mab19

Thanks for your feedback. Could you tell me whether you're your home health agency is connected to a tertiary care system (a hospital system) or if it's an independent agency?

I've just relocated to VA from the West coast and am planning to continue hospice nursing here - probably in the Hampton Roads or Richmond areas. Can anyone give me feedback on what I can expect the hourly compensation range to be? I've been a nurse for ten years and my last two years of experience were in hospice. I've also posted a thread in the Hospice forum regarding this question. Thanks for your help.

It's distressing to me to hear about nurses not billing for the time they actually work. Not only are we cheating ourselves as individuals when we do this, we're also short-changing the profession as a whole by allowing managers to impose unreasonable caseload standards. For example, if hospice administrators see that case-managing nurses are billing around 40 hours for a 12-pt caseload, then these administrators can reasonably expect that other nurses at the agency should be able to meet this same standard. However, if the nurses who are billing 40 hours for a 12-pt caseload are actually working 50 hours, then they are helping to create an unreasonable productivity standard. As I see it, this is one of the age-old problems with the profession of nursing. Instead of setting reasonable boundaries and speaking up for themselves, nurses so often accept mistreatment in the form of unfair or unreasonable work requirements. When we don't speak up against this we help to impose these burdens on our fellow nurses, and on future generations of nurses. Please, please bill for every hour you work. Under the federal Fair Labor Standards Act (FLSA), you are entitled to be payed for every hour worked and should receive overtime pay for every hour worked over 40 hours.

I just took a case managment job with a start-up hospice and we're going to be using Misys for our clinical documentation and billing. After training on the software for a couple of weeks I'm beginning to have my doubts about how well I'm going to be able to integrate this program into my nursing practice. I'll be doing a lot of admissions since this is a startup, and so far it's taken me over 4 hours just to do all of the electronic charting for a practice admission. Does anyone have experience using Misys for nursing documentation in hospice care? Can you comment on how it's affected your patient care, for better or worse? And what sort of hardware is your agency using - tablets or laptops? Thank you!

I'm a hospice RN and also have my JD. To bring successful litigation in this area you'd have to show deviation from the standard of care and resulting harm to the pt- something difficult to do in the area of pain management. Would be interested to know if anyone else is aware of any litigation on this issue.

I think this would depend primarily on your geographic area, your level of experience and your employer's status as union or non-union. I work for a for-profit in a major metro area in the Pacific NW (non-union)and our pay scale is approx 26-29/hr. This is low in comparison to the hospital-associated hospices in our area, where the hourly rate runs into the low 30's.