Help, I need a pandemic-proof position

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by Nurse Beth Nurse Beth, MSN (Columnist) Educator Columnist Innovator Expert Nurse

Specializes in Med Surg, Tele, ICU, Ortho. Has 30 years experience.

Dear Nurse Beth,

I’m a RN with about 12 years experience mostly in hospice, home health, nursing home. I did get a job 2 years ago with pre-admission testing at the hospital. I have been wanting to move on from PAT because it’s boring and there are not a lot of hours due to shortage of OR staff and not running very many cases.

Now come talks of cutting back more because there is so little staff on the floors there's no beds for the extended stay or overnight surgical patients. So PAT will probably furlough people again is my guess. The whole hospital furloughed people with the first covid shutdown.

Now I have two interviews: one is RN case manager at the hospital I currently work at hours are m-f 8-4:30. More pay than what I make now not sure how much. The other is admissions for a reputable hospice company. 3 12s 10a-10p every third weekend. It’s a driving position but I can chart from home. It probably pays even more than case manager but not sure how much. The hospital furloughed me before otherwise I would just stay. They are also very slow at processing transfers from department to department. Any advice on picking a pandemic proof position? 

Dear Wanting to Move On,

If nothing else, this pandemic has showed us that it's hard to second-guess anything.

But it is possible that hospitals will be less likely to furlough nurses this time around since they lost so many nurses last time and now are scrambling to get staff in most areas.

Job security-wise, acute care case manager and hospice admissions are probably about the same. Case managers will always be needed and so will hospice nurses.

The case management job does have some benefits over hospice. The big one is skill set, and transferable skills at that. A lot of nurses would love to break into case management because it's a job that can be done in so many different settings, including remote, and across inpatient, outpatient, acute care, and insurance companies. It's an opportunity.

The case management job is with the hospital, so if it doesn't work out, you will most likely be able to transfer to another department, which is job security.

Finally, you have to decide if either 12 hr shifts or 8 hr shifts are highly important to you, and the same with the every third-weekend requirement.

Best wishes in your decision,

Nurse Beth

amoLucia

amoLucia

Specializes in retired LTC. 7,735 Posts

I may be missing it, but what about on-call in hospice???? Those calls freq require in-person visits (esp with expirations).  No getting around it. Is that in the 10a - 10p???

Likewise, I believe there might be a time deadline for admissions. Again, if hosp discharges on the weekend, the pt must be seen to open the case. A good hosp dischg team can facilitate a good dischg/adm case, but too often the decision isn't made until the weekend rolls around.

Knowing what I do from reading posts here, I would be SUPER cautious , even if the new hospice is "reputable' as the writer comments.

Another caveat is the amt of req charting. So many nurses here comment re the inordinate time req when at home AFTER in-person. The fact that it has even been brought up has me concerned!! So be ye prepared!

Salaried or hourly? Salary will likely be sucking up all your time for no add'tl reimbursement. (Back to my concern re on-all visits & off-clock charting.)

Tough decision for these times. I don't think there's any pandemic-proof jobs.

Hoosier_RN, MSN

Specializes in dialysis. Has 29 years experience. 3,588 Posts

On 9/22/2021 at 7:05 PM, amoLucia said:

I don't think there's any pandemic-proof jobs.

Dialysis. I never dealt with a shut down, in fact, work picked up. This would be clinic or acutes. Home services did no admits in my area for awhile, as they couldn't go into the homes for training, but they are back at it now. Dialysis patients absolutely cannot have a stoppage of their care

 

ETA: and we have PPE aplenty, as it's required anyway. The only addition we had was wearing a mask all shift, instead of just with chest catheters 

rileyjw90, RN

Specializes in Critical Care. Has 1 years experience. 8 Posts

On 9/26/2021 at 9:22 PM, Hoosier_RN said:

Dialysis. I never dealt with a shut down, in fact, work picked up. This would be clinic or acutes. Home services did no admits in my area for awhile, as they couldn't go into the homes for training, but they are back at it now. Dialysis patients absolutely cannot have a stoppage of their care

Also, and I hate to say it, COVID cases that result in critical care has been trashing a lot of kidneys. Especially if there was any sort of prior underlying kidney condition or comorbidity. In the ICU I am at, we have several on prisma and several on hemodialysis that were not on dialysis prior to getting COVID.

Hoosier_RN, MSN

Specializes in dialysis. Has 29 years experience. 3,588 Posts

10 hours ago, rileyjw90 said:

Also, and I hate to say it, COVID cases that result in critical care has been trashing a lot of kidneys. Especially if there was any sort of prior underlying kidney condition or comorbidity. In the ICU I am at, we have several on prisma and several on hemodialysis that were not on dialysis prior to getting COVID.

Unfortunately, many are not regaining function. Years of chemicalized foods, drinks, and meds have done a number on many peoples body parts, making them weak so that an incident could take them down long term or permanently. Sad that it took a pandemic to make so many realize it

amoLucia

amoLucia

Specializes in retired LTC. 7,735 Posts

what is prisma? I could look it up, but I'd have to do some computer highjinx  & then get back. So I ask ...

Hoosier_RN, MSN

Specializes in dialysis. Has 29 years experience. 3,588 Posts

14 hours ago, amoLucia said:

what is prisma? I could look it up, but I'd have to do some computer highjinx  & then get back. So I ask ...

It's a CRRT modality system used in ICU.