CaringRN1234

Hey Shan, When I graduated from nursing school I was almost identical to you. My father had died of cancer and my mother was fighting cancer. So I worked on the oncology floor for a little over a year just to gain the med-surg skill foundation. Then I started with hospice. I feel that I bring a little something extra to my patients having experienced a personal loss myself. It helps them to know that you are there because you care. The oncology experience has also helped me a lot in hospice. Good luck to you.

I want to hear from some other hospice nurses. We had an internal audit done awhile back and they brought up some on call items. Our administrator & social worker has begun to make alot of suggestions about nursing visits during on call (and neither of them are nurses, nor do they either have to take any call so they don't know what it is really like). They are saying that no matter why a patient calls on call that a visit needs to be made. I disagree. I have had many families call just to ask a question. Please give me feedback from the group about your calls. Do you always make a visit or do you triage on the phone and handle via phone if you can. I think a visit should always be offered but sometimes families don't really want you to come out. Another example: maybe pt has elevated temp, we advise to give Tylenol then call back in 20 mins to check on pt. Pts fever has then gone down & pt is resting comfortably. Do you then make a visit or follow the next day & advise family to call if any other problems arise during the night? We cover a very large area (13 counties) with some pts living an hour away in rural areas. It just seems like the nurses in our office are always having to stand up for our clinical judgements by non clinical people. A lot of times they make decisions about what they think should be done before even talking to us. What do you think about this situation? Do any of you find similiar situations in your offices?

At my agency we get $100 per weekday (5pm-830am) and $150 per weekend day (830am-830am). If we go out we get our regular mileage from door to door. If we do an after hours admission (which we rarely do) we get an additional $75 for that. One weekend I had to do 7 hrs of continuous care by myself. My administrator allowed me to take a day off during the week. We only have 2 nurses (myself and one other). We don't have to go out very often on call because we try to be proactive with pts meds & such. Plus our hospice is small with a census of aprx 24 right now.

I am a new "member" but have been reading posts for a long time. I have worked for a local hospice for 1.5 years now and I love hospice nursing. I feel like this is what God has called me to do. The problem is the company I work for. All they seem to care about is "census"! We have had 3 administrators, and 1 Don since I have been there (she was fired). Now it is just myself and one other nurse with a census averaging around 25 (no DON since Feb). We are expected to stay at the office after we see our patients. Found out last week that our administrator is leaving. Back to square one. I have been trying to help our administrator with DON stuff. I actually was offered the DON position but decided against it b/c of the way the company handles everything. I know I would be setting myself up for failure. I just wonder what other people do as far as office time. Are you expected to sit in the office after your patients are seen, until 5 pm? I feel like this is really wasting my time and productivity as there are so many interruptions and distractions I get absolutely nothing done in the office. I am bringing stuff home all the time or lately just letting it all get further behind because all my energy and motivation is zapped. (Not for my patients care but just for all the rest.) I would like to know how you guys handle office work, recerts, followup phone calls (in your car, in the office, at home?), etc. I feel that I need to start setting some new boundaries with our company. My hubby told me today I am totally absorbed with work all the time. I have a precious little girl age 5 she has to be my top priority. Thanks for listening.