How far to too far to drive?!!

[holistic1028]

My agency seems to not have a set boundary of when they will decline to care for a patient. They wanted me to admit a patient that was an hour and 30 minute drive from office to hospice and I believe that is way too far to provide quality service! Just the drive time will be 3 hours total plus the visit which would be at least an hour. Thats already half the work day for one patient!! How do they expect me to case manage and see this patient weekly?! I've explained all of this and they decided to have a HH LVN that lives near the pt to see her weekly, however I would still need to see her biweekly for RN visits. And the problem still remains. Does your agency have set boundaries? And how far should be too far? What would you do in this situation? It's not fair to the patient or family, what if there is a crisis or a PRN visit is needed?!

[CeciliaBlue]

Hello, I'm new to hospice nursing and am just learning about all the unique challenges of the job. I don't believe any of our patients are over 1 hour away. However, the philosophy is that if no other agency is serving that particular geographic area, then we will usually accept the referral. In the case of the patient who is 90 minutes from the office, if there is another agency who serves the area and is closer, then it seems it might be a better fit for the patient.

[sailornurse]

I worked for hospice as NP, we were required to cover the entire county of 3815 square miles. And we did run into the same issue you are discussing. Compounded with many patients/family that only Speak Spanish, meaning the nurses would have to cross over their usual territories to accommodate the family/patient. They did have an on call but they also would over schedule and not allot meal breaks etc. They lost most of the staff over these and other issues.