Azalea Hospice

Careers · Hospice Nurses

Hospice nursing, the way you trained to do it.

10-13 patient caseload, not 22. Documentation that finishes in your workday, not after dinner. A medical director who actually answers the phone. Now hiring case managers and on-call RNs across 8 East Texas counties.

Apply nowSee both RN roles

01 —What's different

We hire RNs for clinical judgment. Then we get out of the way.

The shape of hospice nursing in most national chains: 18-22 patient panels, EMR-driven plans of care, productivity dashboards measuring visits per day, after-hours bleeding into your evenings. You stay until you can't.

We are the opposite of that on every count. Smaller panels so you can actually know each family. Plans of care you write, not the algorithm. A dedicated on-call team so your nights are yours. A medical director who shows up to IDG and consults on real cases — instead of signing certs from a desk.

We can't outbid the biggest chains on starting salary. What we offer instead is the conditions to do this work the way you wish you could.

02 —Compared to a national chain

The honest day-to-day comparison.

DimensionTypical large chainAzalea
Case load (case manager RNs)18-22 patients10-13 patients
Daily home visits8-10 per day4-5 per day
After-hours coverageOften layered on case managersDedicated on-call team
Clinical decision authorityAlgorithm-driven, often overriddenYours; medical director consults, doesn't override
IDG participationPresenter, often passiveActive voice; you shape the response
Documentation timeBleeds into evening / weekendDone within the workday
Mileage reimbursementBelow IRS rate at many chainsFull IRS rate, updated quarterly
Continuing education stipend$300–$500/year typical$1,500/year + paid conference time

03 —Open roles

Two RN pathways. Choose the one that fits.

Hospice RN — Case Manager

Full-time · East Texas territory

You own a panel of 10-13 patients across one of our 8 East Texas counties. You write the plan of care, lead IDG, run the family conversations, and your patients call you by name.

What your week looks like

  • —Mon–Fri territory visits in patients' homes (typically 4-5 per day, not 8-10)
  • —Weekly IDG meeting where you present your cases and shape the team's response
  • —Weekly 1:1 with clinical leadership
  • —Documentation: targeted, focused — you finish within the workday
  • —On-call rotation: ~1 weekend every 6-8 weeks (separate on-call team handles weeknights)

What you'll actually do

  • —Run admission visits and write the initial plan of care
  • —Conduct routine recerts, manage symptom escalation, adjust the plan over time
  • —Lead IDG discussion for your patients — your clinical judgment shapes the team response
  • —Triage urgent symptom calls during the day; warm-hand to on-call after hours
  • —Coach the LVN, aide, chaplain, and social worker on your case
  • —Make the hard family conversations — about prognosis, transitions, the body's last work

Requirements

  • ·Active Texas RN license, unrestricted
  • ·1+ year hospice, home health, oncology, ICU, or geriatric experience preferred
  • ·Comfort with end-of-life conversations
  • ·Reliable vehicle (we reimburse mileage at IRS rate)
  • ·Strong written communication for the EMR and IDG
Apply for Hospice RN — Case Manager →

Hospice On-Call RN

Full-time nights · Rotating weekends · East Texas territory

You are the voice families hear at 2 a.m. — when breathing changes, when pain spikes, when a death is approaching. You triage by phone, drive when needed, stay until the family is held.

What your week looks like

  • —Scheduled night shifts (typically 7p–7a) with structured rest periods between calls
  • —Phone triage from your home base when calls come in
  • —Field visits when phone triage isn't enough — pain crisis, active dying, family in acute distress
  • —Rotating weekend coverage as part of a defined on-call pool, not endless beeper duty
  • —Handoff documentation to the day-shift case manager the next morning

What you'll actually do

  • —Field after-hours triage calls from patients and families
  • —Manage acute symptoms by phone using protocols you helped shape
  • —Dispatch yourself or coordinate with on-call MD when bedside care is needed
  • —Pronounce death when appropriate and walk the family through next steps
  • —Be the steady voice when everything else is loud

Requirements

  • ·Active Texas RN license, unrestricted
  • ·2+ years hospice, ER, ICU, or critical-care experience
  • ·Strong phone presence and de-escalation skills
  • ·Comfortable driving to patient homes alone at night within service area
  • ·Reliable vehicle
Apply for Hospice On-Call RN →

04 —Coming from another setting?

Most of our best RNs didn't start in hospice.

