10 months in hospice and already feeling burned out...

[Cowboys_RN, BSN]

I was offered a hospice position as a new grad but thought I wanted to try working in a hospital first. I worked in a postpartum unit for 7 months and loved it but the 12 hour shifts didn't work with my daycare situation. I took the job at the hospice as a case manager. I loved it at first, I have always loved gero pts. I like working with the pts and getting their symptoms under control and giving them a better quality of life. I also like the freedom with my schedule, the autonomy, etc.

However, 10 months later and I'm already starting to feel burned out. It's not the pts, it's their families and it's the office. I've had some patients on service for 7 months now. I see most of them twice a week, so that's twice a week for 7 months, when there are issues with the family or the home it gets tough to keep on going there over and over again. Then there's the IDT meetings that drag on and on and the case manager meetings, the in-services, the constant changes in policy or documentation. I'm just sort of over it right now.

Is this common for new hospice nurses?

[timewood]

Hello there dear...

At the point you are describing, I changed company's but stayed with hospice. That got me through about another year (I have about 2.5 years total case management). Unfortunately, burn out is very high among case managers. Like you, I love my flexibility but even though the job is flexible, it really does not translate to real "down time". We are a total paper office so I ALWAYS have more that needs to be done. Or I always have something that could be done to my charts, documentation, with a family etc. This job is mentally a 24/7 responsibility like no other- my mind stays like a shaken snow globe of "gotta remember to do ____". I have gotten to the point where it is time to move on. I have decided to take a weekend on-call position (still palliative which I enjoy but without the case management responsibilities) and go back to school.

Maybe a change in company culture and case load would help you...? It would still be case management but maybe it would help you make it through until your child starts school and can skip day care..? (don't know how old).

Best wishes in whatever you do and feel free to contact me.

-Deanna

[finn11707]

I have toyed with the idea of looking for 1/2 time Hospice job and supplementing with someting low key like advice---Burnout is common among casemanagers. My first 1 1/2 years working hospice, I saw patients 3 days per week (no case management) followed by 3 nights per week. I had one 3 day weekend off monthly and it was less stress and burnout and more pay! This was partly due to the minimal contact with office politics. No IDG. And you always feel so much appreciation when you do night call.

Good energizers are: conferences; 'honoring ceremonies'...light candels, play music and say goodbye to your patients who have died each month; take planned vacations---even a 4 day weekend to the spa with the girls every 3-4 months, monthly club with friends--dinner, theater, poetry, book--whatever. We need lots of ongoing self care to keep from burning out (beyond family outtings)-- especially in the first year or two of hospice experience. Be kind to yourself. Do draw some healthy needed boundaries after self reflection on where you may be giving more that you can. (I have a difficult time with this one, so I know...) This is why I use poetry to speak more deepy to patients/families with high emotional issues. Rodger Housden RISKING EVERYTHING is a good broad variety that work well with Hospice work and also Mary Oliver's--Vol 2 collection.

Be easy on yourself IF you do need to take a break from hospice. The work is intense and sometimes calls up emotions and work in all of us, no matter how long we have done the work.

[Cowboys_RN, BSN]

I spoke honestly with the owner about how I am feeling. He suggested I try working for their other company which is strictly home health. It is more task oriented but still allows for flexibility. It really doesn't sound all that appealing to me though. I have a case load of 10 right now, I'm used to 15-17. I think I'm going to work ADRs in the office part of the time and keep my small case load for now. Thanks for the great advice. It's nice knowing I'm not the only one feeling this way!

[youngheartoldhead]

it gets tough to keep on going there over and over again. Then there's the IDT meetings that drag on and on

lol!! Monkey, I feel the same way. when people start going on and on in our meetings I just want to say TIMES UP!! Time is valuable these days -- every second counts and I'm getting MORE and MORE protective of it every day. Get into the habit of rushing everyone. get into a mad hurry and always be on a mission, eventually people will stop messing with you, as long as you are busy about taking care of your work, they can't say a thing. When my managers start moving too slow and things drag, I will get my list out and start calling my "to do list". Order meds from pharmacy, call doctors, call patients. Get that mess done while people are lollygagging so you don't have to take out of your own personal time. And thats exactly what will happen if you let people suck up your time with useless things. don't be afraid to tell people to get the show on the road. these people frequently need clues as to what goes on out in the real world.