Is it time to leave hospice??

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Hello all,

I am in a crossways of sort. I have just spent the last 7 months working as a hospice case manager and I am beyond burnt. I feel horribly sad admitting this.

I resigned from an agency that has been utter chaos since I stepped foot in the door. I had half day orientation in the field, was kicked out on my own, then openly reprimanded as I went along learning. I didn't have a name badge for over a month, no office voice mail for 3 weeks and a pager that didn't work and didn't still when I turned it in. I was suppose to have a local service area that was promised to me and it was ANYTHING but. I had one patient that was over an hour away from our office.. nuts. I had a QA non nurse manager changing patient assignments several times without consulting with anyone.. case manager, family etc. I had a manager who never worked a day in hospice and was utterly clueless to the inner workings and dynamics of those we serve. Worse of all, I got so very tired of saying, I am sorry for things I could not control. No return calls from office management, constant service failures with our pharmacy, patients being denied certain aspects of the hospice benefit despite it being a part of the package elsewhere. It was like OMG.... I can't put my name on this product or service anymore. I tried to support the office, but I will say.. it's a hot pile of you know. I knew that this office had a position open for another team manager. I have the experience.. plus I knew the office needed the support and knowledge... I was told " ah, you don't have the leadership skills for this position... !!" That was the final straw..

Saying that. I left short of my resignation... and so glad I did. I have another agency I am starting with.. but. something different has just crossed my path!!!!

Kaiser contacted me regarding a very interesting case manager position... one that need a clinical backing... and would be dealing with patients but telephonically and on site in certain SNFS. Very different then the crapola place I just left.

I am so beyond burned out from my last 7 months.. I am thinking of leaving hospice all together. Some agencies like the Big O are only interested in the $$$$ I can honestly say that this has been a horrendous experience and they won't even make it to my resume.. as far as I am concerned.. I have been in school the last 6 months not at Odyssey.

THanks for letting me vent.. I fear I am burned beyond recognition.

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Specializes in Hospice, Case Mgt., RN Consultant, ICU.

Definitely sounds like you need a break from hospice for now. Sorry to hear of your experience. I wonder if this is something happening with all hospices. I was a Case Manager with a hospice that was not Odyssey and it was a similar mess. We were expected to use our own cell phones and compensated a very small dollar amount which was never enough. So no Blackberry like Odyssey uses which made it very hard. Three weeks there and still no orientation. Driving all over a very large area instead of having one area. On two seperate teams so meetings every week instead every other. Just a total mess. Could not sleep at night worrying about losing my license in that crazy place. Yep, that one will not go on my resume either! Good luck to you!

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

Take care of yourself first, then you can care for the broken hearted and dying.

Good luck Noey!

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Specializes in Hospice.

I'm afraid that the preponderance of for-profits, the consolidation of the industry into ever-larger chains and the ongoing changes in CMS requirements has turned hospice into something we don't recognize any more. In the 7 years I worked on the same hospice IPU, I had 4 owners, 6 executive directors and 11 unit managers. Yet, somehow, it was the staff nurses' fault when things went wrong.

When CMS initiated the hospice benefit, for profits flooded the field >> increasing incentive to fudge the paperwork to maximize profit >> increasing CMS regulation to control the fraud >> increasing pressure on nurses to work to the profit margin instead of the patients' needs.

Not that non-profit status is any guarantee of competent and/or ethical management ... but at least management doesn't have to answer to a bunch of disconnected shareholders!

Someday, when I get over feeling so furious about the situation, I'm going to hunt down the quarterly reports and prospectuses (prospecti?) that these companies send to shareholders ... in my case, Ardent, Vistacare, Odyssey and Gentiva ... and see what we're really working for, 'cause it sure ain't the patients!

I don't know what to do ... right now I'm still certified and investigating working as a volunteer on the other inpatient unit in town. I won't be able to work as an RN ... but I'll still have the patient contact. I hope the facility and I can find a way to use my hospice skills that won't create huge liability issues.

I do know that I'll never, EVER work for a for-profit hospice again.

ETA: just as an interesting side-note ... every single one of the 4 owners of my hospice has been nailed by CMS for some funny business. One of them lost their CMS certification for a year because of their business practices. Another one signed a consent decree that requires yearly compliance and ethics training for all employees. Feh!

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I'm afraid that the preponderance of for-profits, the consolidation of the industry into ever-larger chains and the ongoing changes in CMS requirements has turned hospice into something we don't recognize any more. In the 7 years I worked on the same hospice IPU, I had 4 owners, 6 executive directors and 11 unit managers. Yet, somehow, it was the staff nurses' fault when things went wrong.

When CMS initiated the hospice benefit, for profits flooded the field >> increasing incentive to fudge the paperwork to maximize profit >> increasing CMS regulation to control the fraud >> increasing pressure on nurses to work to the profit margin instead of the patients' needs.

Not that non-profit status is any guarantee of competent and/or ethical management ... but at least management doesn't have to answer to a bunch of disconnected shareholders!

Someday, when I get over feeling so furious about the situation, I'm going to hunt down the quarterly reports and prospectuses (prospecti?) that these companies send to shareholders ... in my case, Ardent, Vistacare, Odyssey and Gentiva ... and see what we're really working for, 'cause it sure ain't the patients!

I don't know what to do ... right now I'm still certified and investigating working as a volunteer on the other inpatient unit in town. I won't be able to work as an RN ... but I'll still have the patient contact. I hope the facility and I can find a way to use my hospice skills that won't create huge liability issues.

I do know that I'll never, EVER work for a for-profit hospice again.

ETA: just as an interesting side-note ... every single one of the 4 owners of my hospice has been nailed by CMS for some funny business. One of them lost their CMS certification for a year because of their business practices. Another one signed a consent decree that requires yearly compliance and ethics training for all employees. Feh!

I feel the same.. hunt down he share holders. Our office had multiple complaints I mean multiple... ( 5 ) that I know of and many more not admitting to the corporate integrity line. NOTHING WAS DONE in the 6 months I was there. No kidding.. Odyssey does not care... no matter how much crap propaganda they shove down their employees throats.. it's a all garbage.

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take some time if you may to heal. not all hospices

are as bad as your odyssey experience, but many

are mismanaged and you may find yourself in compromising

positions more often than not. unfortunately, hospice has

been overrun with greed which has affected the ability to

provide the compassionate, competent care that is most

needed with this specialty. best wishes!

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unfortunately, hospice has

been overrun with greed which has affected the ability to

provide the compassionate, competent care that is most

needed with this specialty. best wishes!

i wish more folks understood this...that hospice is increasingly becoming a meat market.

with such a merciful perception, very few will believe or accept the concurrent incongruity of greed.

noel, i do believe you need some time off, versus permanently leaving hospice.

time for a new game plan...there remain many noble and honorable hospices.

you'd even do well in a hospital pall unit, i think.

in the meantime, be good to yourself til you're healed.

wishing you the very best.

leslie

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