pt. load for case managers

angshallad · Nov 14, 2009

Hi,

We do have a separate admission nurse, although I may do 1 or 2 openings a week just because of overload. I manage anywhere from 14 to 17 patients at a time. The agency likes us to see 5 patients a day (less if we do an admission). 5 patients a day is usually manageable for me. Hope this helps.

tewdles, RN · Nov 14, 2009

A caseload of 12-15 patients is pretty standard. That certainly varies as the census flexes with deaths and admissions. Four to five visits a day is typical. The agency I currently work for has admission, triage, and oncall staff seperate from the case nurses and field staff.

indianahope · Nov 18, 2009

They like us to cary 12, we've had as many as 14-16. We usually don't have to do our own admissions unless there is no other way. We also take call and sometimes do admissions on-call.

missninaRN · Nov 18, 2009

I've had up to 13, usually12, but do not have an LPN and, in some cases, no aid either, which means I do all pt visits and bathe some of them as well.

I've averaged 7 visits per day until this past week; I've recently had some revocations and deaths so am only carrying 9 right now. I expect that to change very quickly, though, since there are several upcoming admits in the works.

The number of visits per day can get even higher when a pt needs daily visits; I make all of those too because the nearest nurse is 2 to 3 hours away from my pts. I've had more than one patient actively dying at the same time with no backup, which means really long days (10-12 hours sometimes).

My service area is also quite large, which means that, when I am with one of my patients, I am up to 2 hours away from some of my other patients.

I do not have an admissions nurse either.

tewdles, RN · Nov 19, 2009

I've had up to 13, usually12, but do not have an LPN and, in some cases, no aid either, which means I do all pt visits and bathe some of them as well.
I've averaged 7 visits per day until this past week; I've recently had one pt revoke and 3 deaths so am only carrying 9 right now. I expect that to change very quickly, though, since there are several upcoming admits in the works.
The number of visits per day can get even higher when a pt needs daily visits; I make all of those too because the nearest nurse is 2 to 3 hours away from my pts. I've had more than one patient actively dying at the same time with no backup, which means really long days (10-12 hours sometimes).
My service area is also quite large, which means that, when I am with one of my patients, I am up to 2 hours away from some of my other patients.
I do not have an admissions nurse either.

My goodness missninaRN, where are you located? That is awful that you are a hospice all by yourself! I will pray for you.

missninaRN · Nov 19, 2009

My goodness missninaRN, where are you located? That is awful that you are a hospice all by yourself! I will pray for you.

Thanks, Tewdles. I'm serving a rural area of Oklahoma.

I've already made the decision to leave this company and have accepted a position with one that is local to my area. I will have an LPN and aid as well as several other hospice RNs nearby. The office is 3 minutes from my house and was full of cheerful, friendly people when I went in to interview.

I'm hoping my initial experience with hospice is not the norm and that my new employer will respect my personal time and keep their promise to provide backup when I need it.

LMTRN · Nov 21, 2009

I would take any of the jobs that are posted above!

I'm currently working at my hospice's inpatient facility, but have worked on facility and home teams in the not to distant past.

I've had as many as 28 patients, and there is no way you can do justice to that number of people.

Under 20, 18 is my magic number, is ideal. I'm in a suburban area of Florida, so no one is too far.

AtlantaRN, RN · Nov 21, 2009

12-15 they say is the standard load for a case manager at my company. At this time, one RN has 17, and another has 9. This is mostly due to acuity (family dynamics) and also location. We are around metro atlanta so there is a wide coverage area.

linda

tewdles, RN · Nov 22, 2009

I completely agree that 12-18 is a manageable hospice caseload, depending upon the area. We have one nurse who manages 16 patients all in one facility. That is decidedly NOT a stretch. Honestly, I do best with about 12 patients. I can handle more for a short time, but, long term I need to keep it between 12-15. I find that the acuity is often too high to provide the level of care that I prefer when I have more than 12-15.

missninaRN · Nov 22, 2009

Tewdles, do you make all nursing visits on those 12-15 patients, or do you also have an LPN?

I'm just trying to figure out what to expect at my new job. (I also need to learn to assert myself with my new employer so I don't end up in a situation similar to the one in which I now find myself.)

tewdles, RN · Nov 23, 2009

There is no LPN on our team. There are a couple of contingent RNs who see patients. I have turfed several of my visits to them, but I provide the vast majority of the nursing visits to the patients on my caseload.