[NurseFeelGood2005]

Hi everyone,
I just have a few questions for everyone. I interviewed today for a hospice position in my community. I currently am a home health nurse. Anyways, the position I applied for is a FT non salaried position. Are hospice position normally salaried? or hourly? How do hourly visits work? This may sound like a stupid question, but I am in a salaried position now, I am just confused in how my day would work. Also- in another post I read that an admission could be 7-8 hours of work. Is that acurate? If so, would you only do 1 visit in a day if you did an admission?
Thanks
Chrissy

[doodlemom]

Frankly, you will probably get paid a lot more if you are paid by the hour. There is a reason that businesses pay f/t staff in salary - it saves them $$$. It makes better business sense. I wish that I were hourly...although, the up side of salary is if you get slow and you get to take a few hours off here and there or go to the doctor, you are paid for the time you take off. Our nurses usually do 2 admissions in a day. That can take anywhere from 6-10 hours depending on the complexity. It usually takes around 8 (for 2, including documentation, driving).

[mc3]

Originally Posted by doodlemom

Frankly, you will probably get paid a lot more if you are paid by the hour. There is a reason that businesses pay f/t staff in salary - it saves them $$$. It makes better business sense. I wish that I were hourly...although, the up side of salary is if you get slow and you get to take a few hours off here and there or go to the doctor, you are paid for the time you take off. Our nurses usually do 2 admissions in a day. That can take anywhere from 6-10 hours depending on the complexity. It usually takes around 8 (for 2, including documentation, driving).

I am paid hourly by my hospice because I am an LPN. HOWEVER, when our census increased drastically last year, and nurse left who wasn't replaced, I started putting down my overtime hours. For months. And you know what they did?? Put in my review that I had poor time management skills !!!!!(first time they ever said that, BTW) Never said a word about it for the 8 months I was absolutely killing myself. Absolutely no regard that the case load doubled, and then some.....And this isn't the only hospice that does this - the hospice I previously worked for in a different state made the LPN's salaried so they wouldn't have to pay overtime, either. So, morale of the story? They'll get away with paying no OT to you regardless of whether you're salaried or not.
(can you tell I'm still angry about this? And no, I can't call the Labor Relations Board because I do need to work!)

[boozenurse]

Hi there. I have been working for a Hospice co. now for 2 years. I am paid hourly. We have a nurse specifically for admissions. We are responsible for our weekly visits and of course the as needed visits. F/u's for start of care can run from half an hour for "stable pt's" to 2 hrs for those needing more care. Regular visits run from 20 mins to about 1 hour. Depends of course on pt. need. I have 6 of my 12 pt load that have been on service for 1 yr or more. they are very "stable" and I spend about 20 mins. there. Paperwork runs about 10-20 mins extra per pt. during IDT weeks. (interdisciplinary team meeting with M.D.) Hope that helps.

[rnboysmom]

Might just want to check in with state labor laws, I am fairly certain (in our state, anyway) that a hospice couldn't salary an LPN. Salaried have to be "managing" someone--this is how they can salary RN's as they supervise their patients and health aides and manage the patient care. LPN's can't case manage patients and HA has to be under the direct supervision of a RN--don't know how they would stretch those requirements to salary an LPN as federal regulations are pretty clear about all of this. Just an FYI

[rnboysmom]

No offense here, but OUCH--20 minutes for a hospice visit?
That information, along with the fact that 6 of 12 of your patients have been on service for a year or more, are very stable and require minimal visit time sounds very concerning. I would agree with you that it probably wouldn't require a lot of time to get ready for care conference if your patients are this stable after a year of services.

[doodlemom]

Originally Posted by rnboysmom

No offense here, but OUCH--20 minutes for a hospice visit?
That information, along with the fact that 6 of 12 of your patients have been on service for a year or more, are very stable and require minimal visit time sounds very concerning. I would agree with you that it probably wouldn't require a lot of time to get ready for care conference if your patients are this stable after a year of services.

If half of your patients are on service for a year or more, I would question their appropriateness for hospice services....

[rnboysmom]

I agreee. The hospice benefit is never definite, "6 months or less if the disease process runs it's normal course", but, when 50% of your patients have been on service for a year? I couldn't help but notice that you are form Texas, don't they have one of the biggest CAP's in the nation. What I am implying is that WE ALL have to be stewards of the benefit.

[Passion for the Job]

Everyday it changes, now we are going to computer. I have 7 on my caseload. Some take a lot longer than others to average out the day. We do 6 visits a day, to really do your paperwork appropriately (I mean crossing your T's and dotting the I's, updating your plan of care and reviewing it every visit as we should) 6 visits is too many.