[CaringRN1234]

I am a new "member" but have been reading posts for a long time. I have worked for a local hospice for 1.5 years now and I love hospice nursing. I feel like this is what God has called me to do. The problem is the company I work for. All they seem to care about is "census"!

We have had 3 administrators, and 1 Don since I have been there (she was fired). Now it is just myself and one other nurse with a census averaging around 25 (no DON since Feb). We are expected to stay at the office after we see our patients. Found out last week that our administrator is leaving. Back to square one.

I have been trying to help our administrator with DON stuff. I actually was offered the DON position but decided against it b/c of the way the company handles everything. I know I would be setting myself up for failure.

I just wonder what other people do as far as office time. Are you expected to sit in the office after your patients are seen, until 5 pm? I feel like this is really wasting my time and productivity as there are so many interruptions and distractions I get absolutely nothing done in the office.

I am bringing stuff home all the time or lately just letting it all get further behind because all my energy and motivation is zapped. (Not for my patients care but just for all the rest.)

I would like to know how you guys handle office work, recerts, followup phone calls (in your car, in the office, at home?), etc. I feel that I need to start setting some new boundaries with our company. My hubby told me today I am totally absorbed with work all the time. I have a precious little girl age 5 she has to be my top priority.

Thanks for listening.

[RNKittyKat]

Sit in the office till 5pm? What's the purpose of that? Other than required meeting attendance, we have no such mandate.That's childish... unless they're keeping you guys in the bull pen kind of like a relief pitcher ready to send out in the field maybe? But that's what cell phones are for.

I'm at the work of setting boundaries myself just now. It's head butting but I'm making a little bit of leeway. One small step for man, one giant leap for mankind kind of thing. And I'm doing a little bit of adjusting how I work my schedule. I'm getting out very early in the AM now, making my first visit at 7am. That's the target. That way by noon I've made around 5-6 visits leaving the rest of the afternoon for paperwork, do a recert or to sit with a dying patient. I could even head home if there was nothing brewing and finish my paperwork at home. The goal is to be done by 5pm whether it's visits or paperwork. This way I don't have to worry about doing paperwork at night or on weekends. I try to make phone calls during my visits to get them out of the way. So far, so good.

Don't let anyone tell you you're not a caring nurse because you don't want to over extend yourself. The implication might be there. It's pretty common in this kind of work. The "it's a philosophy" or "it's a lifestyle". Read between those lines. Translation: you have no life of your own anymore. It's a prescription for burnout. I want to do this for many years. Setting boundaries is the only way that's going to happen. This will never be 9-5 work to be sure, but some structure is in order to get it as close as possible.

I wish you much luck.

[Hospice Nurse LPN]

I usually finish seeing my patients between noon and 1 p.m. Then, I'll have lunch (either out, but usually I'll have a sandwich at the office). We get off at 4 p.m., so I use my remaining time making follow up phone calls, writing notes, ordering meds, etc. I simply REFUSE to take work home (unless it's my turn for call).

[tencat]

You've got to set some boundaries for yourself. I try really hard not to take any paperwork home with me. I keep my phone off at night unless I'm on call. It's the only way I can last in this business. It is consuming, but where I work we're all a team, and I trust the nurse on call to do a good job for my patients if they need to call in during the night. I work with some nurses who feel like they need to be on all the time, regardless. I can't do that and last.

[renerian]

I feel bad for you. Basically you are covering for other key people/leaders in your agency when the roles are vacant. I assume you were named Interim DON? Someone needs to be named in an interim role for safety and to meet regulatory requirements.

I hope your situation gets better soon,

renerian

[Wren]

Caring...I'd consider another job FAST if you have other hospice options in your area. It doesn't sound like your company is likely to change and you will only continue to burn out with your high case load and lack of support. But to answer your question...like another poster I always avoided taking paperwork (or computer work) home so I tended to stay in the office until I was caught up. But it was always at my own preference, not a requirement. If too much was going on to work at the office and I didn't need to make calls, I sometimes went to a favorite restaurant and charted.

