Hospice Volunteering for premeds

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oldpro

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Hey, as some know I was a Hospice nurse for 9 years, we had great volunteers, and I have suggested to many premeds to volunteer for Hospice as patient contact and volunteer hours, why are so many so negative about this suggestion? I mean what do they think becoming a Doctor will be like? People get sick and die in the hospital setting, doctors loose patients and I guarantee that when they get to clinicals then residency they will have patients die and they will be faced with this, why not start where they can have a lot of support and begin to understand life and death dynamics? I always felt Hospice was rewarding not to be shunned as some have posted to me.

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I think it's just the classic fear of death in the US thing going on. You're right, it really is unfortunate. Although I have yet to work directly in a hospice setting, some of my most meaningful experiences as a resident thus far have been working with the palliative care docs and helping patients and their families navigate the dying process (as a team player, of course).

I would think doing hospice as a pre-med would be an outstanding experience. As I think back on my pre-med experiences, the one's that stand out the most involve the death of a patient in the hospital and being honored to be around during their passing.

I hope you continue to encourage pre-med's to get involved in hospice. However, I wouldn't be too harsh on the pre-meds who are scared of doing so. A lot of this is largely a social phenomena and has to do with pre-conceived ideas of what medicine is as well as a general fear of dying. A gentle education and encouragement seems like the best approach.
 
Hey, as some know I was a Hospice nurse for 9 years, we had great volunteers, and I have suggested to many premeds to volunteer for Hospice as patient contact and volunteer hours, why are so many so negative about this suggestion? I mean what do they think becoming a Doctor will be like? People get sick and die in the hospital setting, doctors loose patients and I guarantee that when they get to clinicals then residency they will have patients die and they will be faced with this, why not start where they can have a lot of support and begin to understand life and death dynamics? I always felt Hospice was rewarding not to be shunned as some have posted to me.
I think it's because most of the premeds are shallow, vapid and only interested in things that result in immediate gratification. Most of the premeds I know are unable to appreciate the more subtle rewards of working with palliative care patients. Combine that with a lack of direct knowledge of what palliative or hospice care really involves and you can see why people tend to have less than stellar ideas about it. This is why I believe you're experiencing what you are.
 
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Thank you, I posted this for the second time here but as a new thread to stir the debate, because Hospice is such an important part of medicine that gets ignored until recently, even the US Gov has made it an Initiative, you see the US Gov has found that the most costly part of care comes in the last 6 months of someones life and that not only useless tests and procedures are performed but people do not have a good life for that last 6 months.

Now I have a belief it should be extended to the last 12 months, WHy? education for patient and family. The Hospice visits can be few in the begging starting a relationship that gets built on trust and the Nurses on the case get to know the person, then care can be rendered well and at a lower cost. It gives time to work out family issues so more can die at home with loved ones. I have personally been in cases for 8 to 10 months and this was very possible, it did work this way, people went to the hospital less and costly procedures avoided.

Hospice is about life and how the last days are concluded with dignity and without too much discomfort, I will work with a Hospice as a FP in a few years.

I will continue to spread this word and work with premeds and encourage volunteerism since I think this is a great experience for anyone wanting to be a Doctor.
 
I'm about to apply for a position as a hospice volunteer soon for just that reason. I've never really been around anyone who was dying expect my grandfather and I want to experience of dealing with death that isn't directly linked to me personally and of helping their families deal with it:)
 
Hospice is about life and how the last days are concluded with dignity and without too much discomfort, I will work with a Hospice as a FP in a few years.

I think that is a wonderful quote: "Hospice is about life..."

Best of luck with the FP and hospice route. Perhaps I'll join you with some psychiatry skills....:)
 
I've been volunteering at a hospice for over a year now and I can say that it has been one of the most rewarding experiences I have. There's a lot more that you learn from volunteering than just learning how to cope with death, though. I think that's what a lot of other pre-meds get caught up on--the death of the patients. Although I feel more comfortable with end-of-life issues and bereavement than I was before, being a friendly visitor at hospice has done so much more for me. I really feel like I can empathize ("Not just sympathize!" is what they tell us) with others better. My social skills with older generations have definitely improved, too. I now know how to enjoy a good relaxing conversation, even if no one actually says anything.
 
