Considering Hospice

[bryan_del, ADN, MSN]

How many hours do hospice nurses usually work in one day? I’ve been told that they usually spend a lot more time in a given day since they go and see their set of patients which can range from 30 min to 1hr, they include the time spent in traffic, and they also include the time spent doing paperwork. All of these factors make them actually work more than 8 hours which is what they are being paid for. Is it worth it at the end?

[Kaisu]

I get paid by the hour (my choice). I do visits on Mondays, Wednesdays and Thursdays. The other two days I do case management, documentation, precepting, etc. The hours vary. With low census, I will put in 30 hours in a week. With high census, or multiple patients becoming active at the same time, I can put in 60 hours. I manage my own time and to a large extent can manage my workloads. If I've had a tough week, I will take it easy the next, if I can.

All this presupposes an agency and management that are flexible, respectful and willing to work as a team for the benefit of the patients. I believe the key is to find a good agency.

[bryan_del, ADN, MSN]

Do you know of any good agencies in the Los Angeles area?

[Kaisu]

I personally don't. I work in Arizona. I got this job through a friend that worked for them. She raved about the agency and guaranteed I would never regret it. They pay more than anyone else in the region and thus get and keep the best people. I feel very fortunate.

[Kelly77marie, RN]

I wholeheartedly agree with kaisu.... I've worked for 3 different hospices in the Phoenix area. The one I currently work for is, hands down, the best. You have to find one where the management style fits your work-home life. I am able to set my own schedule, so if I see all my pts in the first half of my day I can case manage in the afternoon from my car or from home. I can also work around doctor appts, kids school programs, etc. I am not micro-managed, so long as I'm performing to expectations. Sometimes this schedule means I'm preparing for IDG after kids go to bed... but I'm perfectly ok with that!

[bryan_del, ADN, MSN]

Hmmm ok. It’s just hard to find one that has a good reputation for some reason. Do you guys recommend being a visiting nurse, admissions nurse, case manager, or all combined?

[Kelly77marie, RN]

From my experience... go with an established, larger hospice. They will have the resources available to do your job the right way. Smaller hospices are great in theory, but they are hamstringed by tight budgets and small staff. Also, I can only comment from case management experience. I enjoy having a patient load where I form bonds with patients and their families. You don't get that with visiting and admissions.

[bryan_del, ADN, MSN]

Thanks for the help. Does case management require you to be on call?

[Kelly77marie, RN]

Again, depends on agency. Most of the time, yes. How much depends on if your company has dedicated on-call staff or depends on regular staff to fill out their on-call schedule.

[bryan_del, ADN, MSN]

I see thanks for the info. I’ll do some research on larger hospices around my area. Thanks again

[ErinDel, ASN, BSN, RN]

I have been working in hospice for the last 5 months. i work per diem three days per week. i work for a small hospice company and I am the only per diem nurse and we do not have a dedicated admissions nurse. this means that we have to drop what we are doing to go screen a patient and admit them if appropriate. this is very stressful.. my role is to do per diem visits, but i actually case manage the patients I see weekly on the days I work which is stressful. I prepare for IDG, do prep notes, recerts, and admissions. I feel like sometimes i am expected to do full time work on a 3 day work week. I would make sure that where ever you work, they have admission nurses and have more than one per diem nurse. good luck on your search!!

[bryan_del, ADN, MSN]

13 hours ago, Erindel RN said:

I have been working in hospice for the last 5 months. i work per diem three days per week. i work for a small hospice company and I am the only per diem nurse and we do not have a dedicated admissions nurse. this means that we have to drop what we are doing to go screen a patient and admit them if appropriate. this is very stressful.. my role is to do per diem visits, but i actually case manage the patients I see weekly on the days I work which is stressful. I prepare for IDG, do prep notes, recerts, and admissions. I feel like sometimes i am expected to do full time work on a 3 day work week. I would make sure that where ever you work, they have admission nurses and have more than one per diem nurse. good luck on your search!!

Thanks for the tips.