1. some team managers extremely condescending to field staff.
2. Inadequate pay scale, not commensurate with experience. Staff with no hospice experience hired in at higher salaries than experienced nurses nurses with company longevity.
3. Years without raises. Allegedly raises reinstituted this year but only at 1% provided employee met a bunch of "conditions." Also, it takes 4-6 months after yearly evaluation beforethe raise is seen in the paycheck, and it's not retroactive.
4. Poor mileage compensation, Company extremely slow to increase rates when gas prices exhorbitant, but snatch it away in a blink of an eye when gas prices drop.
5. Fee for service pay is not worth the time/effort involved in the visit - comes out to less than normal hourly wage by time you figure in travel, visit, documentation, etc...
6. Professional development severely lacking. Their idea of 'education' is to have someone read a Vitas standard to the team, then pass around an inservice sheet for signatures stating that the employee has ben educated on the process.
7. Unrealistic work loads. RN case managers often have 7-9 visits per day, due to lack of staff; management solution is to have LPN from continuous care make visits however they cannot do fist assessments or contact physicians for orders, or order meds through pharmacy, so even though RN may have "help" she also has extra work that the LPN cannot complete.
8. Lack of dedicated oncall staff, and weekendoncall staff is allowed to refuse assignements which then fall on the back up nurse ( case manager who has already worked her 40 hours plus that week, and now has to go out for fee for service at less than her hourly salary)
9. Lack of admisissions nurse, so again the rn case manager has to pick up the slack when she is back up oncall
10. Way to much oncall responsibility.... case managers are on call 1-2 days per week, and 1-2 weekend days due to lack of case managers...
11. Simply not eough nursing staff, and far too many repsonsibilities fall on case managers who are already working 10-12 hour days to see their 7-9 patients
12. Their is a major exodus in progress, and has been since middle of the year, yet senior management attitude is that each person is replaceable. No effort is made to show appreciation of the staff, and senior management simply does not care that teams are overworked, underpaid, with poor morale, and that many, many, long term employess have begun to seek employement elsewehere