Different roles In hospice

VulgarProphet · Jul 19, 2017

I'm an "RN case manager", which travels to patient's houses. I set my own schedule, which can be flexible depending upon the patient's needs and my own scheduling. The admissions nurse can go out when a patient goes on hospice, explain what hospice is, start setting them up with a plan of care, etc. There are also nurses that strictly give care during the night, so I'm never on-call during those hours. My hours 'on-duty' can range from 8:30am-ish to 4:30pm-ish - it's quite flexible. Do you live on post or nearby? Are you doing CYS childcare? They have care that can start as early as before school hours and extend until after school hours until you're done with your work-day, which more than covers working hours.

Madebymelo · Jul 28, 2017

I also am an RN Case Manager in Georgia. The case manager (or care manager) usually works Monday to Friday 8 or 9ish to 5ish, and you have a set of patients that you see once a week (or more often if needed). The admissions nurse does the initial visit and educates the pt and family about hospice services. The triage nurse is usually one of the on call/after hours nurses that triages the calls coming in after hours. Usually one nurse answers the calls and one nurse is the "runner" who does the visits for emergent needs. As a case manager we see patients at home, ALFs, nursing homes, etc.

westieluv · Jul 28, 2017

The previous posts are spot on. The only thing I would add is that in some cases, the RN case managers who have a team of patients that they see during the day also have to rotate taking call during the night and weekend hours, meaning that they may get called out during the night or on the weekend to see patients other than their own. They usually get days off during the week to compensate for this. Other hospices have dedicated on call nurses instead who take over at 5 pm or whenever the office closes and are available for after hours admissions and emergent visits and don't case manage during the day. Sometimes the on call nurses do the phone triage as well and sometimes they work with a dedicated telephone triage nurse who takes the incoming phone calls and relays the information to them if the situation cannot be handled over the phone.

I have a job where I work with several hospices every time I work and I see a lot of burnout in the cases where the case managers are also expected to rotate taking after hours call. It is so much better when there are dedicated on call nurses to cover the nights and weekends.

Momma1RN, MSN, RN, APRN · Jul 29, 2017

Thank you so much! I am interviewing for an RN care coordinator position, whose hours are listed as M-F 8-4:30, but per the recruiter the schedule is flexible. I'm eager to speak with the manager this week about the role and just how flexible it is. Do you all find that you are doing an excessive amount of driving, and charting a lot after shift? I have two young kids and I am nervous about having hours and hours of charting after I get home. And I'm nervous about the wear and tear on my vehicle (I have an SUV) though they do compensate for mileage. Thanks!

VulgarProphet · Aug 2, 2017

Chart on the go during the day; everyone's favorite spot is the local Panera

Bread/Starbucks. :-) Don't take it home!

My car is a 2013 Toyota Corolla, and my husband and I just bought a brand new Ford Fiesta that he's using. We take our vehicles in for regular service checks, and we are very diligent about changing the oil, rotating the tires, etc. (Which we do ourselves.) We have an "emergency plan" in case I have a breakdown (which I haven't had... yet... *fingers crossed*) where I can take the newer car if something happens to my older Toyota, and drop him off at work, pick him up, etc. If you're not a AAA member, have the numbers of a good tow company and local mechanic in your phone.

So far, I haven't really been doing an excessive amount of driving, but it's all relative. Because the scheduling is flexible, you can try and schedule so that the drive takes you in a circle back to your house, in a cluster, etc.

Hope the interview goes well! Good luck!

TammyG · Aug 9, 2017

The RN case manager position is the most rewarding, but you really do not have flexibility. You need to be available to your patients between 8 AM and 4 PM (or whatever hours the hospital signifies). You can schedule your visits anyway you want, but if a patient needs a visit at 8 AM on a Friday, you need to make it. I know one nurse used to schedule her patients very early in the morning so she had the afternoons to be home and chart when her kids came home from school. I almost never got home before 3 PM, and I often he had two-four hours of charting to do after I got home. It is a very rewarding job but also very involved.