Non-Profit vs For-Profit

[henrysmom]

I am an ICU nurse who has for years wanted to switch to hospice after experiencing way too much terminal suffering in the ICU and after having three close family members die while under hospice care. Have taken the past three years off to stay at home with my little son, but now it's time to re-enter the workplace. I have called two local hospices and will be interviewing soon. I'd like any feedback you guys can provide!

The first hospice is a non-profit here in So California and does not utilize LVNs at all. The second one is a for-profit and utilizes their RNs as patient care managers and each RN has LVN under her, as well as home health aides etc. Can you guys tell me pros and cons of each type of hospice? My good friend is a hospice nurse at a hospice which uses the RNs as patient care managers and says she feels she doesn't always get enough time with family members, but feels her job is easier in a way.

Love any feedback and advice. I've started reading as much about hospice as I can and have joined HPNA. Any other ideas would be appreciated. Thanks in advance! Kim

[aimeee, BSN, RN]

I have not worked in both settings so I can't provide pros/cons of both. Some non-profits hospices utilize LPN's. My hospice is currently moving away from the use of LPN's, mainly because it limits our flexibility. Ideally we would like all nurses to be able to do admissions or manage IV meds. Some questions for the hospice that utilizes the LVN's would be:

For the average patient, how many regular scheduled visits/wk does the RN perform? How many does the LVN perform?

Do the RN/LVN's work as a specific team, or might the LVN visits to the patient be any one of a pool of LVN's?

How is communication managed between the RN Case Manager and the LVN? What procedures have you set in place to optimize the flow of information regarding changes of status and chages to the plan of care?

If I were going to be an RN case manager who had LVN's performing some of my patient visits, I would want a situation that maximizes continuity of care. If you are paired with just one LVN, its going to make communication between the two of you easier and you will be able to know that person's strengths and weaknesses better than if you have to work with a large number of different people on a regular basis. That LVN will be your eyes and ears and hands so you need to be able to work well together.