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The driving is making me a nervous wreck...

Specializes in med/surg, hospice.


Friday was a typical day....I drove well over 200 miles from the time I left home until I pulled back in the driveway. I get up in the morning, run around getting ready, getting kids ready, walking dogs etc. Drop kids off at school and on to my first patient's house...then hopefully pick the kids up before dark and get home just in time to try to throw together some dinner and look over schoolwork. I tuck the kids in and fall asleep as well. I had thought weekends off and a supposed "40 hour" work week would be better than the long days I was putting in at the hospital but it is anything but.

My patients are so spread out...and so many of them are terribly needy right now with some of them having caregivers that are demanding and completely unrealistic in their expectations (the entitlement of some folks absolutely floors me...it is as if they expect to have ownership of you); add to this the new "pharmacy" that we are using and....I am mentally exhausted, discouraged and overwhelmed. I feel like I never really leave this job. It is like trying to keep a dozen different balloons underwater without being able to and the whole time I know I will never get caught up and stay caught up. This is my first hospice job and I am have been expecting the constant state of anxiety to lighten up and it hasn't.

Does anyone have any helpful advice for me? I am drowning fast. :o

I do not want to sound like an alarmist or even a pessimist, especially since I do not know anything about you. Your post says a lot though. You are already aware that you are reaching stress levels that are getting beyond your coping level. My words to you: calmly look at the picture. I was doing home hlth visits for up to 4 employers at the same time with a 40 hr wk commitment with a 40 mile one way commute and hours all over the 24 hour clock for all my clients, all over the place. When I was commuting to night shift, it got so that law enforcement types were having lots of law enforcement "fun" tagging along and monitoring my vehicle (and me) as I went to and from work. I liked to swerve across four lanes of traffic and come out of it before (insert type of MVA). Nobody seemed to think it was very funny at the time I guess. I was "almost" pulled over once (in the daytime). End result: I lost all my jobs and did not work for a very, very long time. There were other very extenuating circumstances along with all of this. But the bottom line of what I am trying to get across to you is that I can tell from what you are saying in your post is that you are becoming progressively tired, which leads to exhaustion, which could lead to far worse. I only wish that I could have corrected my situation in enough time that I could have saved any of my jobs. Look at yourself and your situation now while you have the reasoning power to deal with it. You could end up in a situation like mine where I could not have consciously made the decisions necessary to correct the obvious imbalance that was going on. None of my employers cared (and some people knew) that I was routinely swerving across four lanes of traffic at high rates of speed (literally falling asleep at the wheel). I am convinced that, like they don't care that they now no longer employ me, they also would not care if I had ended up in the morgue. It is not always a one way street when assigning personal resp for employee workplace behavior.

Perhaps you should consider addressing your anxiety issue with your MD? And although I might have sounded somewhat overbearing or overboard in what I've said so far, I truly believe that you might benefit from putting some self-imposed limits on your job duties. Hospice and home hlth tout "autonomy" when attracting nurses to their ranks, so you should be able to limit yourself with your employer. Maybe cut down one visit per day, or rearrange your schedule to something that is more manageable. Just some thoughts. You need to brainstorm for yourself. Also, look on this bulletin board for some insights. It would be a shame for you to reach the point where you lose your job over a situation that might have been alleviated. Good luck to you.

AtlantaRN, RN

Specializes in Med Surg, Hospice, Home Health. Has 13 years experience.

That is alot of miles, I feel for you. I have good days and bad days, just like our hospice patients. I have one patient that really grates on my nerves, she goes out of her way to REMIND everyone that they are "the hired help."...however, she really opened up to another nurse last week (I was sick with an 8 day bout of gastroenteritis). I WANT this other nurse to take her as a patient, as we really don't "jive".

I have a Navigator GPS, so I really don't have to "think" about where I'm going, I just scroll to the patients name, and hit enter; so that has helped me tremendously...that and it TELLS you when to turn in "600 feet," so that has helped. I listen to my Tony Robbins tapes while I drive also.

Call sometimes gets on my nerves. I have one family that will call every 2 days just for the daughter to say 'can someone come take a look at her..."

I don't mind, she is not long for this world, but just some days it really gets on my nerves (btw, our hospice is a new location and the daughter WANTED a nurse 3 days a week, I go out on tuesday and friday and the administrator said "you really should only go out once a week..."but in the brochure, it says 1-3X/week.....so i'm standing my ground on that one.

hope things lighten up for you. How many visits do you do in one day? Also, is there ANYONE else doing call while you are driving all over creation? I get erked when they will call me when I'm working at the hospital...granted, i'm prn, but i'm not on 24/7...



Specializes in CHPN Hospice & Palliative Nurse.

I would speak to your supervisor or administrator and honestly express your concerns. Setting limits is key in this field and it's very easy to have too much on your plate. Perhaps your case load can be decreased to accomodate your drive time or perhaps your patients can be grouped together a bit better. Good Luck and keep us posted.



Specializes in Addictions/rehab, mental health, hospice. Has 20 years experience.

i'm hearin' ya. i also hate the driving. in addition to the on-the-job driving, i also make a 40-minute drive to and from work (i commute). thankfully it's mostly a reverse commute (against traffic), but it's a lot of driving and i don't like it. driving kind of weirds me out with anxiety anyway, and i often stay in the slow lanes. yes, even us guys get anxious :i i find it's important to remember that you can't make everyone happy and you also can't solve every problem, esp. ones that were there for years before you showed up. also remember that while "the buck stops here" with the cm, you're also part of a team. if you can push second visits off on per diem or an lvn, do it. having a home health aide in the home is also helpful, and getting the msw and/or chaplain involved is also a good thing. you can't do this alone. if you have more than 13 or 14 patients, it's too many. talk to your supervisor and express your concerns. you might be surprised how much they might be willing to work with you. you're just one person, not super-nurse.

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