New to HH: traditional vs Hospice

Kaisu · May 22, 2019

I have worked home health and now working hospice, both for the same agency. First and foremost, the agency is key. They can be the best jobs you ever had or they can be a complete nightmare, depending on the policies, procedures and culture of your agency. Make sure whoever you work for is respectful of employees. They must make the employee their priority. If you are respected and supported, you will take care of the patients.

Secondly, it depends on where your heart is. My heart is in hospice. It can be a terrible fit if you are not comfortable with death. All your patients die.

Both are wonderful areas of nursing for me. I make 20% more than in acute care. This agency pays better than anyone else and thus they get and keep the best people. I love the autonomy, the one on one care and the emphasis on my first love, which is teaching.

Search your heart and decide which one you would like, but I would take a home health job with a great agency over hospice with a poor one.

berube · May 22, 2019

Kindred will run you to the ground, awful managment. Company is a decent one, decent benefits, but managment is enough to make u ill

bluenurse10 · May 22, 2019

Thank you for your responses!

Kaisu, what company do you work for?

Berube, do you recommend any company that might be better? Where do you live? I live near St. Augustine, FL. How long has it been since you worked there? I'm curious about the cost of insurance and deductibles, etc. I really enjoyed the interview.

Kaisu · May 22, 2019

I work in Western Arizona for a small company that serves the communities along the Colorado River. We have patients in Quartzite, Parker, Lake Havasu City, Kingman, Mohave Valley and Bullhead City in Arizona and in Big River and Needles CA.

If you google the parent company, you would find a lot of bad reviews from employees. The CEO of our little branch is a nurse. I find that issues of moral and company culture are always top down. I had a good feeling about this company from the first interview and excellent reports from current employees. It is still a crap shoot tho. I feel I lucked out.

If you had good feelings from the interview, and can talk to some employees on the QT, then go for it. If you hate it, you can vote with your feet.

I wish you all the best and good luck!

berube · May 22, 2019

I am in SC been at kindred 10+ yrs, our managemnt is horrible, now could be the branch here, .. money focused, and no none of us ever do enough, they have people woth documentation out 2 weeks and never say a word to them, i just do mynjob and stay u der the radar, kindred is also know for a lot of repetice documentation, i am close to retirement and thats why i stay.

the interview is always good, i use to sit in on them also and when it came to “opinion” time they didn't care..

HH and hospice are 2 different worlds, i did hospice for a bit, just wasnt for me. But if thats ur first love stay with it.

Zippy83 · Jun 25, 2019

I do both hospice and home health and love both. I would gently caution the use of the term ‘traditional’ for home health and referring to hospice as if it is some form of nontraditional or alternate home health. Just for your own benefit in how you view them. They are completely different worlds, the only thing in common is that they take place in the home.

I can’t personally speak for kindred at home, but I would advise you to run far away from Vitas, and ideally start your journey in hospice with a smaller and, if possible, nonprofit agency. Vitas has a terrible reputation where I live, the nurses say they are awful to work for, patients and facilities say they are terrible. And then in a completely different city, I had a family member on Vitas, and I experienced what I considered to be the worst hospice care imaginable for this family member. Not only are they for-profit, which several of the agencies I’ve worked for are and they have still done a good job, but Vitas is the only publicly traded hospice. Wall Street does not belong in hospice care. There were so many medications and supplies that all of the hospices that I work for regularly provide, that Vitas does not provide. The nurses didn’t even practice any form of hand hygiene or infection control, they were disorganized in terms of when to send out staff, many nurses came to the door and knew nothing about the patient. They are ALL about the bottom line.

And the lastly, consider going into only one or the other first, for at least six months, before venturing into the other. Like I said, they are completely different worlds, and if you are new to both, the huge differences in documentation, care plans, etc might be overwhelming.

But no matter what, good luck!

advicenurse1, ADN, BSN, RN · Jan 1, 2020

I did hospice for about 10 years and its a challenging job. I tried home health for just a short period of time but the pay method is less stable than hospice so I only did it for a few months so i'll comment on hospice pros and cons.

Pros- No call lights, no 12 hour shifts, you work alone so no dealing with lazy, messy coworkers, flexible schedule, good pay, you go into patients homes so no "holiday Inn" mentality,

Cons-frequent oncall (at my agency I did oncall about 3 times a month and you may have to go out at 2-3 am to see a patient), alot of nasty, roach infested houses, tons of charting, extensive driving (I drove 60-70 miles some days and had to use my own car, alot of drug seeking (mainly from family members caring for the terminally ill patient)

I personally would never go back to the hospital. My worse day in hospice is better than my best day when I worked in the hospital.