frustrated and overwhelmed

wildcat81 · Mar 30, 2006

iI have been thinking about going into hospice work parttime. It sounds tho' like y'all have the same problems as anywhere..They want you to do more and not give enough staff. How sad that is. I was hoping that in hospice nursing you'd be given more time to spend with the patients and their families. I guess I just need to get out of nursing and just volunteer for our church or something.

CseMgr1, ASN, RN · Mar 30, 2006

I lasted ONE week at my first and only attempt at Hospice six years ago. I should have figured out something was wrong, when they hired me on the spot and didn't bother to tell me until I started working that I would be responsible for seeing a a very unstable patient who lived 100 miles away

at all hours of the day and night. I quit. A former manager of mine who had

gone into Hospice nursing was almost killed, when she fell asleep at the wheel

of her car and flipped it over several times, after working day and night one

night too many. She later quit, telling me: "They've (her managers)

already tried to kill me one time, and they're NOT doing it again".

doodlemom · Mar 30, 2006

I must say that there are still good places to work out there. With hospice becoming a popular business as of late, there are all kinds of fly by night agencies. If you really want to do this work, look for the right place to work. Ask around town about reputable agencies. I feel very fortunate that I work for a very supportive agency that has been around for a long time. We've gone through a lot of struggles over the years - expecially since all of the for-profits have moved into town and have created a lot of competition for us - also causing us to downsize somewhat. But our staff is incredible - our administration is very supportive. I know that there are many agencies around like ours - especially in larger towns and cities. I see them and talk to them at conferences. They are there...keep looking.

aimeee, BSN, RN · Mar 31, 2006

iI have been thinking about going into hospice work parttime. It sounds tho' like y'all have the same problems as anywhere..They want you to do more and not give enough staff. How sad that is. I was hoping that in hospice nursing you'd be given more time to spend with the patients and their families. I guess I just need to get out of nursing and just volunteer for our church or something.

We DO have more time! And what's more, an entire team that is also working to support that patient and family...social worker, home health aide, bereavement counselor, spiritual counselor, volunteer, medical director. But not all hospices are equal. Keep looking until you find one with the right opportunity for you.

mab19 · Mar 31, 2006

I've been a hospice nurse for four years and things have changed so much since I started. Everyone is expected to do more (higher census) with less (reduced staff) and the bottom line is, as a case manager I work way more hours than I can bill for. I keep doing it because that's what it takes to get the job done the way I want to do it.... but we keep hiring nurses and nobody stays very long... wonder why??

It's distressing to me to hear about nurses not billing for the time they actually work. Not only are we cheating ourselves as individuals when we do this, we're also short-changing the profession as a whole by allowing managers to impose unreasonable caseload standards. For example, if hospice administrators see that case-managing nurses are billing around 40 hours for a 12-pt caseload, then these administrators can reasonably expect that other nurses at the agency should be able to meet this same standard. However, if the nurses who are billing 40 hours for a 12-pt caseload are actually working 50 hours, then they are helping to create an unreasonable productivity standard. As I see it, this is one of the age-old problems with the profession of nursing. Instead of setting reasonable boundaries and speaking up for themselves, nurses so often accept mistreatment in the form of unfair or unreasonable work requirements. When we don't speak up against this we help to impose these burdens on our fellow nurses, and on future generations of nurses. Please, please bill for every hour you work. Under the federal Fair Labor Standards Act (FLSA), you are entitled to be payed for every hour worked and should receive overtime pay for every hour worked over 40 hours.

req_read · Mar 31, 2006

mab19,

Well put.

As much as nurses complain about the lack of regard they receive from administrators, physicians, etc., they are, in many ways, their own worst enemies. This is nothing new.

I have been in the business for over 35 years and a nurse manager I once had (who was a good 10 years older than me) told me about an article in a nursing magazine she read when she was just starting out entitled, "Nurses Eat Their Own Young."

The type of person who chooses to go into nursing is typically an individual who nurtures her/his self-esteem by "caring" for others. Administrators know this and use it to their advantage. Lots of people have made lots of money riding on the backs of nurses. It is not at all uncommon to see a hospice nurse (by way of example) working 50 hours per week and turning in 40 while the CEO is out paying cash for his new hummer. Then the nurse writes in to a message board boasting about what a great employee she is.

Nurses care about other people and want everyone to know it. Maintaining self-esteem is a powerful driving force. Unfortunately, that driving force often pushes nurses to the point where they do serious damage to their own profession.

nurselearner · Apr 1, 2006

I think that would be a good topic - boundaries - with our work hours etc. But also I would like to know how all of the experienced hospice nurses set boundaries ( if that is what it should be called) with your feelings and involvement in patient's lives.

I am new to hospice. Feel blessed to be joining a hospice with a real team attitude, belief in a manageable caseload, social workers, clergy, volunteers and team meetings weekly. Just received my orientation manual - Thanks....

req_read · Apr 2, 2006

nurselearner,

For one thing, you learn that you can hurt (feel sadness, fear, loss etc.) and not break. It is okay to hurt.

The problem with learning to not feel is that when you diminish your capacity to feel one emotion you diminish your capacity to feel all emotions in like measure. So if you ever get to a point where you no longer feel fear, congratulations... neither can you feel joy.

Respecting personal boundaries and empathy are two different things. You can feel (your emotions) and still be respectful of boundaries.

In the busy, work-a-day world what often passes for intimacy is boundarylessnes... and what often passes for depth is business. To counter this trend, slow down. Take the time to feel... even when it hurts.

But we are getting off thread here.

BeExcellent · Apr 4, 2006

I use H20. 2 H's= Humor and Humility. and the 0 of Ohhh that expresses my awe. Awe in life, awe in learning, awe in the little things. Hospice is a team thing. Each one of us is an artist painting a different tree. We use different colors, a different angle but hey, it is all good. let all your team members be artists and appreciate the heart of the picture. i don't want to always be right or always get my way. I can have my cranky moments too. (or as Maxine says," It isn't menopause. I'm just this way.)

kelluvanurse · Apr 7, 2006

hello everyone! My last day is April 13th and I start with a new hospice on April 17th. They have promised me a very thorough orientation, it is only part time but they are growing fast and I really think it will be full time in no time. Im just trusting in the lord and I know that he is leading me in the right direction. Thanks to everyone for all of the advice and replies.

req_read · Apr 7, 2006

Congrats!

aimeee, BSN, RN · Apr 8, 2006

Woohoo! That's terrific news! We will want to hear all about the differences after you experience there.