Oncall hospice nurse

RNS5 · Nov 24, 2012

I will be interested to see the replies to this as I'm about to start a position very similar to your's! Good luck to you!

eaduarte · Nov 25, 2012

Hopefully you will have a good experience and I suppose it all depends on how your company looks at on call and what the expectations are. I know that the places I have worked do not keep on call nurses long, but that is because they are scheduled visits on top of doing on call visits. I think that the expectation for doing everything is a little undesirable and too stressful for the people to handle, therefore the places I have worked have had a hard time keeping an on call nurse. I am sure it will be good and as long as you are getting compensated well I think that you will be fine. Also sounds like you have a lot of support with other nurses, so it sounds WAY better than the other setups I have seen.

Good luck to you!

kimhaw · Nov 26, 2012

This is sounding like its going to be presceduled visit/admits along with call. I don't know if I mind or not yet but I do know when I accepted the position I did not think their would be alot of presceduled visits because thats not really call in my opinon. I guess I will see. Its a large hospice so if I can stay in "good graces" in case call does not work out for me I will try to apply for admission RN or Case manger.

Bubbles · Nov 27, 2012

In my experience being the on call RN and trying to do admissions does not work well. Admissions are very time consuming and when the on call RN is doing an admission there is really no on call nurse. One of the largest hospices tried this and it really stressed the triage nurse. One of the purposes of having an on call nurse is so someone is available immediately for changes in condition, deaths, and any other situations that can occur after hours. Routine admissions can easily take five hours to complete. That is why there are seperate admissions nurses to do the admissions.

kimhaw · Nov 27, 2012

Today during orientation I was told they want the on call nurse to be just that "on call" and not have to do admissions. They are presently hiring an admission nurse. Admissions are very time consuming as you said and I can't imagine trying to admit a patient and my phone ringing for a death or change in condition its not fair to either patient.

Bubbles · Nov 28, 2012

That sounds much more reasonable. Good luck to you.

Sterling-RN · Jan 26, 2013

Hi...I spent 2 years as an on call nurse before I moved into a primary nursing role with hospice. It was also 7 on and 7 off. My hours were 4:30pm to 8a. My coverage area was huge, and I was responsible for symptom/death/admission visits. I was also called to confirm continuation of extended care presence.

It was a difficult transition from med/surg and ltc nursing. The travel, the elements, the critical thinking, emotional support needed while at the same time learning hospice philosophy and resources was very challenging. I learned a tremendous amount, but at the cost of dreading the sound of the ring tone on my cell phone. We rarely ever had a fully staffed team, but everyone went way beyond what was expected of them.

My advice is to be extremely organized. Make a list of common terminal diagnoses: CHF, COPD, CA, Dementia, ALS, Renal, Liver, etc., and review common symptoms and common symptom management. Become familiar with what is needed to get meds from a particular pharmacy, how to send patient to an inpatient unit (if that is advised and families are willing), how to initiate continuous care. how to provide non-pharmacological interventions, and providing emotional support/education. Review your practical skills: changing dressings, catheter placements, etc. Review caring for an actively dying patient. Much of this you probably already know, but it makes things somewhat smoother if you have some kind of a outline to guide you in your head.

I would often know the name, age, sex, dx, problem, doc, current medcations, and length of stay with hospice on my way to the home/facility. I would use my drive time to consider possible interventions before I walked in. Caution though...be open to nothing being what you necessarily expected when you get there =).

Hope this helps. I know this is just scratching the surface. If you have any specific questions feel free to message me. Following a year in primary nursing for hospice, I spent another 2 years on the Admission team, which is what I am doing now. So, I may be able to help if there is an admission piece to your role afterall.

kimhaw · Feb 21, 2013

I work 7 on and 7 off and that is the only reason I am still with the company. I am doing more admissions than oncall. Its gets very intense on weekends bc we may have 5 scheduled visits plus on call and we cover a large territory. Sometimes I think managers think we are robots.