Help!!

cubelle · Apr 7, 2016

Monday-Friday 8-5 pm with call. That is what I do, and I love it. I haven't worked the weekend on-call position, but I hear that many hours on can be brutal. I think starting in case management as the Monday through Friday nurse is the best way to learn hospice. I've been doing it 7 years & love it! My best tips-chart in the home & finish your charts right after you see a patient. I do mine in the car in places such as a chic fil a parking lot. If you close out your charts right after you see patients, they are done & you take little home. You will get the hang of it! Best of luck! :)

CFLA.RN · Apr 7, 2016

It really depends on what your home life is like and how often you would have to take call with the m-f. I would have preferred to have the weekend call with terrible hours over the m-f 8-5 with call because after working all week doing regular visits you get to have a weekend with terrible hours or nights during the week where you get no sleep and then end up working all day again. How big the company is makes a huge difference too. How big is the coverage area? Do you have to triage calls and make visits or do you work in an RN/LVN team? If it's a bigger company, is there back up on call in case you get two crisis calls at the same time? I would ask a lot of questions about what their typical weekend calls looks like and also what the weekday visit load is.

Zee_RN, BSN, RN · Apr 8, 2016

My organization is fortunate enough to staff in such a manner that our RN Case Managers rarely take call. They work a regular Mon-Fri 8-5p week (salaried position). They take "on call" only when our regularly scheduled on-call nurses are off; for instance, if one of our regular on-call nurses gets sick, takes vacation day, etc. We have a "back-up on-call" list in the event the regular nurse calls off. Also, someone has to staff the daylight hours on a holiday. We take volunteers first.

So we have a nurse who works 5p-8a Mon - Fri and a w/e nurse who works Fri 5P to Mon 8A (so there's double-coverage on Friday nights). That REALLY cuts down on the amount of on-call our regular case managers have to do. Not bad staffing for a small hospice operation!

Given the choice, I'd go with the MON-FRI routine. Our W/E nurse is awesome-saucebut she does *everything* on the weekends...all evals, consents, admits that may occur as well answer all the phone calls, pronounce patients, do visits, handle emergencies. We have on-call psychosocial too but usually it's the nurse handling everything. :)

Raviepoo · Apr 13, 2016

There is no such thing as better. There is only what works best for you. Weekend on call can sometimes be really insane, but then, so can Monday - Friday. At my agency there is no such thing as 9 - 5 (or 8 - 5.) There is just a patient load, and the needs of the patients.

I prefer on-call to case management, but that's just me. They are different. If you are doing case management you will get to know your families really well. If you are working on call you are likely to step into the lives of people you don't know very well at times of crisis. We are talking about two different skill sets. Which do you think you might do better? Which do you think you might enjoy more? Your answer might be different than mine. You're in the enviable position of being able to chose. What do you want?

Raviepoo · Apr 13, 2016

Our W/E nurse is awesome-saucebut she does *everything* on the weekends...all evals, consents, admits that may occur as well answer all the phone calls, pronounce patients, do visits, handle emergencies. We have on-call psychosocial too but usually it's the nurse handling everything. :)

Yeah. That's the insane part I mentioned in my post. I have had weekends where I have had a line of people waiting for me, plus a death, plus an admission, all needing attention at the same time. Not fun. It wasn't every weekend. Some weekends nobody called at all and I felt guilty for collecting a paycheck.

westieluv · Apr 14, 2016

I have worked in every facet of hospice nursing except for the 8-5 M-F case management role. The reason why is because I learned early on that 8-5 is not realistic a lot of the time. As someone else mentioned, there is no shift for a RNCM, only patient needs. I recently worked as a daytime resource/after hours triage nurse for a large hospice and how many times did I get calls from patients and their families after 5 pm in which they only wanted "their" nurse, even though there was an after hours nurse on duty at 5? A lot! And a lot of times, those RNCMs would still be out in the field at 5pm, 6pm...however long it took to fix everyone's problems and settle them in for the evening.

I think of being a hospice RNCM as more than a full-time job, it is a lifestyle. Many of them have huge hearts and just cannot say no, especially when they are dealing with dying people and stressed out, grieving families. My hat is off to them, they are super nurses, but it has to take a toll on personal time and family life.