Hospice Nurse Burnout

jwelhwel · Apr 10, 2007

I'm getting ready to graduate from the RN program and this is my last research paper due on Monday!!!! I'm working on a research paper titled "Hospice Nurse Burnout" and I hope you can help me by answering some questions.
How is it handled?
How is it monitored?
Do you have monthly meetings to discuss your feelings?
Here are some sample questions that I have: 5 being the highest and 1 the lowest or least
-Powerless
5-4-3-2-1
-I can't solve the problem
5-4-3-2-1
-Overload
5-4-3-2-1
-My job interferes with my personal life.
5-4-3-2-1-
-Too much to do and too little time.
5-4-3-2-1
-Emotional Exhaustion
5-4-3-2-1
-Care for one's own health
5-4-3-2-1
-Focus Group available
5-4-3-2-1
-Attend team support meetings monthly if applicable
5-4-3-2-1
-Consider teamwork an important part of reference and support
5-4-3-2-1
-Receive positive feedback regarding conduct
5-4-3-2-1
-Try to ask for help
5-4-3-2-1
-Miss work more than 3 days per month
5-4-3-2-1
-years in Hospice
16mo-1yr 1yr-3yrs 3yrs-5yrs >5yrs
-Employment status
full time part time
-Education
ADN
BSN MSN
-Gender
Male Female
-Age Group
20-25 26-31 32-40 >40

Sadly, burnout isn't always dealt with well in hospice agencies. I have done a lot of hospice education and the first thing I tell new hospice workers is that in order to prevent burnout, they must SET BOUNDARIES for themselves. People who do not have strong personal boundaries will not stay in hospice work. They must take care of themselves before they can take care of others. Acknowledging limitations is also very important. Hospice is not about "fixing"; it about enabling.

Some hospices have half day "retreats" for field staff several times a year at which a lot of greiving takes place by staff. But mostly support comes from peers in the hospice program. Time must be allowed for that among co-workers in hospice.

Nurse overload (too many patients per nurse) is one of the biggest burnout elements. Again, set boundaries and when a nurse knows she cannot adequately care for any more patients, she/he needs to make that known and then keepthat boundary. This is a hard concept for most nurses.

jwelhwel

mc3, ASN, RN · Apr 11, 2007

I assume you wanted LPN's input also?

mc3

AtlantaRN, RN · Apr 12, 2007

I have learned, like tonight, I had already worked my 8 hours, and i'm on call, got a call at 10:40pm to go to see a patient and I called my administrator to say "I won't be in tomorrow to train the new nurse, she'll have to go with someone else", and I'll move one patients visit to friday....... I've already worked 33 hours this week, so friday I have 3 visits, and the marketer is coming in from corporate...I'm salary and if I don't TELL them what I'm gonna do, they'd have me working 60+ hours a week.......

linda

weatherby · Apr 13, 2007

I feel that all involved in patient care and their opinions are of value. Thank you for your feedback. I do appreciate it!!!

weatherby · Apr 13, 2007

I have learned, like tonight, I had already worked my 8 hours, and i'm on call, got a call at 10:40pm to go to see a patient and I called my administrator to say "I won't be in tomorrow to train the new nurse, she'll have to go with someone else", and I'll move one patients visit to friday....... I've already worked 33 hours this week, so friday I have 3 visits, and the marketer is coming in from corporate...I'm salary and if I don't TELL them what I'm gonna do, they'd have me working 60+ hours a week.......
linda

Thank you!!!!

wonderbee, BSN, RN · Apr 14, 2007

I'm new in hospice. Just three months in the field from an ICU background. The honeymoon phase is over and I currently have a case load of 11 patients scattered in four facilities and two homes. I have no LPN help. There are family meetings, team meetings and then there's the paperwork.

I do feel rewarded in my work. I also feel tired. Countless hours of paperwork at home keep me feeling like I'm always "on". This feeling could be a source of burnout for me at some future date if I don't get a handle on it.

AtlantaRN, RN · Apr 18, 2007

I'm new in hospice. Just three months in the field from an ICU background. The honeymoon phase is over and I currently have a case load of 11 patients scattered in four facilities and two homes. I have no LPN help. There are family meetings, team meetings and then there's the paperwork.
I do feel rewarded in my work. I also feel tired. Countless hours of paperwork at home keep me feeling like I'm always "on". This feeling could be a source of burnout for me at some future date if I don't get a handle on it.

I'm with you. We have to stand firm and TELL THEM what WE are going to do. For instance, as of 5:30 tonight, I have 30 hours under my belt, i'm salaried...therefore they have one of two choices

a. I can work 5 hours tomorrow and 5 hours on friday...

b. I can work 4 hours tomorrow, and 6 hours on friday...

If they want me to get the admission done tomorrow, and see 3 patients

on friday along with the new admission followup; then they will choose B...

If they choose A, then one of the PRN nurses is going to get some hours on friday (and i've already spoken with her). It doesn't matter to me which they choose, but if I don't put my foot down, i'd be working 60 hours a week and I don 't do that now that i'm salaried.

linda

sailormom · Jan 11, 2008

It looks like I missed your deadline however I have the same problem as you are asking about and wanted to ask you if I could get the results of your survey to help try to solve my problem at work.

Please call me if you want to share the results.

936-537-2533

sharona97, BSN, RN · Jan 11, 2008

Very interesting comment: Hospice is not about fixing but enabling. This captured my attention and fits perfectly into an actively dyng situation I am aware of now. Thanks for sharing that.

Sharona

freesia98 · Jan 13, 2008

AtlantaRN has the right idea. You cannot take the very best care of the patients if you don't take the very best care of you first! I have been in hospice for several years and believe your patients take enough of you...don't allow your employer steal the rest.