As hospice providers struggle with industry-wide care shortages, some are taking matters into their own hands with in-house residency programs.
A lack of hospice-specific clinical training is a significant barrier to recruitment. A 2018 study found that few nursing students are exposed to hospice or palliative care during their education, and most feel unready to care for patients and families at the end of life.
Some hospices have therefore decided to offer this training themselves. according to dr According to Stephanie Patel, CEO of Massachusetts-based hospice provider Care Dimensions, not only can this better prepare new employees to work in this field, but it can also help attract potential employees in the first place.
“People are looking for a lot more mentoring and time to learn the field. People aren’t just going to jump straight into hospice with no experience,” Patel told Hospice News. “They ask a lot more questions about orientation and onboarding. That’s one of the reasons we started our residency a few years ago.”
Our hope was that by creating this residency we could build a pipeline of nurses who had exceptional training and then go ahead and train more nurses. It would open up the opportunity and show how rewarding being a hospice nurse can be and how it differs from other fields.
It’s six nurses at a time and it’s really open to any nurse. We have a new graduate degree and then another degree for the nurses who come with experience.
Care Dimensions began his residency with a $180,000 grant from the Cambia Health Foundation’s Sojourns Scholar Leadership Program.
The residency provides training for six nurses annually in two majors, including one for recent graduates. The second course is designed for nurses who have experience in other clinical settings but are new to hospice and palliative care.
Most nurses are trained in hospitals and some are reluctant to transfer to a hospice. According to Patel, this is partly due to misconceptions about the service and what it entails.
“Our hope was that by creating this residency, we could build a pipeline of exceptionally trained nurses and then train more nurses,” Patel said. “It would open up the opportunity and show how rewarding being a hospice nurse can be and how it is different from other fields.”
Care Dimensions is not alone in this approach.
Calvary Hospital, based in New York City, also offers a nursing station. Calvary is the only acute care hospital in the United States that focuses primarily on hospice and palliative care.
The program includes didactic instruction aimed at ensuring that participating nurses achieve certification in palliative care and hospice, and a preceptor component that takes place both in the inpatient setting and in the patients’ homes.
Calvary also used a communications platform to monitor and provide feedback to nurses making home visits.
“It’s very competitive to attract these nurses to work in different hospice organizations,” said Dr. Calvary Chief Operating Officer Christopher Comfort told Hospice News. “So our idea was to start a process that would allow us to recruit nurses who may have been in this field for a long time, but also allow us to attract new graduate nurses and those who have worked in different fields who were now interested in hospice and palliative care.”
A similar residency exists at UnityPoint Health, an integrated healthcare system with campuses in Iowa, Illinois and Wisconsin. The nonprofit organization provides hospice and other community-based services through its UnityPoint at Home segment, serving both metropolitan and rural communities.
UnityPoint’s program is accredited by the American Nurses Credentialing Center. According to Katrina Agnew, vice president of hospice at UnityPoint Health, the residency will focus on helping newly licensed nurses transition into the workforce, in addition to setting-specific clinical training in hospice and home health care.
“We’ve been really successful in recruiting nurses into our program,” Agnew told Hospice News. “I’ve seen a couple enroll from the nursing residency program to become an RN case manager or clinical supervisor, a really positive career path for them.”