Reasonable (?) caseloads

Is it me, or them? What's a caseload where you can give people the time they need and still have a life?

As you know, much depends on the acuity level of those patients and how much travel time you have as well. 8 patients could be a full load if they are all very high acuity and you are spending a lot of road time as well. Or, the flip side is, 14 could be a very manageable load if they are split between two facilities and are pretty stable. That's our thinking without the LPN in the mix. Factoring in the LPN is difficult because much depends on how strong they are in their assessment, documentation, critical thinking and communication.

I imagine you are fitting an IDT meeting into those 4 days as well which shoots half a day. Is the idea supposed to be 4 10 hour days for you...or are you supposed to be 32 hours per week? And do you have to do your own admissions?

I'm sorry you are finding your current set up to be overwhelming. (((hugs))) Sounds like something needs to change for you.

We try to keep around 12 - 14 but I've had as many as 16 and some of our nurses have had up to 20!!!. The hospice that I used to work for never made us get above 12 for home team and 16 for facility team. We used prn's for high census and if the census stayed high and was growing, then we'd hire a new nurse. Gone are those days for me. I miss them! I think a manageable census is 10-12 for home and 12-14 for facility. Anything above that and I think that you are not able to do the kind of work that these patient's and families deserve.

Forgot one thing...sorry to go on! How do you carry your case load in just 4 days? Who carries the pager on the 5th?

Forgot one thing...sorry to go on! How do you carry your case load in just 4 days? Who carries the pager on the 5th?

Basically I try to see everybody and take care of things during my four days on, and if an emergency comes up on Day 5, the office dispatches the LPN or a per-diem nurse. Kind of like if a family calls on the weekend or at night and gets an on-call nurse. Haven't had any complaints because of course I run like crazy for four days trying to think of everything.

The responses to my post are confirming my suspicions that our caseloads are impossible.

I really appreciate everyone's input.

I imagine you are fitting an IDT meeting into those 4 days as well which shoots half a day. Is the idea supposed to be 4 10 hour days for you...or are you supposed to be 32 hours per week? And do you have to do your own admissions?

S'posed to be four 7.5-hour days= 30 hrs/ week. Har har!!

We occasionally have to do own admissions. Not usually.

As for the IDT meeting... well, surviving that probably is worth starting a whole new thread....

I work for a non-profit joint. We're suppose to have 12. I however, have carried 16-18 for the past year as the census has grown. Most of my co-workers do 14. I get singled out for more becuse I specialize in 4 SNFs. I don't have a LVN to assist. So it's quite the busy week. Yeah...I'm starting to get burnt out. I was talking to a nurse from a for profit place and they are expected to manage 16-20!

I was talking to a nurse from a for profit place and they are expected to manage 16-20!

That happens to us now and then, but its during one of those unavoidable times when someone resigns, the census takes a jump, and someone is out on sick leave. It certainly isn't the norm!

That happens to us now and then, but its during one of those unavoidable times when someone resigns, the census takes a jump, and someone is out on sick leave. It certainly isn't the norm!

Yep, heavy loads sometimes can't be helped, like those 20-minute visits which turn out to require two hours. Or more. That's the nature of the work.

Decided to speak to my supervisor tomorrow about my concerns. You can't get what you want if you don't ask...

I work for a for profit hospice in a very rural setting. My caseload runs between 15 to 19. Only one patient is in a facility, and I have some patients who are between 75 to 100 miles apart. My normal day will be 6 to 8 visits or 25 to 32 visits a week. My question is, do other hospices make allowances for casemanagers who cover a very large territory or not? I cover four counties and travel approximately 800 to 1200 miles a week, not including the drive to and from the first and last patients house. Do all hospice nurses work like this? I am getting discouraged and don't feel I am able to give patients the care they deserve.

I have 22 right now; all except for one in LTC. I hate dealing with LTCs. The staff are so picky, really quick to complain about completely stupid issues. And as you might imagine, most of the pts. have dementia. It's getting very depressing.

Way too much work on after-hours time, way too much on-call. And we do our own admissions.

I get calls about pts. I'm supposedly case managing that I have seen maybe once; it's really hard to update a family member when you have no clue what's been going on with the pt. Often, a perdiem nurse or an LPN has seen the pt. more than I.

Deleted; double post.

I work for a for profit hospice in a very rural setting. My caseload runs between 15 to 19. Only one patient is in a facility, and I have some patients who are between 75 to 100 miles apart. My normal day will be 6 to 8 visits or 25 to 32 visits a week. My question is, do other hospices make allowances for casemanagers who cover a very large territory or not? I cover four counties and travel approximately 800 to 1200 miles a week, not including the drive to and from the first and last patients house. Do all hospice nurses work like this? I am getting discouraged and don't feel I am able to give patients the care they deserve.

I think they are expecting WAY too much from you. That is a lot of pt's to have in such a large area.