I'm out


  • Specializes in medicine, hospice. Has 7 years experience.

After 2.5 years in hospice, I'm out, at least for now. I love hospice work, the patients, the families. But the management was so bad I couldn't do it anymore.

There was a mass exodus of the core of the team a while back, due to the new manager of our hospice (hospital based), which pretty much decimated it in my opinion, and it never recovered.

Why? So many reasons. The call schedule is harsh. Politics. Favoritism. Lower pay than other hospice agencies.

I don't know how it is with other hospice agencies, but at ours, the CMs take ( theoretically) one night of call per week and one weekend day per month ( either Sat or Sun, 24 hours). There is no back up. If you have the night from hell you're on your own. Late admissions are done by whoever is on call. There is no triage. Weekends tend to be heavy with admissions and visits of one kind or another.

When nurses quit, which has been often, the CM s have to divvy up that person's call until new people are hired, trained, etc. which takes several weeks. the CM s do get time off if their hours get to the point of overtime. This can be problematic though because then PRN s are seeing their patients a lot, so less continuity of care. Plus the CMs are still tired and stressed, and they just never really have enough scheduled, predictable time off because the schedule is always in flux.

Being on call is difficult in itself because it's semi rural. We would routinely get sent out well beyond our stated mileage boundaries. Terrain can be rough, and meth production is rampant so you have that demographic. cell service is spotty. so going out alone at night on call can be harrowing. On call does seem to get called quite a bit.

I love hospice, I feel I'm good at it, received excellent reviews. I hope someday I can go back. But work conditions for the nurses will have to improve. It's just WAY not enough money for the toll it takes.

Just thought I'd share that; ventilating I guess. Thanks for listening.


158 Posts

Specializes in Hospice, Case Mgt., RN Consultant, ICU. Has 35 years experience.

I hear you goldberryRN! Hospice is such a wonderful program so it is a darn shame when somehow it is thought that personnel can continue to function in the conditions you describe. I wish you well!

Specializes in Hospice and Palliative Nurse.

So true! Hospice is expected to be staffed 24/7, it surprises me that only a few companies staff on call separately? It makes sense to have on call staff that triage and go out when necessary. It increases patient /family satisfaction tremendously and keeps staff much happier!! Cheaper than having to continuously advertise for help, hire, train...rinse and repeat :)


149 Posts

I hear you! I left another hospice agency for that exact reason! I'm happy with the company I'm with now though. Maybe you can give it a whirl with a different hospice once you've taken a little break? Hospice needs all the good CMs it can get!