Hospice nursing is teachable. Clinical judgment, family presence, and the comfort to sit with hard moments are what we hire for. Here's the typical experience of clinicians joining us from other paths:

Coming from ICU or ER

The hardest adjustment is the pace shift. ICU rewards intervention; hospice rewards presence. Most ICU/ER nurses who succeed in hospice describe the first 90 days as decompression — and then they don't want to go back.

Coming from oncology

You already know these conversations. The shift here is that you keep walking with the family through the part of the disease no one talks about. Many oncology nurses say it's the most meaningful work they've ever done.

Coming from home health

The skills transfer directly — territory work, family-system care, autonomous decision-making in homes. The difference is the depth of the relationship: you're often with these families for months, not visits.

Coming from med-surg or LTC

The biggest learning curve is symptom management at end-of-life — pain, dyspnea, terminal agitation. We pair every new RN with a mentor for the first 90 days; you won't be solo on a symptom crisis until you're ready.

Coming from a hospice chain

Welcome. The culture shock will be in your favor. Most clinicians coming from chains describe the first month as 'wait, this is allowed?' Yes. We trust your clinical judgment.

05 —From our RNs

In their own words.

“I left a regional chain because I had 22 patients and I couldn't tell you half their names. At Azalea I have 11, I know each family, and last week a granddaughter sent me a card. That's why I started doing this work in the first place.”

— RN, case manager·3 years at Azalea

“On-call nights are hard. They were hard at my old job too. The difference is I'm not also case-managing 18 patients during the day. I sleep when I'm not on. I drove out twice last week and I was ready both times because I wasn't running on fumes.”

— On-call RN·2 years at Azalea

06 —Compensation & benefits

What we pay — and what we invest beyond pay.

  • —Competitive base salary in line with East Texas hospice market (we can't outbid the largest national chains; we don't try)
  • —Full IRS-rate mileage reimbursement (most chains pay less)
  • —Health, dental, vision — premium covered for employee
  • —4% retirement match with immediate vesting
  • —Generous PTO with hospice-specific bereavement leave
  • —$1,500/year CME stipend + paid conference attendance (NHPCO, AAHPM, TX hospice association)
  • —Tuition reimbursement for CHPN and CHPLN certifications
  • —Sabbatical eligibility at 5 years

Salary range discussed in the first phone conversation. We don't list a number publicly because comp varies with experience and shift type — but we'll tell you the actual range before we ask for your resume.

07 —RN-specific questions

What nurses ask us most.

What's the actual patient panel for an RN case manager?
10–13 patients. Industry average is 18–22. The smaller panel is the single biggest reason clinicians come to us and stay.
How often is on-call?
For case manager RNs: roughly one weekend every 6–8 weeks. We staff a separate dedicated on-call team for nights and most weekends. You aren't moonlighting as the answering service after a full caseload day.
Will I work alone, or with a team?
Both. Case management is autonomous — you own your panel. But you're part of an Interdisciplinary Group (IDG) that meets weekly. Your patients are also seen by an LVN, aide, chaplain, and social worker. You coordinate that team.
How does Azalea compare on pay vs. the big chains?
Honestly: competitive but not market-leading. The largest national chains can outbid us on starting salary by $5-10K. What you get instead is the conditions to actually become great at this work, real autonomy, smaller panel, and a culture worth staying in. Total comp (mileage, CME, benefits) often closes the gap.
What's the EMR like?
We use a hospice-specific EMR designed around the IDG model, not a hospital EMR retrofitted for home care. Documentation is focused; you can finish within the workday in most cases.
Is there a path to certification (CHPN, CHPLN)?
Yes — fully reimbursed. We encourage it after 12-18 months on the team. Many of our case managers carry one or both.
What does the interview process look like?
Phone conversation (30 min) → half-day clinical shadow with an active case manager → offer or honest no within 5 business days. Both sides decide at the shadow. This is unusual and intentional.
I've never done hospice. Should I apply?
Yes, if you have a background in oncology, ICU, ER, home health, LTC, or geriatrics. We hire for clinical judgment and family presence — hospice-specific skills (pain protocols, IDG facilitation, terminal symptom management) are teachable. We pair you with a mentor for the first 90 days.

Accreditations & certifications

CMS

Medicare-Certified

CMS Provider · NPI #1700460789

TX

Texas-Licensed

DSHS HCSSA #020708

CHAP Accredited — Community Health Accreditation Partner

CHAP Accredited

Independent accreditation

Ready to nurse the way you trained?

Send a resume. Ask a question. Come shadow a clinician on the team. We'll respond within five business days, honestly either way.

Email care@azaleahospice.comOr call (903) 555-0000
All open roles · Meet our medical director · About Azalea
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