Need your input before we all quit.......

[KJB_65]

I work for a non profit Hospice who is killing their case managers. I manage 20 patients with no other nurse to help me. I also do my own admissions. I have been told I must have 23 patients then I can get a part time LPN to form a team. Other case managers have anywhere from 23-29 patients and they all have full-time LPN's working with them. I was actually belittled on the phone a week ago during a time when I had 2 particularly demanding situations. I asked for one of the PRN nurses to come help me for one day to see some of my stable folks. One of my patients with Lung Ca was transitioning and in a nursing home. Her sweet, devoted husband promised her she could go home to die. The HHA that works with me and myself both spent hours with them daily teaching him how to take care of her at home. This was a Monday when she came home and Friday she expired. This was a true labor of love. They were a beautiful, lovely couple who had been married for 51 years. During the same week, I had a pt transferred from Hospital home on TPN. Dx was stomach ca with mets to liver. I had to teach his extremely nervous CG how to use the pump, manage his meds etc. I went every day at 4pm and spent no less than an hour and a half with them. I even made the visits on my weekend off and after my regular hours when I wasn't on call for continuity of teaching. During this particular week, I had 18 patients. My supervisor's statement to me was "why are you having so much difficulty with 18 patients when other case managers have almost 30"? my answer: "they have an LPN to make visits and I dont". She was nasty to say the least........................so after this very long post my question is please list the amount of patients you are case managing and if you have a nurse that helps you. I am going to take the numbers yall provide and turn them into management. I won't copy any user names. I just need the statistics. Any help will be greatly appreciated.

[introspectiveRN]

Thanks for all of your replies. I have compiled the average number of patients that you all said you manage and have given it to my administrator & supervisor who by the way just put in her resignation. Nothing I give them will change the situation and I am actively looking for a new job. We are certificate of need and only 2 hospice agencies in my city. I may have to go back to home care which makes me want to throw up. I'm just not sure what I want to do. I'm disenchanted with my career to say the least. Thank you again.

I am so sorry to hear all of this ...I really hope that a better opportunity presents itself for you...

[shrinky]

I hear what you all are saying and I can tell you that our non-profit Hospice does not make $$$$, we recently had a telethon to raise $$$ to bail us out of a $250,000 debt. Our PCC is very careful about making sure that patients are Hospice appropriate and our case load is no more than 10-12. We have discharged a significant number of patients who do not meet LMRPs at recert, and some of these have been picked up by a for profit Hospice afterward. I realize it usually is about money and we are a hospital based Hospice and not very large, but we have been in this area for 15 or more years. I think that it is a sad state of affairs when people want to make $$$$$ from the dying population and if my Hospice was like that I would have to retire early. You cannot give of yourself to them with numbers as you mention without burning out quickly. My hats are off to all of you who work under those conditions, I could not anymore. However, until God calls me out of this type of work, I am in it for the long run with thoughts of expanding to neonatal and perinatal Hospice. God bless you.