mb55

HH is minimum of 5.5 points per day. Average 30-35 visits /week

Thank you for your input! The caseload of Hospice they said is ideally 12-14, but currently it's more like 16-18. There is no Admission or weekday night call nurse, only a weekend nurse. So, really, the call is the biggest drawback to me. They would be split b/w 3 RN's. It comes out to 6-7 nights a month on call :-( I know either is going to be a huge learning curve.

I'll try to keep this as brief and to the point as possible 😊 I've been an ICU Nurse for @13 years. Have been in different units and hospitals. I am totally done! Burned out beyond belief. I've decided to leave the hospital environment and go into Home Health or Home Hospice. I am not expecting it to be easy or less stressful.... Just different, and I need/want that. I've been offered a case manager position with both. I've always liked my palliative /comfort care patients the best. I feel like I'm truly helping instead of just prolonging a painful death or extending a life with no real quality of life. But I feel HH would be more interesting. Both positions have there pros and cons. I'm hoping someone here has done both or decided between the two and can help me through the thought process so I make the best decision. I'll gladly answer any questions. Thank you in advance for your help.

The Hospice on call is Mon-Thurs nights split between 3 RN's. There is a full time weekend on call nurse. Weekends required when nurse is sick or on vacation. The HH was told to me to be 2-3 nights a month and one of those being a weekend. Not sure if day or night, or both. The Hospice territory is bigger than the HH territory.

Hey! Which did you end up going with? HH or Hospice? I'm in the same exact position right now and don't know which one to choose 🙁

I'll try to keep this as brief and to the point as possible 😊 I've been an ICU Nurse for @13 years. Have been in different units and hospitals. I am totally done! Burned out beyond belief. I've decided to leave the hospital environment and go into Home Health or Home Hospice. I am not expecting it to be easy or less stressful.... Just different, and I need/want that. I've been offered a case manager position with both. I've always liked my palliative /comfort care patients the best. I feel like I'm truly helping instead of just prolonging a painful death or extending a life with no real quality of life. Both positions have there pros and cons. I'm hoping someone here has done both or decided between the two and can help me through the thought process so I make the best decision. I'll gladly answer any questions. Thank you in advance for your help.

I am so sick of PATIENT/FAMILY satisfaction!!!! If hospitals would actually give a crap about NURSES satisfaction, gave nurses input into policy changes and practices, didn't blame nursing for almost everything.......maybe we'd be happier. Which in return would increase the beloved patient/family satisfaction scores!

I want out of the Hospital so bad. Been there almost 10 years. I can't stand it anymore. I have become such a miserable, bitter person that hates most people now because of all the crap from administration, and demanding/unreasonable patients and families.

We used to restrict visitation from 6:30 to 8:30. Both shifts. This gave ample time for report and initial assessments, etc. We are now Open. All visitors all the time. Family centered, supposedly only one significant other is allowed during shift change/report. However, everyone and their brother too (literally) come in and out at will. Of course administration implemented this new rule, NOT the actual bedside caregivers. Not a single one of us RN's like this situation. We need some time to, pardon me but, get our **** together. When visitation was restricted, it gave me time to thoroughly read charts/orders and truly assess my patient and plan my shift. Also, I was more able to answer families questions. Now, I get bombarded with questions when I literally haven't even spoken to or touched my patient. I feel like I can't/don't do as accurate of an assessment when someone is staring at me, watching every move, and asking questions the whole time.

I worked a Medical Step-down unit with ratio of either 3:1 or 4:1. I worked there 2 years before transferring to the Cardio-thoracic SICU. Talk about overwhelming! I got through the 11 week orientation though. It was an awesome and scary feeling to seeing your patient come directly from open heart surgery on multiple drips, vent, IABP, etcc. to (hopefully) sitting up in the bed waiting to transfer to the SD unit the very next day! After 2 years of frustration with the ego of Cardiac surgeons, I transferred to a Medical ICU. Patients aren't as awesome, but the comradery with the ICU MD's is great! I never had a very "rewarding" feel on the floor. Most were failure to wean, frequent fliers (which you will see in ICU as well). Both ICU's I've been in are either 1:1 if very sick or usually 2:1. TIME MANAGEMENT is a must! Keep up with charting. Most of your shifts will be routine, but things can go from smooth to complete chaos in a matter of seconds. If you're already behind, prepare to be there late to finish charting. CRITICAL THINKING. OF course you'll learn this as you see more, but most of the MD's expect when you call them to be able to tell them exactly what is going on and what you need. Prepare to hear an earful if you call them in the middle of the night and don't know what to ask for specifically. THICK SKIN. Some patients and or families are going to be difficult at best. The patient's going through DT's seem to be the worst. They will drain you physically and mentally. Ask a lot of questions. Those that come in and act as if they know everything, or don't ask and screw things up don't last. Be a team player. When you're not busy, help others. You're going to need help at times, and as "professional" as nurses are supposed to be, they are also just as vindictive. I'm sure there is so much more to tell, but I don't want to write a novel here :) If you have any specific questions, feel free to inbox me. Good luck!

Thanks for the advice. I did try to get into Home Health within my hospital, but wasn't even picked to interview due to "other more qualified applicants". I didn't know to take into consideration what type of agency it is. This one has been around @20 yrs, but less than a year in my location. I did ask about turnover, they have had one a month for the past 5 months......that kind of worried me. Besides hospital based HH, what would you guys say are good, reputable agencies. Or how exactly can I determine how they are?

Hello all. I have been an RN for 9 years. All 9 years have been in the hospital. Medical ICU and Cardio-Thoracic Surgical ICU. @ 3 months ago I received a significant injury including a Lisfranc injury and a meniscus tear in my knee. Also, I have back issues including spondylosis and 2 bulging discs. Very often at the end of my 2 or 3 shifts I can barely get out of bed due to pain. Anyway, this lead me to consider if I can tolerate 12hr physically demanding shifts on my feet. I applied for and was offered a Baylor RN Home Health position. Still 12hr shifts, but has to be less physical! I can't say I like my job. I do love working 3 nights one week and 2 nights the next. Because I work weekends the pay is very nice. BUT, I am tired of the hospital drama and politics. The catty women I work with. No appreciation for what we do from patients. families, and upper management. I have read so many positive and negative statements about HH nursing, so I'm struggling with whether to make the transition or not. The agency I would work for is a pay-per-visit. $40 for reg visits, $80 for admits. 0.40/mile. Benefits include Med/Dental, 401, and paid time off. Can anyone that made this type of change let me know if it was the best decision you made, or do you regret it? I just am so undecided. Thank you in advance for any advice :)