I agree with many of the comments posted here. I was a hospice volunteer for 6 years before med school, and feel that hospice "work" was probably the single best experience to prepare me for residency so far. Few patients actually die on hospital service, but the skills you learn in hospice are useful with almost every patient.
 
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Hospice volunteering is a great way to see an important part of medicine before entering medical school. I was a hospice volunteer for several years before I went to med school. I would recommend this type of volunteering to anyone that is considering going into medicine. Death is an integral part of medicine and you have to know how to deal with it.
 
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Just wanted to let you guys know that as a premed i've taken your recommendations to heart and have begun my hospice volunteer training.
 
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A long volunteer History ( like a year) stands out in the Premed Application and you could also get your shadow experience from the Hopice Doc too ( many are FP or IM Docs and practice outside of Hospice.
 
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I believe another reason hospice volunteering might be viewed negatively is due to ignorance. Soooooo many people a misinformed about what hospice really is. Many people think it's somehow related to PAS etc. Another thing is that many hospice patients are elderly and sadly, a lot of people don't want to have anything to do with this population, and thus miss out on a very rewarding experience.
 
I am at this minute leaving to go to an interview for a volunteer position at a hospice. I really enjoyed reading your opinions about the benefits of volunteering in hospice care, and I am sure I will get a good experience out of it. Thank you!
 
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For premeds, volunteering for Hospice probably doesn't seem as interesting as seeing weird cases and cool procedures in the hospital ER. Not that many people are really aware of what Hospice is, and as a result, the premeds don't see what a valuable growth experience it can be to volunteer there. Then there's the heaviness of death, which can most definitely be a difficult thing to deal with when you're a young person (or anyone really).

I was fortunate enough to recently meet a doc in Hospice, and from a medical student standpoint, that experience made me think about death and patient/doctor interaction way more than the video we saw in class about the subject. I'm actually thinking about volunteering at our local Hospice when I return to medical school in the fall.
 
I (pre-med) will be starting hospice training for several weeks to train to get more patient contact.

How do you suggest I get the most out of this experience? What are some of the things I should look out for?

Any help would be appreciated.
 
I just got done talking with a doc in hospice and he really got me thinking. So many different ways of looking at peace, death, etc.
 
Wow oldpro, you REALLY got me interested in this. I'm going to find more info on it. Seems like a very noble thing to do.
 
I've worked as a volunteer for two hospice organizations. One was general hospice (I'll just refer to this position as plain ol' hospice from here on), the other was specifically AIDS hospice. Both organizations stood out in the same way...they both had extensive training programs before placing workers with patients.

Hospice training was intense. It was conducted over the course of two weeks, about 24 hours total. We met and listened to hospice supervisors, hospice workers, patients, and doctors. We got to ask questions of patients who were in the terminal stages of their disease, and we got to ask questions of doctors who deal with terminal illnesses often. We attended a seminar on different cultural and religious approaches to bereavement. We laughed, we sang, we cried. Most importantly, we were better prepared.

My training for AIDS hospice was similar, altho less intensive. It lasted a weekend, about 12 hours total. We learned about the disease, we learned about what it means to live with the disease. We were trained not only by workers, but by some workers who were living with the disease themselves.

In both hospices, I learned much. I worked with all sorts of patients, some who were parents, some who were completely alone in the world. I made some good friends, most of whom are gone now. I got to see firsthand how hard it is for a mother of twin 7 year old girls to prepare her family for her passing. I went above and beyond for her (and broke a rule or two in the process)...I did so much research at my local University about her condition, I think I spent about 50 dollars in printing fees that weekend. She eventually succumbed to her illness. It was all part of my learning process...learning what it means to let go. It's not easy, but it can be good. I guess that might be sort of hard to understand unless you've been there, what 'good death' means.

I think what Dienekes said is probably pretty right on. Most pre-meds are young and all they know is that they want to be the smartest and the best. Most, not all, but most of them haven't yet reached the point where they're able to comprehend what it means to truly care, to be there for someone to the last moments. And as thedelicatessan so accurately stated, death is not the easiest subject to immerse yourself in. It is a heaviness, most definitely.

