New Hospice Case Manager

Specialties Hospice

Published

Specializes in LTC.

Hi everyone. I was recently offered a job as a hospice case manager. I have just under 2 years of nursing experience, with the magority of my time spent in a LTC facility where I've taken care of several hospice patients. I'm really excited about this position. Hospice is like a calling for me. I really want to succeed, although sometimes I lack self confidence. I will have 6 weeks of orientation, and after that a 12 patient case load. Sound bad? Any advice or encouragement you more experienced hospice nurses can give would be greatly appreciated. Thanks in advance.

AddieRN :nurse:

Specializes in hospice.

Hi AddieRN,

I have been a hospice case manager for six months now. This is my first job as a nurse. I wish I only had a case load of 12. I have a case load of 25 and it is hell! I sure hope all nusing jobs are not like this. It breaks my heart to think this is what nursing is like. Your company sounds a lot more reasonable. I wish you lots of luck!

Specializes in hospice.

Me Too

Specializes in Cardiac, Oncology, Hospice.

I have been a full time hospice case manager for 7 months now. I got 6 weeks orientation and am still working up to a full case load which for us is between 12 to 14. I really do like my company. Good luck to you! Hospice was my calling as well

Specializes in ER, Cardiac, Hospice, Hyperbaric, Float.

Sounds WONDERFUL, Addie!!! Seriously, it does! And where you work, nputte, as well! Seriously, could you two PM me where you work? I am looking for another agency, as I love Hospice but am very unhappy and upset about things where I am working now. I'm jealous, but I wish you the best! :p

Specializes in Hospice.

I manage between 12-17 patients at a time. 12 is a good amount for a new nurse. When I have 12 it leaves me with 6 visits 4 days a week and Wednesday is my catch up day and check on my sicker patients. 6 weeks orientation is about prefect. It sounds like you work for a good agency.

Specializes in LTC.

Thanks for the replies. I know hospice is what I want to do, but what I don't understand is where is all my self-confidence? I get myself down, because I don't have the critical care experience that a lot of nurses have. Is my LTC experience enough to make me a successful hospice nurse? I don't want to take on this job and fail. So the fear of the unknown gets to me. At the same time, I'm scared that if I pass this up, I'll be regretful. It's hard to get on with this company, and this job just happened to fall in my lap, like it was God's Will. Tomorrow is the big day that I have to make the decision, the thought of it makes me sick on my stomach. I need advice, and prayers. :confused:

Specializes in Various.

Take the job. They will train you and you will like it.

Specializes in Hospice/palliative care.

I hope you took the job! Hospice is a wonderful calling. I did case management for 2 years and now manage a team of fantastic nurses. It's a great job. Allow yourself at least a year to learn how to case manage. Don't be hard on yourself! It's a lot to learn and you will feel very stupid at times, but it will come! Good luck!

Specializes in LTC.

Just wanted to let you all know,I took the job! I'm really excited. I think I'll do good. Like any nursing job, I know it'll take a good 6 months to a year to get comfortable. I look forward to comforting my patients, and helping them through their final journeys. It seems like I will be working with a great team of people. I'll keep you posted on how the job is going. Thanks for all the advice. :D

Specializes in Med Surg, Hospice, Home Health.

ive been an RN for 14 yrs, the last 4 in hospice. Did 3 yrs as day shift case manager for hospice. The last yr, i've done weekend on call. I do a great job, but all it takes is someone to complain, and my self confidence goes out the window.

Especially if i'm tired.

For instance, full code patient with dementia with a history of recurrent seizures----daughter called last night, patient having recurrent seizures NOTHING in the home to stop the seizures (no benzodiazapines, no klonopin-nothing to stop the seizures at home)...I asked what she normally does-she calls 911 and mom goes to Emory...so that is what I told her to do. ((I called my Branch director last night because my clinical director didn't answer her phone-which is fairly common-my branch director completely understood and told me to go to sleep and call emory in the morning)) Daughter called office to complain this morning that there was nothing at the house to stop a seizure and to complain that i couldn't fix the problem.....Clinical manager said "you should have made a visit and then decided to call 911." RIGHT-while patient is having seizures for 30-45 minutes until i arrive? That would be neglegent............

Anywhoo-you will gain confidence. Others may cause you to question your confidence. What I ask myself is "can I fix this???" Pain, diarrhea, constipation....the "standard" problems-YES I CAN FIX..... Seizures with no ativan/valium in the home--no-I can't fix.

You will gain confidence with time, and you will learn from yours and others shortcomings. Frankly, you will never make the same mistake twice.

Call on your coworkers for assistance. It is great just to talk to another nurse to ask "what do you think?" ((Especially if i'm tired, i do this)).

Best of luck to you. It will get better. Lean on the social workers and chaplains for assistance-alot of times patients and families need them more than they need our clinical skills.....

Specializes in Med Surg, Hospice, Home Health.

ADDIE: Also, there are alot of great books on palliative care. There is a little red book-i can't remember what it is called, but it is like a "cheat sheet" for caring for each body system. I have an old hospice pharmacia book that has algorithms for common issues faced in hospice.

One great book i found on http://www.dealoz.com is Textbook of Palliative Nursing-Ferrell and Coyle.

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