Thinking of leaving hospice - page 2

I love my job, I really do. But I am burned out. It's the on call hours. CM caseload of 12-15, call Fri @5- Mon @8 every 3rd weekend and 2 nights a week. My health has suffered and I am tired. This... Read More

  1. by   batsoy1919
    I'm in the same situation you're in stephy. i have been a full time RN case manager for a hospice company for almost 3 months now that over utilizes nurses. Right now my case load is around 20-25 patients. That does not include when a patient needs an initial evaluation, CC visits, emergency visits (which is not in my caseload. They just so happen that they don't have another RN around the area.), and, admission. To top it off the DON had the nerve to tell me that some RNs take case loads of 15 patients per day( almost died laughing). I had to tell the DON that she can find another full time RN who can do that case load they were assigning me. This hospice company that i'm working with Right now have NO regards toward quality of care to patients. It's just all about the money.
  2. by   seawayjay
    Hello...just joined
    I am attempting to go into Hospice here in Austin..the pay seems very low...what is the best company here...My background is 29 years in Critical care, Charge nurse and doing Palliative and end of life frequently in hospital.
  3. by   nurseontheway
    I think that having a work/life balance is essential in our field. I am a new hospice nurse and in some ways I miss my old schedule of 4/10 hour days. We have a weekend on call nurse but are required to take call during the week. I have found that there isn't a perfect job out there and it truly takes a special person to work in this field. I love it so far and can see myself working in hospice for the long run. I also think that you should look for a different company to work for.
  4. by   favthing
    I felt totally taken advantage of in hospice. It was a horrible experience. How sad, as it seems a lot of hospice nurses completely give of themselves...the businesses take advantage of this devotion. I thought is was fascinating, also, how the nurses seemed to compete with each other at the small center where I worked; it was as if whoever gave of their free time and money and energy the most was the best.
  5. by   khooker200
    I am probably leaving hospice after being in it for over 5 years. It's sad because it isn't the patients or the work that is making me leave. It is the unrealistic workload and geographical area combined with overtime you do not get paid for. I am tired. Pure and simple. It was worse when I was a CM so I switched to ON-Call weekends so I could go back to school. We expanded our geographical area tremendously in the last 18 months and so I am now driving one way over 40+ miles to see patients at 2 AM. Most of the time it is Assisted Living Facilities that call non-stop and you have to go, since they cannot take phone orders or handle being triaged well. I work sometimes 14-16 hours days without so much as a bathroom break due to the drive time, and trying but miserably failing to meet that one hour response time expectation. Did I mention I have to cover nights on those days as well and have more than once been out all or part of the night, without sleep, just to be called back in to work another 14 hour day, NOT including charting time. We also have to do scheduled admissions and scheduled visits the CM assign as well. Due to our census increasing by about 100 patients OVER what our normal was when I took the change in job, our scheduled visits have also more than doubled. I asked about adding staff or at least having a back-up person we could call in case we were drowning or needed to sleep (lord forbid) and it was denied, only to be even busier now. The final straw has come down to being asked to do an admission after 2 ft of snow fell, with ice currently falling, parts of the interstate shut down in a state of emergency, and the admission was over an hour drive away on a non-hazardous weather day. The patient was not dying, and is still currently on our census with plans to discharge for stabiilty/not being appropriate. But because it was an ALF, I was told "we cannot upset them due to they give us referrals". We are a non-profit, and this is not the mission statement that I so valued in the beginning. We are increasingly about numbers and not patient care, and definitely not for the safety of our workers. There are times I really feel I am going to fall asleep driving home. In a 65 hour call shift, I work literally most of that and get paid for 40 hours, and still have charting and reports to finish up on Monday (which I am not paid for). I have been offered a position in Peds at a local hospital making more money and I am thinking of taking it. I have aspirations to be an FNP, and think the experience and stable schedule would be beneficial, though I am going to miss my passion.
  6. by   pfeliks
    I have been in Hospice for four years. I am lucky in that the company I work for has 2 dedicated on-call nurses. They cover ALL after hours work. Case Managers never have to take on-call.
  7. by   HeavenlyRN
    Unfortunately, I am thinking about leaving hospice too. I have been a hospice CM for 6 months a far as the patients, I love it. But I am struggling with the long days, working 10 hours per day and only getting paid for 8. spending my weekends doing notes because there wasn't enough time during the week; and being expected to see other nurse's patients when they call out. I have difficulty managing my own caseload without having to take care of someone else's. I am sad, because I really do love what I do, but my quality of life has dropped significantly since I started in this specialty. And unfortunately, most hospices seem to have similar problems. Not sure what I am going to do....
    But OP I wish you well and hope you can find a way to stay in this specialty that we love.
  8. by   tyvin
    You need to find a normal day load job. The on-calls are different with each unit, but it's best if they have their own. I'll take a weekend a month but not all the time. The reason (at first) I became hospice was because the hours were so great.

