I am in southern New Jersey, covering 2 counties (both pretty large counties). For the most part the patients are split in 2 teams, sort of. My mileage runs from 50 to 100+ a day, according to where I am going. And that does not count the miles it is to the office, and the miles after my last patient. I have been in hospice for almost 3 years, been a nurse for 24 years and although I sound like I am complaining, I know it is a much better fit for me then long term care. As an Rn in long term care, I DID get burned out 2 times due to the awful demands of residents, families, paperwork and keeping the administration happy. I found it was impossible to do all that was demanded without taking more shortcuts than I was willing to take. And since I had quit nursing 2 other times, only to go back to be burned out yet again, I looked at hospice. I can use most of the skill set I had from LTC, but have the one on one contact with patients and their families that I want. And I had wanted to do hospice nursing for a long time. The opportunity came up, so I jumped at it.
Now, Tewdles, I have a question for you. What would the "US national standard number of hospice patients" be? Or where could I find that information? We are told by corporate that we should have 15 to 19 patients as full time case managers. I have been at or over 20 for it seems like months. This weekend was not a good one for us...6 out of 80 patients passed, in 2 days. So now I am at 19. That sounds manageable, 4 visits a day, but it never works that way, as we all know. And now the office is trying to demand we take a half hour lunch break. And don't understand that I really don't want to...that means I get home a half hour later then I do now. (8:15 tonight as I had paperwork to finish for team meeting this week), and if I want to eat lunch, I have a sandwich while I am driving (as that is usually 1.5 to 3 hours a day).
I will say that there are 2 things I stick to my guns about and I learned these things after about a year of working in hospice. My cell phone goes off the second I am done for the day, (and is never on for weekends) and I will NOT take paperwork home anymore. At least 2 of the case managers have their cell phones on at all times, and seem to encourage their patients to call them in the middle of the night, insead of the on-call number. I will not do that. We pay a nurse to do on call, and if she is stumped (which almost never happens) she has our home numbers. It has gotten so it seems to be expected that instead of doing paperwork in the office and putting it on our timesheets, we should take it home to do on our off time...it is never openly encouraged, as that would be very illegal, but we are constantly being reminded that excessive office time impacts negatively on our "productivity" numbers. I say fine, as when I am in the office there are always others there and it is known that I don't fool around in there, I am there to work, if you want to have a personal conversation with me, lets go out for a quick ciggie! Then it is back to work!
You thoughts would be greatly appreciated.