You must take care of yourself (and your family) first or you won't have the inner resources to be there for your patients. Take care and good luck!

[AtlantaRN]

"
I just wonder what other people do as far as office time. Are you expected to sit in the office after your patients are seen, until 5 pm? I feel like this is really wasting my time and productivity as there are so many interruptions and distractions I get absolutely nothing done in the office.

I am bringing stuff home all the time or lately just letting it all get further behind because all my energy and motivation is zapped. (Not for my patients care but just for all the rest.)

I would like to know how you guys handle office work, recerts, followup phone calls (in your car, in the office, at home?), etc. I feel that I need to start setting some new boundaries with our company. My hubby told me today I am totally absorbed with work all the time. I have a precious little girl age 5 she has to be my top priority.
"


God bless you. I can so relate... I'm expected to work (they say 40, but it's more like 45-55 a week), when I'm done with my visits, i'm supposed to go back to the office and do paperwork (I don't have a computer at work, so I go home and work...). Manager wanted to "talk with me about my hourly expectations"...she had no idea I was working up to 55h a week. probably because she is late on monday and usually is gone by 12 noon on friday, as she has a vacation home in a neighboring state... Also, I take 10-12 days call from 5p-9a and then 24 hour call is one the weekend days.....

You need a break.

I've decided as a corporate representative will be in the office tomorrow, i'm ready to give my notice unless goals are clearly stated with administration. I have an administrator who is an RN, but wants to sit behind the desk and delegate everything. Now, we only have a census of 12 patients, so we don't have the staff or additional resources to have someone sit on her arse behind a desk (roughly 32 hours a week). Burns my butt that I work so many hours, and the other salaried persons show up late, and NEVER work 40 hours.




Hope it gets better for you. I am learning to set boundaries myself. With lots of prayer sent your way....

Linda

[indianahope]

OP: I'm so glad you brought up this topic....I've been at it 7 years now and have done poorly at setting limits and am now also facing burnout.

It's kind of crazy...we have had inservices about burnout and what to do to avoid it, but when we start to try to set limits management really doesn't like it.

Missed personal appointments scheduled well after the time I should be off work when I've been sent out to make visits, etc. are occuring more frequently. As a result I end up getting home late, too tired to cook so we eat out..then it's late and so I don't exercise or walk..then I'm resentful and don't sleep well...around and around. Then the next day at work I hear from management: "You were out late last night so you have to leave early today" (so they don't have to pay overtime). It's pretty sneaky, in a way, not to use the on-call nurse in that situation because she would get time and a half for on-call visit. They're smart enough to send a nurse not on call then make him/her leave early the next day. Heck, they don't even do comp time right. We really should get comped at time and a half, but we don't.

This week rather than go back to the office after my visits I drove to a nearby park and sat in my car and did charting/phone calls. Got way more done than I would have back in the office. It was wonderful. I've decided to stop checking my voicemails after I leave work. Not doing too well with this one, but I'm going to keep trying. I'm going to stop answering my home phone when I'm not on-call. I'm not sure What I will do the next time I'm not on-call and they ask me to go make a visit 15 minutes before I'm supposed to go home.

I've been told by some of the other nurses to say, "I'm sorry, but I already have plans at such and such so it won't be possible for me to do that." In other words, no.

We are expected to attend bereavement services several times a year to support our families...a couple of hours here and there at no compensation. I do lot's of job-related research on the computer at home at night...It is rather insidious how all-consuming this job can become. (if we let it)

When I reread my post I'm astounded and almost embarrassed at how angry I sound and almost erased the whole thing but maybe it needs to come out. Seeing it in print really makes me realize that changes must be made if I am to continue... It doesn't feel good to be this resentful and I want to function at my best, profesionally.

And, I want my life back, to some extent. I miss my old hobbies. I miss my friends. I'm sure my husband is sick of hearing the same old stuff every day....I've become such a whiner!

Anyway, I wish you the Very Best and hope you are able to make some changes before it's too late. It sounds like you really like hospice nursing and it would be a shame to lose you. I hope you will post back and let us know how you are doing.