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Discussion

Case Load and Productivity

In my agency we do hospice an palliative together. This is of course pro and cons. Sometimes the case load gets unbalanced and it is hard to schedule everybody. Productivity is 5 visits a day and case load for full time CM is typically between 18-26 depending on the kind of cases. It is just implied that when you have many revisits or a patient is active and needs daily visits that you will fall into overtime because you will have more than 5 visits/day. You get paid extra for the extra visits but I am struggling with the thought that we should work overtime several times a week (understaffed and not much per diem help). There is just no law that looks at realistic staffing in home agencies. I am not very accepting of extra work as I am in graduate school and have family, also I do not want to get burned out like others that have left. What are your thoughts on the topic productivity/caseload/overtime?

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    A caseload of 26 implies, in my view, that none of those patients need to be visited more than weekly.

    Are there no per diem nurses? No visit nurses who do not case manage and can cover a routine weekly visit to free the CM up for more acute needs?

    How do your nursing co-workers feel about this?

    Has there been a team discussion of coverage of patients?

    Who takes on call responsibilities? Who does SOC? What happens if your patient requires a couple hours of your time? Is the agency unable to support your need for assistance?

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    HOLY COW! Case load of 26! That is totally unreasonable. I have been working as a hospice nurse for over 10 years and I have found that there are some decent places to work and some places that will work you into a coma if you let them. My advice is do your homework and find a hospice that has more realistic expectations and preferably one without a daily quota. Having an on call team also is VERY beneficial. To me, a reasonable case load is no more than 15 patients in a geographically centralized area. Otherwise, in this job, you will get burnt out and bitter very quickly. Hope this helps. Good Luck

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    26 is too much!

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    Yup too much! I am struggling to keep 16 patients compliant with wound care, charting, and weekly communication with each family. At my company the "ideal" case load is 12 but we rarely see that number, when we do it doesn't stay that low for long.

    26 is way too much!

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