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Greetings... Hospice Nurse Falling Apart

Posted

Specializes in CCU, ICU, Cardio Pul', Hospice. Has 5 years experience.

Hi all,

I moved to Hospice from the ICU last year, mainly because I feel I have had a calling to this field. And quite frankly I do. (When things go right...LMAO) Our Hospice has been hit pretty hard, and Im the new baby on the block. My very first day out on my own, was in a stand off in a drug diversion issue with a bilateral amputee who was beating this tis poor paralplegic man for his meds. I wouldn;t leave to have him hit again. Got him out after staying nearly 8 hours drug task force in... (must say...the police in that county are the BOMB) heck do they sey that anymore?

When first hired... they explained that I would have two nights on call a month. We then went to a full week on call 24/7 where I nearly killed my self working, and now we are down to a night a week but now... even though we take call ... we still get 16 hour calls on top of working 40 hours, and then take weekend calls which last from Friday night at 4:30pm until 8 am on monday morning. Our staff have had accidents and needed sugeries and leaving the rest of us to hold up the fort till they get back and now they are tying to teach us McKesson in 2 days with a launch for the 1st.

I am crying between drives in the car, I have a crazt strung out drug person stalking me over her mother we put in respite to keep the c/g calm and I feel like smashing my head against the wall.

I love this job... I love what I do... I love my patients and I feel like I belong no where else...... why do I feel so stressed out all of the time. Any free time I have had... believe it or not I have been sleeping.. because I can't any other time. I have had a belly wash of pt die on me, and I know you shouldn't get close, but this one lady I was very close to I adored her to death. Im seeing her now in my dreams and when I am driving her smiling face pops into my mind, and I know she isn't hurting... anymore... I know... but

WE have a great team. Wonderful nurses and social workers, and our bossess are just as strung out as they are... and If I hear one more time...

Do what you have to do to see them, well... quite frankly... they have been getting in and out visits because I end up with 12-14 visits a day to make in a huge 4 county area. They want to spend a great deal of money on a triage call service which doesn't make any sense to the nurses because swe still go out anyway. There is no more help coming. And just when you feel like you can't take anymore.. and ask for a day off, some of the managers make you feel like crap for asking.

Starting to think that going back to the hospita to do my three square 12's and I am done is looking pretty good right about now. But I would hate... I would miss the driving and visiting with my babies .

I asked for a time when we nurses could get together and uplift each other and comfort each other, teach other what each of us know... The answer today was not now...

Anyone feel like cloning me?

sniffs sniffs... :sniff:

Higgs

Specializes in Med/surg. ED. Palliative. Geront. Has 20 years experience.

Dude, you're heading for a nervous breakdown. Either that or something dreadful will happen and you'll get blamed. (After all, when it hits the fan, no matter what really happened, it'll always be pinned on a nurse).

Go back to the hospital, and just enjoy being a nurse just and taking care of people. What's making this job intolerable for you is the system you're stuck in - not your lack of caring or skills.

To quote Billy Crystal's wife in City Slickers...Go and find your smile.

12 to 14 visits a day in a 4 county area? WOW, is all I have to say. Unless you have a bunch of visits all together in a nursing home I don't see how this is realistic. How can you give good care? I would definitely be looking for a different job with a better caseload. My boss feels 4 to 5 visits a day are acceptable considering rural drive times. If we have a bunch in a nursing home it could be a bit higher just because we don't have to drive between visits. Remind me to thank my boss for being realistic.

Debblynn....

btw...look for a different job before you crash and burn.

shrinky

Specializes in Hospice, Palliative Care, OB/GYN, Peds,. Has 43 years experience.

Your case load is too high and no one should do that many visits a day and then be on call to boot. What you are expected to do is physically impossible and too demanding. You all also need bereavement for the staff because you all have feelings too. Hospice can be very rewarding but not with the load you have to carry every day. If Hospice is for you don't give it up , check around for other jobs but be sure you ask the right questions before taking another job. We are required to make 4 visits a day (we are a rural area with very few SNF patients) so driving is taken into consideration. Usual caseload is 10-12 patients and may include in hospital Hospice patients. So many larger Hospices require you to see so many patients, it is not in the best interest of staff nor patients to see so many. I feel for you and any other nurses who have to do so much and to have to feel so discouraged. God bless and I will be praying for you. :redbeathe

:yeahthat: It isn't hospice - it is your caseload and the hours you work. Unrealistic. And unsafe. I agree - either everyone needs to just go "on strike" so to speak about this or you need to find another hospice job.

I love hospice - but wouldn't work the hours you are working.

