Hospice case management

jCLNC · Aug 19, 2007

Can you give me an idea of how a typical day might go for someone who is a hospice case manager? The setting would be visiting pts in various nursing homes. Any info at all would be appreciated. Thanks.

Hi, :uhoh3:

My typical day starts at 8:30am. I do between 3-5 visits a day. This will taken up with the actual visit times, the travel and the communcatin necessary to the MD, absent family, and pharmacies. Also documentation and followup phone calls from the previous days.

Does that help?

steelcityrn, RN · Aug 19, 2007

You will go to the nursing home and assess the patient for any decline, pain ect. Check to make sure the patient has been receiving their medication, esp prn. You will supervise your n.a., give report to the home on the patient and to the family. Call the M.D. if needed. I call hospice the fluff and puff service, meaning, you should have ample time to care and comfort patient and family. Documentation of course as per your company protocol. Usually some form of documentation left with facility. Fulltime hospice nurses here usually see4, 5 or 6 a day depending on travel.

tencat · Aug 20, 2007

Sheesh! I wish I had time to 'fluff and puff' patients and their families. I work for a for-profit hospice, and they are always looking to increase our patient loads as much as possible to make more money. I still love the work, but I don't have the time to provide the excellent care I want to provide due to 'let's get more patients enrolled'...:angryfire

Rnmomajmj · Aug 20, 2007

Wow! I thought I was the only hospice nursing having this problem! We have recently lost our DON who was excellent! She would get out and help us in anyway she could. Now without her our census as dropped but now everything falls on the nurses. We have no one to collaborate with on our patients. I'm new to hospice and still have a lot of questions and when you are trying to see 6-7 patients per day, do all evals, admissions, recerts, contacting Dr's that never seem to get back to you in a timely manner, who has time to call the families???? I do love hospice work but am really burnt out right now and feeling like corporate has left us to sink or swim and so far I'm sinking....

worstnurse1 · Mar 9, 2008

Hospice is great work! You have freedom of being out on the road. Managing you caseload and being an AWESOME nurse at a most difficult time in peoples lives. A LOT more rewarding then the thankless nursing jobs in hospitals and nursing homes! 3 to 5 pt's a day, visit times vary based on situations.

Doctors are great in responding if you fax them a request, MOST get what you need for your pt's when they have time to review the case, call you with questions , and are not constantly interrupted during their busy day seeing pt's, by the hospice nurse.

The BEST hospice was in Massachusetts/RI, managed by an awesome RN. Had our own hospice Dr, have basic commonly prescribed standing orders. Also supplied commonly prescribed meds, so that cuts down on calling doctors. The main thing is being organized and having support from the team you work with. Hope that helps.

shrinky · Mar 11, 2008

You really need to find out up front information about case load, on call, extent of your territory, benefits, etc before joining a Hospice. I have been in this field for 7 years and will probably give 4 more before i retire, there is nothing else I would rather do. However i would not kill myself with the work load, we have 8-10 patients to case load which is quite manageable, maybe 4 visits a day. I find that I spend 1-1&1/2 hours in a home if I am doing my job well. It certainly is rewarding and challenging, and not everyone can do what we do as Hospice nurses. We need to give ouirselves a round of applause. :yeah: