On-call hospice nurse

Specialties Hospice

Published

How are after hour and weekend responsibilities structured in the hospice agency you work in?

I am oncall hospice

full time, no help, progressively given more admits, barely sleeping, burnt out.

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My hospice has an "on call" team so the case managers truly are "off" at 5 pm (at least in the sense that they do not need to respond to patient calls or do visits). On-call nurses have regularly scheduled shifts. It is pretty much non-stop except between midnight and 7 am, so nurses are paid by the hour. The midnight-7 am nurses are paid by the visit, $110-$160 depending on the length of the visit.

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Specializes in LTC, Hospice.

We have an on call nurse from 5pm Friday to 8am Monday, myself and the other LPN are responsible for our own patients during the week.

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We have a census of around 150, up from 60 when I started 18 months ago. Our patients can be up to 90 minutes apart from one another.

We have a weekday on-call nurse, salaried, who works M-Th 430p til 8a with a case manager on call as backup. I work Fri 430p-Monday 8a, on call all 64 hours, salaried. I've never had to triage and we've always had backup(s), as our agency places a high value on rapid response time (max 60-90 min). I love that we are able to give our patients that kind of attention, and I'm sure it's the reason we've grown like we have. We are currently hoping to add a second "me" - full time weekend RN - to our posse. Right now our case managers serve as backups during the week, with two backups rotating call with me every weekend.

Our after-hours times can get pretty crazy, long days and long drives, but even so, everyone from triage nurses to managers on call are passionate and dedicated. I've always sensed our entire team is committed to excellent patient care, and it's awesome!

I can't personally imagine doing triage simultaneously or working without backups: I'm spoiled! ;)

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Specializes in School Nursing.
We have a census of around 150, up from 60 when I started 18 months ago. Our patients can be up to 90 minutes apart from one another.

We have a weekday on-call nurse, salaried, who works M-Th 430p til 8a with a case manager on call as backup. I work Fri 430p-Monday 8a, on call all 64 hours, salaried. I've never had to triage and we've always had backup(s), as our agency places a high value on rapid response time (max 60-90 min). I love that we are able to give our patients that kind of attention, and I'm sure it's the reason we've grown like we have. We are currently hoping to add a second "me" - full time weekend RN - to our posse. Right now our case managers serve as backups during the week, with two backups rotating call with me every weekend.

Our after-hours times can get pretty crazy, long days and long drives, but even so, everyone from triage nurses to managers on call are passionate and dedicated. I've always sensed our entire team is committed to excellent patient care, and it's awesome!

I can't personally imagine doing triage simultaneously or working without backups: I'm spoiled! ;)

Your company sounds a lot like ours. We have two on call/triage nurses who work 5pm- 8:30am weekdays and 24 hours Sat/Sun. They are on a rotation where they get every other weekend off. The CMs rotate as back up, but it's really rare that backup is initiated.

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Specializes in LTC, HH, ER, MedSurg, Agency, Travel Nursing.

Interesting topic, and good read.

I'm just going into Hospice.

In fact my first day is tomorrow.

I'm the On-Call weekend nurse, 6p Friday to 9a Monday.

On call in-direct is like $5 per hour @ 62 hours and the low end of $35/visit plus mileage @ standard

IRS rate of .56¢.

From what it looks like going by the above, I might have to ask for a raise.

Something I didn't quite understand in my interview though what's the difference between on-call direct and on-call indirect?

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I work in a rural hospice covering two large Western US counties, with a census from 24-40 pts or so. I'm the only on call RN, and I work a week on and a week off. The RN CMs cover call on my off weeks. I get salary but off contract focused visits are $50 per (same as for mandatory meetings and nurses' support group), with $100 for death visits and $125 per admit (agree not worth it d/t time involved, but I do it to help out and be a "team player" when asked--if I'm asked it means they're pretty desperate).

I don't have on call SW/SCC--just me and the admin OC, with an RN two hours away on call for the "mothership" branch, who can triage calls if I'm out of cell range in the mountains or swamped. I handle the psychosocial and spiritual distress AMAP but will call our SW/SCC if clearly needed, like an APS situation or once a son was blocking access to his agonal father while in the throes of a spiritual meltdown.

I love not waking to an alarm and having a week off every other week! Glad to not be a CM and have to keep up with IDG notes.

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I work hospice on-call with a census of 85-120 pts. I am oncall friday 5pm-8am monday am, and 5pm-8am mon -thurs. I have no back up. I triage all my calls, and make all my own visits if needed. On the weekends I get average 25-38 calls with lots of visits. I do this all on my own and often get scheduled "urgent" admits throughout the week. I am usually beyond despair by the end of the week, not just tired. My total hours on call are 123. I am salaried with no bonus or extra compensation for visits or admits.

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I work hospice on-call with a census of 85-120 pts. I am oncall friday 5pm-8am monday am, and 5pm-8am mon -thurs. I have no back up. I triage all my calls, and make all my own visits if needed. On the weekends I get average 25-38 calls with lots of visits. I do this all on my own and often get scheduled "urgent" admits throughout the week. I am usually beyond despair by the end of the week, not just tired. My total hours on call are 123. I am salaried with no bonus or extra compensation for visits or admits.

It is just wrong and abusive that you are treated that way. I can't believe that any hospice administration who treats their staff so poorly, would be conscientious enough to treat and advocate for their pts and families.

I can believe that they might be more about the 'money'

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Specializes in Hospice.

I work for a hospice with a census of about 425. We actually employ "extended hours nursing staff". They are hired for various 12 or 8 hours shifts on evenings and weekends. 8a-8p, 9a-9p, 12p-12a, 4p-12a and 12a to 8a. Generally prior to midnight there is more than one nurse on shift.

The process is that the patient / family calls the main number and the answering service takes the call. The triage nurse is notified and calls the family back. He/She will triage the call and then contact the extended hours nurse as needed. The triage and extended hours nurses are paid the hourly nurse rate visit or not.

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Isnt that against the law? I would think it would be hipaa violation to take triage calls during a patient visit. Also against the law to take calls while driving to a patient visit and try taking notes...very dangerous. What are your thoughts?

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Wow……I was a weekend RN for a hospice (census roughly 160) for some time. I worked 8 hour shifts on Friday and Monday to help the team nurses with overflow and did 12 hour shifts on sat/sun. On the weekend I would visit any continuous care cases, do the first/initial assessment on any admissions, visit anybody that the team felt needed to be checked on over the weekend and help out however was needed. Some weekends that was up to 10 visits, some it was 4. I did have backup but that was one of the case managers who did the Monday-Friday gig. We also had our triage line and triage nurses. The triage nurse took emergency calls and answered those…..however if they got busy I would be their back-up. No I didn't have to do admits, we had dedicated admit nurses.

We cover a fairly large geographic area. 100+ miles days were common. 212 was my record. Management never factors in the fact that it may be a 45 minute drive between 2 cases or that home patients rarely want to be seen at 7pm unless there is a problem!

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