Hospice Inpatient Unit

In reviewing these older postings, I'm getting many answers

Where I worked the ratio was 1:8. One RN with one aide. I can tell you that it could be extremely busy and overwhelming. While the manager was "available," she often wasn't really available. Admits took about an hour. Meds can be numerous. Pain control can take alot of doing. Emotional support takes lots of time. I think a ratio of 1:8 is too much, but "they" (the people who set such standards nationally) think a ratio of 1:12 is reasonable!

Good luck on your interview. Four patients - definitely doable - I have had up to 6 with the help of a 12 hr CNA. There are days on an inpatient unit when you have time to chat with families and patients and feel in control. Then there are days when it seems someone rang a bell and ALL the patients are dying at once and needing hands on care. One question to ask is if there are volunteers available for helping with meals, phones, sitting with patients. Another question is how timely you are able to obtain medications - if you are connected to a hospital that makes things easier. A freestanding inpatient unit can sometimes run into difficulty getting "different" meds. Wish I were in your place - my inpatient unit closed 8 years ago and I moved to another area where we have high hopes of "someday" opening one. I will probably be too old to work there when it finally becomes a reality!

We have 10 beds and 3 RN's.

Somedays, even this staffing ratio this isnt enough.

Dont take the job. You wont have enough time to do anything to your satisfaction. A patient asks 'Am I going to die? What is happening to me?'' and you'll have to say 'sorry, cant talk - got to go.'

You also need to know that what is "planned" is frequently not what happens. As with other areas of health care, a lot depends on the bean counters. Hospice is paid a flat rate for inpatient care and they have to provide staffing within that constraint.

Many assume that since we do not do life-extending care that there's less work involved ... no codes, icu transfers, monitoring, etc.

This is just plain wrong ... almost all of the patients on my unit are total care and often have labor-intensive issues such as diarrhea, agitated confusion, major anxiety or pain issues ... not to mention needy families undergoing an intensely stressful period. Then there are the admissions ... which, in many places, are not confined to day shift. We won't even get into the full code patients ... it happens and seems to be more common as time goes on.

As leslie pointed out, GIP is the icu of hospice care, and needs icu staffing. What we actually get is frequently very different.