Whether or not to take a lucrative on-call position..?

Specialties Hospice

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Hi all! Had a question for people who are or have ever worked as an on-call hospice nurse.

I currently work at an LTAC, and I'm on the back end of a major burn-out - I enjoy working with my team there and I enjoy caring for our patients, but our workload tends to be through the roof. Recently, I was called by a company that was staffing for a hospice that just opened up near our area. The opportunity is pretty lucrative - besides a hefty benefits package and mileage compensation (plus a company car after a transitionary period), they're offering to pay nearly triple of what I currently make as an annual salary, and even folks I know are telling me it's something I should seriously consider. What concerns me, though, is both my level of experience and how badly I've been burning out in the field.

I've only been a nurse for about a year and a half, and I've only worked at my current facility for about 9 months. I have had experience with hospice patients, their families, and managing the death of a patient, and honestly those cases were some of the more rewarding ones I can remember, and the facility did say they were willing to extensively train me.

On my burnout however, even 12 hour shifts at my work have taken a toll on me (I recently went to the emergency room for a stress-related issue from work), and I worry how being an on-call nurse would affect me. I'd be expected to be on call 24 hours through the weekend, and then during weekdays from 5pm to 8am and work 7 days on, 7 days off - that's definitely a big lifestyle change, and I worry if I'll burn out worse even more.

To be quite fair, I've been losing a lot of the fulfillment I had for being an RN at this LTAC, but I wanted to stay for a full year so it would be a bit easier to find a better career opportunity. There was an opening in an Orthopedics department at a local hospital, but it doesn't pay nearly as much as this hospice opportunity. Personally my real passion has always been Nursery and pediatrics, but jobs are hard to find at the moment as well. Not to mention a great chunk of the reason I'm in nursing is to help support my family at the moment - it's not a great reason, I know, especially since you should work with something you enjoy, but it keeps me focused on what needs to be done and I do derive pleasure from my work where I can.

All in all in a nutshell, for you nurses who've worked as on-call, did you find your experience worth it? Do you think a fledgling RN like myself could handle the obligation, especially if the benefits it provides are lucrative enough? Any insights would be much appreciated, thanks in advance!

Specializes in School Nursing.

Do you know what the census will be? Will you have back up if needed? I love being a hospice nurse, but I'm a case manager and don't do call (though I am back up approximately once a week). We have two 'on call' nurses who rotate weekends and weeknights, they do work hard but they seem to enjoy what they're doing!

Hi! Haven't discussed what census is like with them just yet, we're still in the interview process (or should I say "should we send this candidate's profile over" process). I do know I'll be getting backup and rotating weekends and weeknights, though I'll be expected to work at least one weekend a month. What do the responsibilities usually entail? A lot of admissions and troubleshooting with patients?

Whoops, double post

Specializes in School Nursing.
What do the responsibilities usually entail? A lot of admissions and troubleshooting with patients?

Pretty much, yes. They triage phone calls during the non-regular business hours and do visits as necessary after triaging the phone call. They also do admissions that occur after hours and on weekends. The also do tuck-in visits that fall on weekends as well as visits for patients that can not wait until the next week for routine visits. How stressful and busy you will be will be directly related to the patient census AND how well the patients on service are 'tucked in' by the regular team. If patients and care givers are well supported and educated during routine visits, you wont get nearly as many calls for little things like medication questions and refills. However, if the normal staff is extremely overwhelmed with high case loads, things will fall through the cracks and chances are a lot will fall on you. Good luck to you!

Ah, thank you! What do house visits usually entail, or what have you seen in your experience? I've found I can never be too prepared for anything.

Specializes in School Nursing.

You may get called out for a leaking Foley, uncontrolled symptoms like pain, agitation, SOB, etc. etc., patient falls, changes in condition, wound care/treatment, etc. etc. There is really no limit to the issues that can pop up on a shift. You'll be primarily responsible for death calls during your shifts as well. Lots and lots and lots of education and emotional support!!

I worked Hospice Triage and loved it. I miss doing it and will be going back to it. I worked regular hours and on call 1 weekend a month. I loved the challenge of going into a train wreck situation and having the PT and family CALM when I left. Very rewarding, but as newhospicern said, You could walk into ANYTHING , u just don't know. Plus there is the types of homes you may go into. Some neat and tidy, others with Cock roaches all over the place. If you can handle not knowing what your getting into on a Visit, Go for it. But if u like a set, orderly type of situation, it may not be for you. BE PREPARED.

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