their own and just to kind of guide them and help them through this very difficult transition, not only the patient but also the family because you know the patient is gone and whatever you believe happens after that but the family is left behind and so that's the other difficult part there. Definitely I think that our job is so important because how a person passes away isn't just experienced that day when they pass away but their family members remember that for the rest of their lives and it carries on and if you can make that moment, not very traumatic. Then that person, their family members don't have to live with that trauma for the rest of their lives like I've experienced that with personal family members and so I know how important that is to see, you know, to not live with that if you can get that support for sure. Most definitely. It sounds like there's a lot of, you know, there could be a lot of burden on the nurse to kind of go into through death on a pretty regular basis. So what do you do to maintain your sanity to keep your own self healthy, both physically and mentally and kind of balance that work life. You definitely have to, I think, especially for hospice nursing, we take home or charting because we work out of our cars. If you saw my car you'd see a whole desk set up it's I've turned it into an office itself but you, you go to you work at patients houses you work in your car under you find half of the job is finding shade and where to park. So you can do some charting. But when you get home you know sometimes they're so charting to do so it's hard to check out when you're at home and I think it's important to have kind of scheduled activities that are just not at home like exercise classes or I was doing cardio kickboxing classes for a while and I felt really good at that time or my brother does like cardio hip hop dancing and I do that once a week so just really being outside of your car and your home and doing an activity kind of really allows you to check out for a little while otherwise you're still kind of in that work mode, even when you're home sometimes. Yeah, I agree physical activity is super important to check out and especially in your case if you can just get away, you know from the usual in work environment because otherwise that's probably a stack of charts that you find at home and you're finding yourself charting until 10pm or later and so it's good that you that you're doing that that you're actually getting away and and focusing on yourself. So, yeah, I think that is one of the most important things because, you know, everywhere nursing we experience death or we can experience death but in hospice. Again, it's, it's a it's an everyday occurrence or you know maybe not every day but that's kind of like every patient in which eventually won't get there. And so because you're so close to them. That's even harder because then, you know, like the experience that you shared with this one patient, they kind of become your extended family, and to really be able to, you know, not get dragged down and burned out if it's very important to take care of you. And I think you're doing a lot of good things there and you know me I am always about eat well and exercise. That's always the most important thing to do so so I commend you for that. It's, it's also, I think it's helpful in addition to checking out is relying on your team members like your social worker, especially your hospice aids and your chaplains to kind of help you by setting eyes on your patient and really engaging with them to be involved and I think that when you have other people helping you more so than just taking on most of the load yourself, it really helps a lot. You don't feel as overwhelmed, I would say with each patient. I agree yeah that teamwork we already touched on that is so important. So, thank you so much for enlightening me and the audience on hospice nursing, which is not something that we get to hear about very often but it's a very important part of nursing. And thank you for a time good luck with that and good luck with your new baby coming. Thank you so much good to see you. See you too.