Originally Posted by All_Smiles_RN
Can you give me an idea of how a typical day might go for someone who is a hospice case manager? The setting would be visiting pts in various nursing homes. Any info at all would be appreciated. Thanks.
I work for a Hospice that has been established for many years in our town. We have home care and we have contracts with nursing homes, and we provide all four types of hospice care (routine, inpatient, respite, and continuous care).
There are hospice regulations that you need to be familiar with and understand, but basically this is how one of my days goes:
My hours are from 8:30am to 5:00pm but I am salaried, so if my job requires me to work a little longer, I'm still paid the same.
My case load runs between 10 and 14 patients. I have some who are cared for in home by family or paid caregivers, and some in the local nursing homes.
Acuity is based on the patient's condition, that is: co-morbidity of symptoms, how well they respond to pailliative treatments and medications, and how fast they decline. Our agency lets their case managers set their own pt-visit ratios. For instance, if I have a patient who is actively dying, I would visit them more often, even daily if the family needed that much support. (Usually they do.) In the nursing homes, you must make sure that the two charts match (yours and the nursing home...the orders, notes, etc.) Also, invite the staff to your IDT meetings, and attend their careplanning meetings. This requires effort...because sometimes times vary.
I usually do between 3-5 visits a day, and that will take up my eight hours with: travel, contact with MD or absent family, followup phone calls to patients and family seen the day before, documentation...etc.
Being a hospice case manager means that you are responsible for coordinating all the needs of the patient: if you recognize needs that the SW, chaplain, or volunteer can meet, pull them into the picture, don't try to be all for the patient...that's what being a team player is about. You also have to be a self-starter, a dependable worker, and an organized nurse to keep up with all the things that go on every day. But every nurses' job requires that!
I hope this helps you a little.
Jen
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