I've done a lot of volunteering in my life, quite a bit. But I can honestly say that my hospice experiences were some of the most meaningful and educational. Volunteering in hospice, as well as in geriatric care, can be invaluable rites of passage. And like Azadi said, you learn how to just be there for someone. Sometimes that's all that's needed, just someone to be there.
 
I (pre-med) will be starting hospice training for several weeks to train to get more patient contact.

How do you suggest I get the most out of this experience? What are some of the things I should look out for?

Any help would be appreciated.

Not sure if you're asking for help with the training process or with the volunteering. In terms of training, you'll probably have a range of activities from lectures on HIPAA and hand-washing (zzz) to conversations with other members of the hospice team (nurses, aides, chaplain, etc.) and some self-introspection activities. If your training is good, you'll be told everything you need to know; there's not really anything to "study" for. You might ask your trainer for a bibliography on end-of-life issues and do a bit of reading (I know of a couple of memoir-type things written by volunteers, as well as the more intense stuff by Kubler-Ross, etc.). The thing about hospice is that there's only so much you can do to "prepare" yourself. Every patient you see will need something different from you, and often even the same patient will need different things from day to day. It's just not predictable. The most important thing may just be to learn/remember to be open, flexible, responsive. The focus has to be on what you're giving to the patient, not on what you're getting from the experience.

As for volunteering itself: what you do will depend to some extent on the census of your particular hospice--how many pts, what types of illnesses, what stage of the dying process they're in. Probably best to let your vol. coordinator guide you at first in the selection of patients to work with, in part because some pts come on to the service with very specific needs/requests/challenges and the VC, with feedback from the rest of the team, will be best equipped to make such assignments. If you have the opportunity, though, I'd recommend trying to get a variety of experiences within your comfort zone. You could try to get assigned to patients with a variety of diagnoses (cancer, dementia, ALS, whatever). Try older adults, people closer to your age, peds pts. Try working with pts whose prognosis is closer to the 6-month mark so you can develop a longer-term relationship; try vigil service with pts who are actively dying. But keep your mind open. Some encounters might be disappointing. You might feel at times like you're not really being helpful. At other times, you'll perhaps have profound experiences. Congrats on the decision to volunteer with hospice; I hope it's as wonderful for you as it has been for me.

NYM
 
Personally, I don't recommend working with peds patients until you've either a) had some extensive training, or b) you've had a bit of experience. Dealing with the death of a child can be pretty traumatic, and it's not for someone who isn't well prepared.
 
Personally, I don't recommend working with peds patients until you've either a) had some extensive training, or b) you've had a bit of experience. Dealing with the death of a child can be pretty traumatic, and it's not for someone who isn't well prepared.

You're right; my bad. And as far as that goes, there might also be extra challenges connected with patients who are the same age as a volunteer or the volunteer's close family members (parents, siblings, etc.).
 
I'm only saying because I volunteered in peds ICU when I was in my early 20s, and after losing 2 patients, I was a wreck. I partially blame the lack of training we had, it was only about 4 hours long and then they threw us in.
 
Not sure if you're asking for help with the training process or with the volunteering. In terms of training, you'll probably have a range of activities from lectures on HIPAA and hand-washing (zzz) to conversations with other members of the hospice team (nurses, aides, chaplain, etc.) and some self-introspection activities. If your training is good, you'll be told everything you need to know; there's not really anything to "study" for. You might ask your trainer for a bibliography on end-of-life issues and do a bit of reading (I know of a couple of memoir-type things written by volunteers, as well as the more intense stuff by Kubler-Ross, etc.). The thing about hospice is that there's only so much you can do to "prepare" yourself. Every patient you see will need something different from you, and often even the same patient will need different things from day to day. It's just not predictable. The most important thing may just be to learn/remember to be open, flexible, responsive. The focus has to be on what you're giving to the patient, not on what you're getting from the experience.

I've recently just gone through the hospice training and we did pretty much everything you mentioned. Your comment about there only being so much you can do to "prepare" yourself is reassuring. I am going to be scheduled to meet with a patient for the first time in two weeks. Volunteering as a "companion" seems sort of intimidating at the moment, but I am hoping I will be able to help and get something out of the experience. Your advice about being open, flexible, responsive and focusing on the patient rather than yourself seems very good.
 
