End of my rope...

[DLS_PMHNP, MSN, RN, NP]

A question to all my fellow hospice nurses/case managers:

How many pts (cases), on average, do you usually have?

How many weekly visits do you usually do?

Do you have to do new admissions in addition to your normal case mgmt load?

Does you company worry more about $$ or pt satisfaction?

I would just LOVE to have some feedback from folks on this. I'm getting to the end of my rope with my hospice position. I'd like to have an idea of what is the norm?

I have 14 patients in my caseload, 24 weekly visits. IDT QOW (for 4 hours), no time to do IDT notes. Our admin thinks if we are "in the office" doing paperwork (ie" IDT notes, follow up phone calls, etc) that we don't have enough pts in our caseloads.

I am very discouraged right now.

Thanks for your feedback.

Best,

Diane, RN

[tewdles, RN]

Sorry to hear you are feeling discouraged.

My agency is NFP, we have intentionally low caseloads. RN Case Managers 0.8-1.0 FTE carry 10-12 patients when working solo. RN CM's working as a team with an LPN carry 20-25 pts. The expectation is for RN CM's to complete 5 visits/day on average. We consider IDT prep to largely be incorporated into the routine documentation of a CM and it works pretty well that way. All of our IDT notes and documentation are electronic.

Our IDT meetings are also QOW but they generally take only a few hours. We often have CM's coming and going during the meetings and we generally discuss between 25-80 pts depending upon which IDT (we conduct, on average, 3 seperate IDT meetings each week). Our meetings are very much directed at discussion of where the pt is today and what we anticipate for them in the upcoming days/2 weeks.

Our agency is understanding that some administrative time is required for RN CMs to effectively manage a caseload. However, management is attentive to how much time an RN requires to accomplish this and are quick to provide support, guidance, or suggestions to improve productivity and success. I work for an extraordinary hospice!

Good luck.