Weekend hospice call offer

CrochetNurse154 · Aug 10, 2022

First, can you clarify are you covering just hospice patients or also home health? That didn't seem to be very clear in your initial post. If you're covering both, then run. Hospice is plenty on its own without adding home care into the mix.

If I've just misunderstood, and you're seeing just hospice patients... well, this varies between organizations. A few questions I would ask: are you the only on call nurse during this time? If not, are you the primary nurse? Are you going to be triaging calls as well as doing visits, or just visits? If you're the primary nurse, do you have a nurse for backup in case you get bogged down with too many calls? Do you frequently do admissions on the weekends? (this can be VERY time consuming and ties you up for several hours) and finally, how big is the territory? You want to know how far you'll be going in between patients.

I've worked as a 7 on/7 off nurse in hospice for an organization whose census fluctuated from around 25 when I started to just shy of 50 when I left. I was considered the primary nurse- I both took the calls that came in after hours and triaged them, as well as did visits. I did have a backup nurse in case I got overwhelmed, but that was only added after I spent many a weekend with only a few hours of sleep and complained to management about how unsafe this was. There were good nights/weeks. A good weekend was one where I only had a handful of calls and a handful of visits. A bad weekend would be a Saturday where I might have 2 scheduled admits, get called for a GIP admission at the local hospital, plus 4-6 routine scheduled visits, spread all around a 60 mild radius from our office.

Overall I found hospice to be an extremely rewarding specialty, but the organization you work for can make or break the experience. Good luck!

Kelly77marie, RN · Aug 12, 2022

I completely second all the questions to ask from the previous posts. They are important questions and can make or break the position.

Peachpit · Dec 31, 2023

I know this post is old but I will throw my 2 cents in..I accepted an on call weekend position a few months ago. 5pm Fri to 8 am Monday, census averages 20 patients.

There is an answering service but no triage so all calls fall to me. There is no back up other than the Admin who I can call for questions. Routine visits that get missed for whatever reason are rescheduled for the weekend as well.

While I like having time off during the week, the lack of support on weekends/lack of backup and routine matters being pushed to the weekends has made me seriously reconsider the position.

My advice is: if you want to work hospice/on call go with an agency that has a triage center or at least has another person you can "buddy" with on the weekends so you can divvy up hours if needed so you are not sleep deprived or handing non urgent issues when tending to urgent issues. Work for an agency who has a responsive doctor - I had a patient pass a few weeks ago - I notified the MD via secure text AND called - never received a response. Work for an agency whose policy is visits are to be documented the same day ( I see patients who case managers haven't updated their information for several days so there is often times unnecessary confusion about a situation because I do not have up to date information to pull from)

Hospice, especially on call, is stressful enough w/o the little things not being tended to.

JayVie · Feb 8

I've been around the block and back again in hospice. Regarding a census of 20, that requires two case managers (or one RN and one LPN) and about two aides. Assuming there is adequate staffing, you should not be picking up any missed visits for the case manager. I was doing dumped on with routine visits during my first on-call job because we had a green CM, and once she was replaced with a seasoned CM with a professional work ethic, I NEVER did routine visits on the weekends. I then became a CM and would do 4-5 visits daily, so with a mere 20 patients, I'd be asking what that CM is doing with all that extra time. Also, if the CM is doing the job properly by providing thorough education to the caregivers with inclusion of potential symptoms, in writing, then your job should be easy.