I'm not sure I entirely agree with musicologist. I think while it is important to be able to focus on the patient, you are obviously doing this to take something away from the experience, and you shouldn't feel bad about doing so. I wish more clinicians spent time with dying patients, if not for the patient's benefit, then at least for their own, so that they can see what it's like and learn how to respond appropriately and be compassionate. So many don't, to the detriment of patient care.

Also, about what dying patients "need" from you - don't think of it as you actively doing something that they need. I often find that a calm, quiet presence is what the dying need, and nothing more. Occasionally, they will ask you to listen to them, and you should be ready to spend alot of time doing just that - listening, or listening to the family.

I agree there is not much you can do to prepare for this, other than take stock of your own personal attitudes & beliefs about dying and see how that compares to the reality. good luck
 
So far volunteering at a local hospice has given me mixed emotions. My first week I met with a patient. We talked for a while and I planned to visit with him the following week. When it was time for our next visit I drove up to the facility armed with knowledge of his interests and generally excited for our visit. When I arrived one of the nurses told me he had passed away this morning. I'm definitely sticking with it, but this position seems very difficult emotionally. It was so surreal because although he was on hospice, he seemed so alive the previous week.

Does it ever get better?
 
Quick question. Would it make a difference to volunteer at a nursing home as opposed to a hospice? I'm not 100% sure of the differences between them, if any at all. I have a nursing home practically within walking distance of where I live and a hospice about 20 minutes away. The time difference really isn't a problem, I'm more just curious.
 
So far volunteering at a local hospice has given me mixed emotions. My first week I met with a patient. We talked for a while and I planned to visit with him the following week. When it was time for our next visit I drove up to the facility armed with knowledge of his interests and generally excited for our visit. When I arrived one of the nurses told me he had passed away this morning. I'm definitely sticking with it, but this position seems very difficult emotionally. It was so surreal because although he was on hospice, he seemed so alive the previous week.

Does it ever get better?

It's kinda expected given that they are in stage. However, it is much worse when you finally develop a good relationship with them. My patient right now looks pretty lively... relatively. We get a long really well. Heck, she even gives me her biscuit at lunch! I don't know how long she has left which makes me feel kinda insecure. I don't like being rematched with someone. Though, it does get better if you sort out your thoughts well enough.
 
Quick question. Would it make a difference to volunteer at a nursing home as opposed to a hospice? I'm not 100% sure of the differences between them, if any at all. I have a nursing home practically within walking distance of where I live and a hospice about 20 minutes away. The time difference really isn't a problem, I'm more just curious.

It doesn't really matter. I volunteer at a nursing home through the hospice network. The volunteer coordinator paired me up with someone in the nursing home. So, my guess is yes they are the same.
 
Quick question. Would it make a difference to volunteer at a nursing home as opposed to a hospice? I'm not 100% sure of the differences between them, if any at all. I have a nursing home practically within walking distance of where I live and a hospice about 20 minutes away. The time difference really isn't a problem, I'm more just curious.

There are differences. Both will help develop great communication skills with patients, but the experience at Hospice will be decidedly more emotional since dying patients are the norm instead of a relative exception. Nursing home patients tend to be more stable medically whereas you'll see a variety of patients that have just come from surgeries, failed chemo, rare terminal illnesses, etc. in hospices.

My experiences getting to know and understand dying patients by volunteering over the last three years (as well as dealing with the "hands-on" challenges of changing incontinent patients and dealing with gruesome sights & smells that accompany many patients) have been incredibly formative and valuable. I had to learn to be able to connect with a patient on a personal level and be able to disconnect two weeks later as I helped with their post-mortem care.

I'd highly recommend the hospice, but you will get a lot of either.
 
So far volunteering at a local hospice has given me mixed emotions. My first week I met with a patient. We talked for a while and I planned to visit with him the following week. When it was time for our next visit I drove up to the facility armed with knowledge of his interests and generally excited for our visit. When I arrived one of the nurses told me he had passed away this morning. I'm definitely sticking with it, but this position seems very difficult emotionally. It was so surreal because although he was on hospice, he seemed so alive the previous week.

Does it ever get better?

Yes, it does.

