Burned out, is hospice for me

[acuriousnurse]

I have been a nurse for almost 4 years now. I started on a medical-oncology floor which i hated and transitioned to home hospice about 8 months ago to follow my nursing dream. It all started out great. There were bad cases, of course, but I enjoyed taking time with patients and getting to know them.

Over the past few months my caseload has changed a lot, and with all the payment changes my company seems to be freaking out about cost. I lost 15 patients between the beginning of December to the middle of January. I took on a pediatric case with the promise that they would try to keep my caseload down and not bombard me with admissions. Well that went by the wayside and i ended up with 14 patients, two with pleurex drains and one that ended-up having a psychotic episode (which his daughters refused to take him to the ED for).

I know that my company is really struggling to keep it's head above water, so we are cutting back on everything... and guess who gets to talk to patients about it? There are multiple patients that we have explain why we are no longer providing supplies and what that means for them.

So pretty much I've gotten to this point where I have stopped caring about my job and what I'm doing. It's hard to admit, but often I see a call coming from my office and all I can think is "what now?" People want me to fix there problems and I just can't. I can help with pain, but if your father is trying to cut you with a knife you need to call the police, I'm sorry if that is too blunt.

I wonder if I was meant for this part of nursing, or even nursing at all. I love being there for patients and families when there is a symptom I can control. I feel blessed for all the tender moments I've seen and experienced. I feel so lucky that those people let me into their lives and I was able to help them have a good death.

On the other hand I hate having to deal with all the paperwork, changes in what we provide, families wanting the benefits of hospice while still getting curative treatment (and constantly arguing their case to me a person with no power to change anything). Office politics are also bringing me down as I often have issues with the staff not transferring calls the appropriate way.

I am taking my first vacation this coming week, which I think will be helpful. I know that I need to take more breaks.

I know that I am not going to stay at this company... but where do I go from here?

[jadelpn, LPN, EMT-B]

What about home health in general? Some public health nursing? Hospice is something that nurses do get burnt out on.

If your issue is with the sheer amount of paperwork--that is everywhere. And yes, cutbacks are also everywhere. But instead of supplies it is in the time constraints, acute patient load that type of thing.

I would definitely take your vacation to relax. On the same token, I would have a look at what types of jobs would be available to you in your area.

Best wishes!

[acuriousnurse]

I am looking for what is available right now. I want to get the experience of living somewhere else, so I think this is coming at the perfect time. It will be 1 year in May, which gives me enough time to find another job.

[Libby1987]

Much of what you're experiencing is going on in home health as well, but we do have a different type of success with our patients. There are still difficult and/or sad cases but we also have a lot of improvements which is pretty uplifting.