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Going Down With The Ship...Advice?


Hi, all. I know there are a couple of you hospice nurses out there. ;) I live in a rural area that is having a heck of a time getting nurses in any area, let alone hospice. For some reason the company I work for doesn't get that we can't take any more patients and give them adequate care. I have a caseload of 15, my fellow nurse has 13. We have a nurse quitting who has 11 patients. We are expected to handle call and admissions with little to no help from the main office in another city where the nurses there only deal with their case loads. The main office is 80 miles away and has a nurse who only handles admissions, and they have two on-call nurses who do only call. Our rural office represents about 35% of the company's total patient load in our area, but every time I point out that we cannot keep admitting patients in our neck of the woods, I get told that we have to admit everyone because if we don't, we won't get referrals any more. We are the only hospice in a 60 mile radius. I don't think we'll be lacking for patients, and quite frankly if another company came in to our small town at this point in time, it would be doing us a HUGE favor. I don't know if I'm venting or crying out for help or ideas.....but if you all have any, I'd be glad to hear them! I love hospice nursing. But dang it....are they all like this?

Try to hang in there

I'm in a small town also. When I started 5 years ago. I was the only RN out here. Now we have a team of 5 with a team leader. Try to get the word out. That helped here. When I had to call the clinic for things, I'd share "good things" about the job.

However, the first 2 nurses that joined me out in this area...left. It is SO hard to get management to listen.

I would repeatedly remind my manager that I was drawn to this job because of the co. reputation for caring and how sad that "I was wrong...because when you take more pts...you are telling ME that you care more about the almighty dollar than you do pts or your employees". That seemed to fluff a few feathers. I shared that not only with my manager but her boss also. The adds in the paper for more staff were more apparent after that.

BE THE SQUEEKY WHEEL. Best of luck to you.

RN4ustat, BSN, RN

Specializes in Hospice, ER, Telemetry. Has 15 years experience.

No, not all hospices are like the one you're working for. I worked for a large, nationally known hospice last year and can truly feel your pain because it sounds like a carbon copy of the scenario I experienced!! Our Executive director and Patient Care Manager were ignorant to our problems/concerns!! We begged desperately for more help and were promised multiple times that help was on the way but it never really was. The PCM promised to come out into the field to help ease our load but never did!! After nearly a year, I couldn't take it anymore and I went to work for a hospice 9 miles down the road. At first I was afraid that it would be the same situation but I've been with this company nearly 9 months and I've given up waiting for the other shoe to fall because I truly don't think it will!! I am truly amazed by the teamwork with this company. Everyone pitches in to help when there is a crisis and our team director is so supportive!! Hang in there!! Oh by the way, none of the nurses I worked with at the other company are still there..........imagine that!! I think the burnout rate is about 3 months........Sad isn't it?!

tencat I wish I could come help you. My ship is going down for the opposite reason, marketing is not bringing in the patients. Of course the owners blame that on the clinical side because we don't admit all of the referrals. But when the lady is driving, she doesn't meet criteria for DEBILITY! lol Anyway, would love to restart with a company looking for a leader. Right now, though, I have decided to see the country and do some hospice travel nursing. California here I come!!!

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