HeavenlyRN

Unfortunately, I am thinking about leaving hospice too. I have been a hospice CM for 6 months a far as the patients, I love it. But I am struggling with the long days, working 10 hours per day and only getting paid for 8. spending my weekends doing notes because there wasn't enough time during the week; and being expected to see other nurse's patients when they call out. I have difficulty managing my own caseload without having to take care of someone else's. I am sad, because I really do love what I do, but my quality of life has dropped significantly since I started in this specialty. And unfortunately, most hospices seem to have similar problems. Not sure what I am going to do.... But OP I wish you well and hope you can find a way to stay in this specialty that we love.

Clearly every agency situation is different. I stand by what I said about the requirements at my hospice. I do facilities as well, but all of my patients are NOT in the same facility. If that were the case, I could easily do 5 visits per day. And our documentation does NOT take 15 minutes (I wish it did only take that long!) My productivity is not an issue as I do what is required and more to take care of my patients. Glad your situation is working for you but remember everyone's situation is different and cannot always be compared.

I am new to hospice nursing, but I find that 4 visits a day is more than enough for me. Between all of the excessive documentation that is required and the phone calls/care coordination that happens in-between, I cannot imagine doing more than 4 visits in one day. so far my hospice does not have a minimum number of visits required for the week and I hope it stays that way.

4boysmama thank you for sharing your solution. It is a great idea I will have to think about. Just not sure I want to carry 2 phones and have another bill ( even though $30 is extremely reasonable!)

Our company requires us to use our own cell phones. We receive a stipend of $60 per month. We were told in orientation not to give our phone number to families or facilities. I never do because once they have your number, there are no boundaries and people call you whenever they want to. I had problems when I took over my patients because the previous nurse gave out her cell phone number and also encouraged people to text her as well. Needless to say my families and facilities were not happy with me initially when I would not give out my number, but referred them to the main hospice number. It's not that I am uncaring, I love my patients, but if you do not set boundaries, this job can consume you and you will find yourself working when you should be off.

Congratulations nurseontheway!!! I am a new hospice nurse too (about 3 months). I don't have a lot of advice yet, but just wanted to offer encouragement. I agree with the others about the binder and plastic sleeves for necessary forms. I also carry a folder in my binder for each pt that I keep a copy of the face sheet in. It is very convenient to have all of that pt information handy when I have to call the pharmacy, MD, family member etc. and I don't have my laptop out. Good luck and I hope you love it!

Nutella, thank you so much for this information that you shared. I am a new hospice nurse and will be going into facilities. This is very helpful and has alerted me to some potential pitfalls to avoid. To the OP, so sorry about your position. Thank you for sharing and I wish you all the best.

Hi, I am new to hospice and just wanted to offer some support. I would be burned out from that on-call schedule too. Is it possible to find a hospice that has an after hours/weekend on call team so that the CM is not over-burdened? Not to sound naïve or anything, but that is how the schedule works at my new job. The CM never take after hours or weekend on call responsibility. There are other nurses hired specifically for that purpose. Best wishes to you and I hope you can find a position that does not require you to leave this specialty.

I would recommend the traditional BSN route as well. I also had a Bachelor's degree prior to becoming a nurse and found this was the best route. ABSN programs tend to be very expensive and the thought of cramming everything into 12 months was not appealing to me. However, it is a viable option if it works for you financially and you are ok with the time frame. I personally would not recommend the LPN route (nothing against LPNs!!!), however, based on your ultimate goal (NP), it would seem that becoming an LPN first would just prolong the journey unnecessarily. Whatever you decide, best wishes to you in your career change. Switching to nursing was one of the best things I have ever done.

Seriously, I would report this person to the BON for practicing without a license.

Good questions Larrythenurse. The UAP's in my group homes administer medication using the three-way check method, however we do not use Therap. But I would be interested to hear how this is working because other agencies in my area are using Therap and the idea has definitely been discussed at my facility.

That's a tough one. For clients who aren't able to follow the instruction to take a deep breath, I generally just get behind them and position my stethoscope at the L or R right base first and just listen as they inhale and exhale naturally. Usually they will just naturally take a deep inspiration within 1-2 minutes and I am right there to hear it. It can be time consuming, but when you really need to assess sometimes that is all you can do. Sometimes I also give them a few sips of juice or water and it seems that after they swallow, they tend to take a deep breath or twoafter the last swallow. Again, you have to pretty much be in position ready to hear it when it comes.