You'll find a balance between finding meaningful friendships and learning to keep a clinical attachment. The first couple of deaths of patients that you have spent a lot of time with will be the toughest, but you have to always focus on the positive; you were able to provide companionship and a listening ear in their final days which they might not have had otherwise. This is one of the most precious gifts you can give anyone.

I find it helpful to watch how nurses and CNAs interact with patients. Some use (sometimes offensive) humor about their work as a means of protection from too much emotional involvement. Others are rather reserved or even callous. IMHO the best will still connect at a personal level - even to the point of crying after a patient's death - but are able to deal with their emotions relatively quickly and move on to the needs of their other patients. That last part is the hard part.

Try talking with a nurse, a more experienced volunteer, or someone else you confide in about your experiences. Often, you'll feel better just letting it out.
 
Hey everyone,

I have been a hospice volunteer for about 6 months and have been going 1-2 times a month. My time in the nursing homes is almost exclusively sitting down and talking to the patients and seeing if they need anything. I got into it after my grandmother passed away. She spent her final month on hospice.

All that being said, I do not feel like I am doing a good job as a hospice volunteer. I mean I go to the nursing homes every time with the intention of brightening the patient's day and having a good conversation, but so far in my experience (with three different patients) I can't really tell if the patients even want me there. One of them was very friendly but couldn't really communicate so I didn't know what to do....any advice for how to spend time with a patient who can't really focus or talk when I don't have any other critical skills to provide? Also, two of the patients seemed like they didn't really want me there. I think it may have been pride or they felt like it was beneath their dignity...those are just guesses, I don't really know.

Anyway, the reason I brought all this up was to see if anyone had any advice on what I should do or how I could make my visits more beneficial to the patients, or if anyone could simply say that they experienced the same things and that a lot of times the quality/type of interaction just depends on the patient.

Is it possible that my experience is like this because I am a young male visiting male patients? Maybe female patients talk more....I just want to help and I'm not sure that I am.

(Sorry for the rambling)
 
Man, I am in the EXACT same boat. I'm a 24 year old, energetic guy and always try to seem upbeat and excited. It's definitely obvious that not all of the patients there are wanting that. I have been volunteering for about a year but have somewhat spotty attendance because I do get discouraged by the vibe I get from some patients.

The only advice I can give is just to allow the independent patients their space. Some others are more than happy to have someone to talk with and have some very good stories to share. No matter how hard you try, you cannot bring flowers and sunshine to every patient all the time. If you want to be a doc, you better get used to that.

Good luck!
 
i've really enjoyed this thread and would love it if any one else has advice or experiences to share.

I'm actually a veterinary student but my dog and I were just certified through TDI as a therapy dog/handler pair and we are starting at a hospice next month. I'm really looking forward to it, but also a little nervous. Any thoughts or suggestions or experiences (particularly those involving experiences with or thoughts about canine partners) would be greatly appreciated!
 
Oh man, we had one volunteer bring her dog in and the patients/families LOVED it. Hopefully, your dog has the demeanor to let a bunch of strangers pet it and crowd around it.
 
I volunteered in a hospice as a premed and medical student and felt it was very valuable for the reasons you spelled out. It is natural for people to feel uncomfortable with this type of work. I certainly was, but I've always been of the mind that I should get more experience in the things I was uncomfortable with.
 
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Hi,
I am a Dentist " new Grad" and I'd love work for hospice, volunteer.
Anybody knows how? I live in southern california.
Thanks
:)Moje
 
Not to be snide, but as a native Orange Countian, I'd say that (depending on how you slice it) at about 10,000 square miles Southern California is a pretty big place populated with over 22 million inhabitants. So, giving a location as Southern California is pretty vague. I'd say because of the sprawl, it's arguably even more vague than saying something like, "I live in New York City."

In any event, knowing only what was given, here go some first-pass leads:
Los Angeles Hospice
San Diego Hospice and The Institute for Palliative Medicine

I searched by location and "hospice" using this VolunteerMatch search tool:
and came up with these others as a start:
Odyssey Hospice, Riverside
St. Michael's Hospice, Irvine
VNA & Hospice of Southern California, San Bernardino

Etc., you get the picture.

Cheers!
 
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