Be an advocate for your patients and for yourself!! :redbeathe

steph

I have to agree to all that responded to your plea. Too many patients to much stress as well. Take their advise. A see an average of six patients...on a bad day, seven. I take call but that's because I work per diem. Call is from Friday 4:30pm to Sunday 4:30 pm. It's busy as I take call and see clients. We too have an excellent team but I could never take the stress given you. Just remember, every visit you do is money in their pocket!

Edited by irishnoreenRN
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Sharry RN

Specializes in Hospice, Psyc, post surg. Has 24 years experience.

I would highly recommend extra Liability Insurance like NSO:

http://www.nso.com/

As one nurse said, if something happens to a patient while you are stressed to the point of breaking or even if you aren't the organization will point to you 1st. I've been in Home Health/Hospice for over 15 yrs & have had this extra insurance from day one even though I haven't had to use it. Our union rep recommended it to all of us.

Personally I work in a great Hospice as a case manager where we have only 4-5 pts in a 10 hr day. We have wonderful managers that really support us. Even with that we can get burnt out quick if we take on to much responsiblilty & allow the patient or families to become co-dependent (old word) on us personally. They (patients & families) are still responsible for their decisions & family for most of the care once they have all the facts & as we teach them. And we aren't the only persons that can give them service that is what I love about having the whole IDG team especially the CNA's, MSW's, & Chaplains.

Shari

You can't take care of others if you don't take care of yourself. Look into a Palliative care unit. It is in the same field and in the hospital. You don't take care of your patients as long but you are able to make a difference in their and their families lives.

grbrico

Specializes in CCU, ICU, Cardio Pul', Hospice. Has 5 years experience.

Thanks for the input.. I have always carried extra insurance since the day I received my nursing license... thank you for suggesting that.. hopefully someone who read this who didn't have it... will get it.

Im in a much better frame of mind right now.... did talk with my managers.... Im back to seeing 6-7 patients daily our call has dropped to one night a week with a weekend coverage every 9 weeks. It wasn't just me then... It was all the nurses were stretched as far as they could go. During thier "crisis" they lost 5 nurses in the process... they all quit... I believe it hit em harder than they expected.

AtlantaRN, RN

Specializes in Med Surg, Hospice, Home Health. Has 13 years experience.

God bless you dear one! We have a load of 12 patients, and we don't see all of them in one day! Staff nurses are 10 hours a day and they work 40 hours a week with the last night being on call (so we get one full day off). I have moved to the weekend shift, on call friday 5pm through monday at 8am, last weekend was great with only 6 calls and I only had to make one visit. ((I know that isn't the norm because I was on vacation 2 weeks and the other nurses had weekends from h*ll)). I'm praying for divine intervention. I was at the point you are now before the weekend person stepped down, and I asked to take his position (I was blessed as i was the last person hired and no one else wanted the job).

Blessings and Gods peace be upon you dear one.

Linda

Dear falling apart,

I am a student nurse and I am very interested in becoming a Hospice Nurse. I have one daughter who has graduated from college and the other is begining her Junior year in Sept. I too feel that it is my calling to help those who can't help themselves. After reading you blog I felt a sinking feeling that maybe Hospice would not be right for me. The other respondents helped me see that you have to search for the job that is right for you. The reason I wanted to become a hospice nurse was to get to know the families and to help them through the dying process. My mother-in-law passed away over 20 years ago and I will never forget the kindness of the hospice nurses. Without them my husband and father-in-law could not have survived the ordeal. I am very good with people and I hope that this will be rewarding. If anyone has any advice I would love to hear from you. I will be starting my Junior year in the BSN program but my husband is not supportive about me going back to school or working. Keep your chin up I am sure the families love you!!!!!!:bowingpur

dosamigos76, RN

Specializes in Hospice. Has 7 years experience.

Run, don't walk away... Hospice doesn't have to be like that. That is not safe and it's not right. You can't be the kind of nurse you want to be with 12-14 visits a day, even without any call. There are good agencies out there, but please don't stay in that kind of situation.

riverwink

Specializes in ICU, Hospice.

Holy cow and I thought I had it bad. 12-14 pts. a day is enough to make anyone crazy! That is sooo dangerous. Glad to hear you carry extra insurance and that the work load has become more sane. I see between 5 - 7 (on a bad day) in a rural area...that's crazy enough. Our on call is one night a week two weeks of the month, two nights a week one week of the month and then the last week is weekend oncall from 1630 Friday till 0800 on Monday. :bugeyes:

I know how you feel. I was working 10-12 hours a day, almost every weekend and several times during the week on call, that is on top of working during the day. It took me having my husband moving out to realize that you need a life other than your job. I love this work and have NO desire to return to the hospital, but I love my family more. I went to my boss, talked to her, and now work at most two nights a week and one weekend a month. If you ave a family remember that this job effects EVERYONE you come in contact with.

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