So, pick one already!

Tough decision. Here's the skinny. All will have good and bad points. The superviser u like may change jobs and King Kong takes his place. At Hospice A u start out with a light case load and then...someone quits and your caseload doubles. "Start up" hospice? Expect to be called on to be a "team player", that translates to LOTS of hours working. Pick a hospice that leaves time for YOU to think and be with your family. Hospice enriches your life and if you don't have time to live, it is a bummer.

I agree with BeExellent. A start up hospice equals a LOT of hours, on call, and a lot of turnover and burnout. I have never worked for a hospice that pays per visit - only per hour or salaried. Our PRN's get paid per visit. I have known people that have worked for Vitas and as much as I can't stand the for-profit end of this business, I would probably choose them over any other for-profit if I had to. Their training is supposed to be good. My experience has been in working with long time established (25 plus years) community based (read non profit) agencies and this has worked well for me. The staff are there because they believe in the mission and that = decreased turnover. Some of the people I have worked with have been there for 15-20 years. I worked for a (very) short time for a start up with a small census and got burned out in a matter of weeks and left. Just to give you an idea of how long a visit can be... You may do a quick 30-45 minute visit with a stable patient. A time of death can be 2-4 hours depending on what's going on. We try to get the chaplain or SW to come and relieve us if we are very busy but our policy is to wait until the funeral home gets there. A 10.00 flat fee for driving could be a rip off if you are not being paid per hour. Your driving time could be more than an hour round trip so keep that in mind. If you had a 2 hour visit and your drive time was an hour round trip, you'd get paid 60 bucks - that's 20.00/hr. The 65.00 that you speak of is for the admission visit itself? If it is, this is way too little. Just to give you an idea, our full time admissions nurses do 2 admissions - sometimes 3 and that's pushing it - in an 8 hour day. Good luck making your decision. I hope this helps some.

Here's another factor to consider regarding admissions....large hospices may have somebody doing the signup (giving the info about how hospice works and having the patient/family sign the admission consents etc.) and then the admission nurse is doing the assessment part only. This is an important thing to know, especially if they are going to pay you per admission rather than hourly. The signup part can be hugely variable...from 10 minutes for a patient/family who has already experienced hospice and knows this is what they want to do, to over an hour for those with lots of questions and lots of angst. Also, on pay per admission, what if you go out and then they DON'T admit (they change their mind or they die minutes before you arrive)?

The nursing portion of the admission is also tough to predict. If the patient is in a terrible state with lots of symptoms to be brought under control and the family needs lots of teaching and reassurance it can take a couple hours to just begin setting things to rights.

We may have a more elaborate process and higher expectations of that admission visit, but I don't think I have ever seen one done in under 3 hours (including all the signup explanation, paperwork, and charting) from start to finish. About 4 is average, and it can run up to 6 for a messy one with a long travel time.