[peace_solace]

Hi all,
I'm thinking of making the transition from home health case manager to hospice triage/on-call RN. Has anyone made this transition? How are the two similar, and how are they different? Is the charting as extensive in hospice as it is in home health? The position I'm looking at is a salaried on-call position from midnight on Saturday to 1 p.m. on Monday every week, being paid for 32 hours. Does that sound like a pretty good deal? I've been a full-time case manager for a home health agency and I'm hoping that maybe there will be a slight decrease in the amount of charting, just because of the fact that it's a smaller amount of time each week that I'm on duty and perhaps fewer visits altogether? Also I've had several palliative care patients in my experience as a home health nurse -- do you think that will help me? I would guess that some of the issues that arise would be similar.

[aimeee]

I would guess that the charting requirements would be less.....as far as whether its fair compensation, its hard to tell. It all depends on how busy you are during that time period. I would ask what the average ACTUAL hours are and also ask if you can shadow somebody during at least a portion of that time period so you can get a better idea of what is required of you. Home health care of palliative patients is somewhat similar. The biggest difference is that if they are really having trouble in home health you can just send them off to the ER but in Hospice, most of the time you need to do whatever it takes to get the situation under control at home because they dont want to go back there anymore.

[hospicenurse]

I agree that the hospice charting is probably a little less than homecare - I've worked both. Some things I would ask about this position are what is the geographical area you would be responsible for? What is the average daily census? How many calls do they average a night? How many deaths in a week? Who are your support people? Do you triage calls and have another nurse or sw to see some of the patients when visits are needed? What is the agency's policy for pronouncements? In my former hospice the nurse always went out and and pronounced. In my current organization it is the SW's on call who go to the home. Will you get mileage reimbursement for your travel? Will you truly just take after hours calls or will you be expected to pick up late in the day admissions or routine visits that get pushed to you? In my experience this position can be a really nice one and the pay is great, or it can be a nightmare if the organization takes advantage of you. So do your homework carefully and get as much as you can in writing.
Good Luck!

hn