What is an easy caseload?

[cosmicmama, BSN, RN]

After 16 years of hospital nursing (ED, MED/Surg, then L&D for many years), I am thinking of getting out of acute care and going into hospice. I'm burned out on hospital politics and 12 hours night shifts. It's been in the back of my mind since my dad died several years ago, his hospice nurse was an angel.

The company I'm looking at claims "Working independently and planning their daily work schedule" and "Small manageable caseload" of 12 patients at a time. That is very important to me, I'm not willing to jump out of the frying pan and into the fire ie. work more than 40 hours per week.

How flexible is your schedule, really? And how manageable is 12 patients? How often do you visit each of them on average?

Thanks in advance.

[kimcamRN]

10-12 is average where I work. It's manageable depending on the acuity, distance between patients and what your call responsiblities will be. We also have an awesome PRN nurse who helps out when things get hectic. I find that my patients tend to go into crisis in clusters, which can make things difficult to say the least. I've been working in hospice 3 years now and I love it, but don't know that I've ever had an "easy" caseload.

[SoCalRN1970]

Hello there.. Welcome to Hospice! There is such a need for nurses in this specialty and you have a strong clinical background which is a huge huge asset.

What an average caseload should be around 12/13. BUT! keep in mind acuity and distance also come into play with meeting your patients needs.

Some patients are seen weekly only, they are the one's who are relatively without much changes, others are daily if actively dying, family not coping or symptoms not controlled, plotting how many visits are almost done weekly with day to day tweeking .

An average week should consist of daily visits 3-5 depending again on distance, acuity, needs of patients. Most patients under my care are seen weekly, but that does changes as does their physical symptoms, need for education or clinical intervention. All of what you are in charge of!

Being a hospice RN allows for independence unlike anything in the hospital. You may be in a bit of shock, but a good kind of shock.. I hope your agency abides by what they are telling you. Many times bait and switch occur just in order to get an breathing RN in the door. I'd do a bit of research, talk to anyone if you know anyone there.

Out of all my employers I have ever have in the world of hospice... My most recent offered me an area that did not exist, expected me to explain why it took me an hour to commute in traffic, why I was with a patient 2.5 hours with a transitioning patient and they gave me 15 patients to case manage 4 days a week, while they had me be a "runner" and "admission" RN on Sunday... definitely NOT what was disclosed to me during my hiring. It was sprung on me that I also was expected to do on call once a week, ideally on Friday or Saturday... EVERY week.. I WAS SCHEDULED OFF.. THOSE DAYS! Manipulative agencies exist. As heart breaking as this was, I walked after only a month. I drove 1600 miles in one month, and seriously? thats more than a one way trip from Los Angeles to Seattle!! Do some research if you at all can. Ask what is your employee retention like? What happened to the person I am replacing? Just and FYI.

[ErinS, BSN, RN]

I work in a hospice with a fairly young and acute population. There are weeks where even 12 patients would put me over 40 hours, and I have done this for 3 years. 12 patients is the max we try to give our new nurses, but we are finding that they are still working quite a bit of overtime for the first 2 months. The other thing about hospice is that I am personally responsible for the pt's, so if a weekend nurse can not work, I may have to go in. Also, while we like to keep caseloads low, we have never turned away an admission. So if all the nurses have 12 patients, and 10 more are admitted, you could quickly find your case load closer to 15.

As to the previous poster, who mentioned they drove 1600 miles in one month- this is not unusual where I work. The area is 60 miles from north to south, and close to 100 miles from east to west, so there are days where I drive 100 miles.

So I guess what I am saying is that if you absolutely do not want to work more than 40 hours a week, hospice may not be for you. But I love this line of work, I love my patients, and I have never regretted a single hour I have spent working.

[AtlantaRN, RN]

12-14 is a good caseload. right now our case mgrs have between 9-18 a piece. granted, we are metro atlanta and cover a large service area. one nurse puts easily 500+ miles a week on her car. i'm a weekend on call rn. i put anywhere from 100-250 miles a day on a weekend......

[jschut, BSN, RN]

I am a bait and switch victim.

Told upon hire there would be no weekends or holidays, and I had a 40 hour week on salary, with the possibility of MAYBE having to drive to another city (since I was the nurse that lived locally).

Well, it ends up, I am the nurse that is driving an hour away every day, has over 20 visits a week, and spends till 10-11 every night on paperwork. I have to be available at the drop of a hat, and am on call one night a week, and as 2nd RN on call, for an entire week at a time.

My bosses will answer the phone when they choose to, but heaven forbid if you don't answer them within 5 minutes....

I have had drugs missing from a patients house, and nothing has been done, I have asked for help, and nothing has been done (except tell me I HAVE to turn in paperwork at a certain time...), I have been lied to, manipulated against, and generally treated like crap.

I am still there because I have some things going on in my life right now and need this job... but by the end of this year, I may very well be in search of other employment.

Yes, the money is good, but when all the hours I put in, and all the driving I do is added up... it's not worth it to me.