On-call hospice nurse
- 0Jul 31, '12 by lwheatleyHow are after hour and weekend responsibilities structured in the hospice agency you work in?
- 4Aug 4, '12 by jeannepaulI am an on call nurse, hense the hour I am writing this. I start Friday at 5p and go until Monday morn at 8a. I also have a case manager backup and either a social worker or chaplain on call also, along with on call hha's. the calls come into our triage service and if they cannot answer question or a visit is needed, they call me.
I used to do everything and only use my backup if I was with a pt and a visit was needed, but I found myself working way too many hours straight without a break, so now I will divide visits up on Saturday morning so I am available to do the admits and whatever else comes in. I try to get a break in the evening to ensure I am ok for the night. I will use the sw/chaplain to do hospice 101, and consents to free me up for visits also.
I have also worked for a large hospice and we had 4 full time on call nurses and we rotated getting calls or went to the patients closest to us.
The only thing I REFUSE to do is both triage and visits. There is no way you can take calls and make visits at the same time. You will not get any sleep, it is dangerous on the road, plus what family wants you to be answering calls while you are with them. I will quit before I ever do it again. It almost killed me.
- 0Aug 21, '12 by nurseinmojeannepaul what is the census of the hospice you work for? I just interviewed for a job that sounds a lot like what you are doing. I was told they would pay an hourly/salaried rate for the time and a per visit "bonus". The current census is 47. With that, can I expect to be pretty busy?
- 1Aug 25, '12 by jeannepaulwe have about 90 pts right now. A per visit bonus sounds nice. I don't get anything except my regular salary unless I work during the week helping out then it is 60.00 per visit. they also pay 100 for admits but that is not worth my time to do, it takes way too much time to do them start to finish properly.
- 0Oct 4, '12 by angelcat70New to the board so this is my first post. I am a full time on call nurse for a small non profit county hospice. Patient load 30 to 40. I am on call 98hrs a week (get paid for 40hrs/week salary - I have yet to work actual 40hrs - 24hrs on Sunday and 16 hrs a day Mon thru Thurs. Another nurse takes Fri and Sat with same back up. I have a social worker on call, case managers and nurse management share back up duties. I am responsible for triage and visits if necessary and after hour admits. The case managers I work with are awesome and try their best to take care of issues before call starts. I have learned to utilize the team, understand that you can't do it all and delegate accordingly. If the feces is getting ready to hit the fan make sure your back up is aware they may be needed.
- 0Oct 11, '12 by CIL1969RNCounting my BLESSINGS I am the every other week call nurse. 5p to 8a M-F and 24 sat and sun. Get paid for 80 if I go out once or a thousand times. I get OT if I do anything my week off. Census of 40 at present with some really good case managers. Only out once this week with 2 phone calls for tuck ins.
- 1Aug 6, '13 by LookUp2SkyHi HillieRN - I totally understand your concern! I was the first, full-time, on call nurse hired with a not-for-profit agency, with a census in the 50's. No rules, no boundaries, no back up, etc. After over 1 1/2 yrs, I am still there desperately, diplomatically trying to make them aware of the "potential" harm in not providing a back-up. Mostly, it will be the patients who might suffer. We serve a huge geographic territory, with one-hour minimum between some patients. In hospice, family members are not happy with that type of response time, and no matter how diplomatically you try to explain that you will be there as fast as possible (because of no back up)...they perceive it that someone else is more important than their loved one.
I work 7 on and 7 "off." It is straight salary for 5pm Friday straight through until Monday morning, at 8am...back on Monday night at 5pm until 8am Tuesday, etc., until Friday morning, then supposedly "off 7." However, they want me at team, weekly, mandatory inservices, etc on my "off" time, with no additional pay. It consists of 123 hours of on-call, 63 straight hours for weekend. So, even though paid for 80, I am available (or reserved) for 43 hours over the 80 hours I get paid for.
I am not a quitter, and continue to diligently/gently take suggestions to them, which have to go through corporate, but am not sure any adjustments will be made I do admissions, deaths, triage, lab work, respite visits and on-call visits...all for one small salary. I guess I'm thankful to have a job, but most thankful to have "riches of heart" in working with hospice patients.
Long story/response later-lol. Yes, it's quality of care/patients that suffer when there is no back-up. Feasibly, it is not possible for one person to do the work after hours, that it takes a whole team to do during the day/week. "There is no "I" in team."