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.

I work for a Hospice that has been established for many years in our town. We have home care and we have contracts with nursing homes, and we provide all four types of hospice care (routine, inpatient, respite, and continuous care).

:idea:There are hospice regulations that you need to be familiar with and understand, but basically this is how one of my days goes:

My hours are from 8:30am to 5:00pm but I am salaried, so if my job requires me to work a little longer, I'm still paid the same.

My case load runs between 10 and 14 patients. I have some who are cared for in home by family or paid caregivers, and some in the local nursing homes.

Acuity is based on the patient's condition, that is: co-morbidity of symptoms, how well they respond to pailliative treatments and medications, and how fast they decline. Our agency lets their case managers set their own pt-visit ratios. For instance, if I have a patient who is actively dying, I would visit them more often, even daily if the family needed that much support. (Usually they do.) In the nursing homes, you must make sure that the two charts match (yours and the nursing home...the orders, notes, etc.) Also, invite the staff to your IDT meetings, and attend their careplanning meetings. This requires effort...because sometimes times vary.

I usually do between 3-5 visits a day, and that will take up my eight hours with: travel, contact with MD or absent family, followup phone calls to patients and family seen the day before, documentation...etc.

Being a hospice case manager means that you are responsible for coordinating all the needs of the patient: if you recognize needs that the SW, chaplain, or volunteer can meet, pull them into the picture, don't try to be all for the patient...that's what being a team player is about. You also have to be a self-starter, a dependable worker, and an organized nurse to keep up with all the things that go on every day. But every nurses' job requires that!

I hope this helps you a little. :lol2:

Jen

truffles111 · Apr 15, 2010

i know this posting is old, but could you tell me how much and the type of experience needed to become a hospice case manager. is it possible for a new grad??? (with a BA in psych and a BSN)

Bubbles · Apr 19, 2010

In my experience as a hospice nurse, both as an On Call Nurse and an RN Case Manager I found the nurses all had years of diversified experience. How comfortable are you in doing assessments and changing Foleys and doing wound care, etc? The hospice nurse deals with a variety of medical conditions with her patients, not just the actual hospice diagnosis so a Med-surg and/or ICU/CCU background is very helpful, if not essential. Hope this helps.

abc987 · Jan 12, 2011

I am wondering if you chose to become an RN case manager. I am in a similar position. I am a new grad (May 2010). I started workign in a long term care facility but was recently offered a position as an RN case manager. If you took the job, what can you tell me about it? what are the hours like, the work load, the pay, benefits, etc. thank you a million ! hope it worked out great for you!

Beth D, RN · Nov 21, 2011

A typical day depends on the case load, patient acuity, any emergencies, wound care, etc.. I am with a company that has been established for a few years. Right now my caseload is 16. I start my day at 8am. With my caseload as big as it is, i see between 6 and 8 patients a day. I was a new grad RN when i was offered this job, but I had several years of experience as an LPN in long term care and Med-Surg. You must be very organized, be able to think outside the box, be very compassionate, and realize that you will see these people and become part of their lives if the patient is with you for any length of time. You must have a way to decompress from the job, or you will burn out very quickly. I have the freedom to organize my patients the way i want. I love my job and the freedom it gives me. I also love that I can help someone who may not have the resources to have the quality of care they need at the end of life. :nurse: It takes a special nurse to work in Hospice. if you try it and dont like it, then dont be upset. It is definitely not for everyone.