    Your shift sounds terrible...if it's truly your calling, find another hospice to work for; or better yet create your own! Depending on how large your organization is, you shouldn't have to be on call all that often.

    Were you hired as an on-call?
  9. by   xsnurse
    I just recently stated working for hospice as an admissions nurse. I'm only PRN but the full time staff work 4 10 hour shifts and 1 weekend a month. That sounds pretty good to me compared to all the on call the CM has to do.
  10. by   Zee_RN
    I work for a small, for-profit hospice. Average census around 63. We have dedicated on-call nurses who cover the evening/nights (5pm-8am weekdays) and the weekend (Fri 5p to Mon 8a). The only times our regular RN CM take on-call is if the on-call nurse calls off, takes a vacation or a day off. It is definitely one of the great things with my company; a lot of small hospices like ours rotate their fulltime staff to cover on-call. Look for a place like ours!
    Last edit by Zee_RN on Mar 21, '16 : Reason: spelling error
  11. by   CHoytRN
    Hello Zee, Can you please tell me if your dedicated on call staff are paid a shift differential?
  12. by   knurse8
    I finally left hospice after 7 years. I never thought Id leave my perfect calling and still feel sad about abandoning pt/families and never using my hospice knowledge, talents and gifts ever again. Unfortunately there are a lot of Hospice companies that are in the business of "caring" to reap huge profits. Hiring staff is just the 'means to the end'. Add to the mix poor management, lack of support/training, and over worked staff as a recipe for failure. And while all areas of healthcare are overburdening nurses to the point of burn out, hospice has that added emotional component. What other job would you be driving home and get a call pt had bad fall, so you turn your car around go back to assess and treat, get home 2-3 hours late and still have charting to complete, then go to death pronouncement (because its you favorite pt and the on call nurse is busy w another death) . This specialty attracts nurses with compassionate hearts, but then bleeds them dry. Now I make a lot less money, but in exchange I'm taking better care of myself, sleep better (not being attached to my phone and turning it off at night!!!) While there things I don't miss like driving in traffic, bad corporate leaders/policies, office drama....I mostly walked away from the business of hospice. Hopefully I can return to end of life care as a volunteer or doula when I retire. Overall take away is positive, many pt's/family stories are forever etched in my memory and I'm so grateful for the experience and take away extraordinary life lessons.
  13. by   knurse8
    I finally left hospice after 7 years. I never thought Id leave my perfect calling and still feel sad about abandoning pt/families and never using my hospice knowledge, talents and gifts ever again. Unfortunately there are a lot of Hospice companies that are in the business of "caring" to reap huge profits. Hiring staff is just the 'means to the end'. Add to the mix poor management, lack of support/training, and over worked staff as a recipe for failure. And while all areas of healthcare are overburdening nurses to the point of burn out, hospice has that added emotional component. What other job would you be driving home and get a call pt had bad fall, so you turn your car around go back to assess and treat, get home 2-3 hours late and still have charting to complete, then go to death pronouncement (because its you favorite pt and the on call nurse is busy w another death) . This specialty attracts nurses with compassionate hearts, but then bleeds them dry. Now I make a lot less money, but in exchange I'm taking better care of myself, sleep better (not being attached to my phone and turning it off at night!!!) While there things I don't miss like driving in traffic, bad corporate leaders/policies, office drama....I mostly walked away from the business of hospice. Hopefully I can return to end of life care as a volunteer or doula when I retire. Overall take away is positive, many pt's/family stories are forever etched in my memory and I'm so grateful for the experience and extraordinary life lessons.

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