Hospice in DFW

TheCommuter, BSN, RN · Apr 2, 2016

As far as hospices in DFW are concerned, take your pick: there's American Hospice, Vitas, Odyssey, Mission Hospice, Asana, Alpha Omega, Tender Heart, Universal, Community, Brentwood, and a slew of others that are not coming to mind right now.

Each hospice pays differently, and I do not know how much every single company I've mentioned is paying.

nutella, MSN, RN · Apr 3, 2016

Hi all, I am looking for a change, and hospice has been tugging at my heart strings for years. I've been a nurse for about 10 years.... started as a tech, then LPN/LVN, RN, and now finishing my BSN. I've always been in a hospital.
Does anyone have any advice on how to see if hospice would really be a good fit for me? Is there a good company to start with in Dallas, texas? Is it a reqular schedule, or do you get called 24/7? How much, if I might ask, does a company pay? What are "good companies" vs "bad companies"?
Any wisdom and help would be great. I live near McKinney, if that helps your answers.

I do not know about your area but in general hospice can vary significantly from company to company.

In home hospice there is usually at least some on call because hospice has to be available 24/7. In good companies they have hospice nurses hired for on call night and weekends and the regular nurses only cover vacation times or sick times. On call can be no call if you are lucky or the hospice serves mostly nursing homes or you can have nights when you have to drive out multiple times.

Case load varies and in my experience anything above 15-18 gets you to an insane level when you case manage.

Nowadays you have to be super proficient in nursing to be a good hospice nurse - a lot of teaching, knowledge about symptom control, pumps and so on.

In my area there has been an ongoing shortage of hospice nurses. The reason is that hospices tend to burn out nurses. They tell new hires that they have a productivity of 5 visits for examples but do not tell them that the manager will literally try to push for 7 visits/day to cover "emergencies". They take advantage of nurses and in some cases it boarders on abuse. When I started in hospice I was told that if I had to stay with a patient in crisis it would not be a problem - the team would help me with my other visits that day. But when it actually happened the only thing I got from management was "sorry - can't help you".

Also, depending on the coverage area you may have to drive a lot, winter included.

If you do end up applying and go for an interview ask about their on call, weekend rotation, productivity, pay (hourly vs salaried), expectations for availability during the day, training. I would also say to shadow with a hospice nurse at least for half a day.

softrbreeze · Apr 3, 2016

My advice as a hospice case manager for the last 10 years is to avoid the large national hospices, take notice of any warning bells in your head when you go for an interview, and keep in mind that 16-18 visits a week is likely all you can do and still have quality nursing visits/documentation without going over 40 hrs/wk. Previous hospice experience is highly valued so, if you must, you can accept a less desirable position with the long-term goal of changing to another hospice after a year or so. You will most likely have to take weekend or night call on occasion in addition to your regular daytime hours. Pay can vary widely per hospice. If you want to experience hospice first, apply for a prn or call position to test the waters. That would be a lot more enjoyable than the case management aspect of the job, for sure. It's the mind-numbing paperwork that is usually sucks your soul dry muahaha:banghead:

CFLA.RN · Apr 7, 2016

Each hospice is definitely different and it's important to find one that will train you correctly. As far as going with a bigger, national company vs a local company that really depends on what benefits you are looking for. The bigger companies often have full time on-call staff and admissions nurses. Smaller companies usually have the full time staff take on-call which can be really slow or really busy. I have also found that national companies pay significantly lower than some of the local companies. I like to work with companies that utilize RN/LVN teams rather than companies that only use RN's but that's a personal preference.

As far as trying to see if hospice is a good fit for you - I would sign up as a volunteer and ask to ride out with a hospice nurse one day. Not every company would let you do it but I bet some will. Pay varies per company, position, and experience. I would say a good average - 70-75,000 with extra for on-call days and visits. Expect to have some kind of contact 24/7 but it's manageable if you know how to say no to extra visits and set boundaries with patients (ie I tell patients...here's my number, I'm available from 8-5, after 5 call the on-call number and they will gladly help you. If you call me I won't be able to answer because I will be with my family). Just know that you will always, constantly, and forever be charting! It is the true downside of home hospice care.

Chuckles10 · Apr 8, 2016

I am a lpn continuous care nurse. I can tell you that you really have to be into hospice to function at the bsn level. As you may already know they will hire you as a case manager. From what I see from all the case manager's that I have worked with it seems stressful. You have to try to keep everybody happy, your right smack in the middle of everything. Everybody is coming to you.. 50% of the job is being an active listener and the other 50% is critical thinking...if you can do that you won't have too much trouble. Now if that is what you like go for it you will be great..some nurses are.

Depending on what company you work for you may have oncall duties in addition to your cases. Oncall means when someone passes at 3am in the morning you jump out of your bed to go and pronounce because LPN cannot pronounce. You prepare death certificate, you talk to the funeral home, you talk to the family, you are as gracias as possible to everyone. In addition to that, when you are oncall if the continuous care nurse is having trouble managing the patient's symptoms you have to come out and try to get things under control yourself. This can happen anytime at night, 2, 3, 4,5am in the morning. Hospice is a beautiful thing. I may not sound so happy now but I am just burnt out and taking a vaca from hospice for awhile. I do love hospice. I like continuous care the most because I really like bedside nursing. When my patient's symptoms and pain is under control I feel good. Sometimes its challenging but its a great feeling to know that you kept someone from suffering and feeling pain. Good luck