What is Hospice Care?
Hospice care is end of life care that is given to those with 6 months or less to live. When under hospice care, a patient agrees to stop all curative treatments and focus on pain relief.
Hospice care is typically offered to those who are no longer responding to treatment, and no further attempts are made to treat the underlying disease or condition. The sole focus is on relieving painful symptoms and allowing the patient to be as comfortable as possible.
Hospice nurses provide care in patients’ homes, hospice facilities, and nursing homes, as well as after a hospital stay.
Another option besides hospice care is palliative care. Palliative care is very similar to hospice care, the key difference being that under palliative care, the patient can still receive curative treatment.
While hospice care requires a 6 month life expectancy and for all attempts to cure the underlying condition to cease so they can focus on simply easing the pain, palliative care still makes efforts to cure the root condition, and as such has no life expectancy requirement.
Palliative care can be offered to anyone with a potentially terminal illness or chronic condition. An emphasis is placed on the patient’s comfort and treating painful symptoms, but their doctors will still be working to cure the disease.
Regardless of whether the patient is in outpatient or inpatient hospice care, they will be assigned a hospice team. That team is composed of the patient’s doctors, nurses, a social worker, a religious leader, an emotional support counselor, and other volunteers helping the patient. Hospice nurses work closely with other healthcare professionals, including social workers, to provide comprehensive support to patients and their families.
What Does a Hospice Nurse Do?
The nurses are one of the most important parts of the hospice team. There are several types of hospice nurses that are all part of the team. They each have different roles and interact differently with the patient in nursing.
Admission nurses: admission nurses consult with the patient and their family early on in the process, and explain to them their options of hospice care, palliative care, or other options open to the patient. They continue to contact the patient with updates on possible treatment plans they can qualify for.
The admission nurse is the main point of informational contact that the patient gets, and they are constantly helping explain the changing options for the patient’s care plan. While they may not give any medical care to the patient, they are still incredibly helpful and important to them. As a beacon of much needed information, they are another comforting figure in this trying time for the patient and their families.
Case managers: the case manager has a similar job to the social worker of the hospice team. Their job is to map out and oversee the patient’s care plan. They work with the other members of the hospice team to properly allocate resources and focus where caregiving is most needed. They will also decide how much counseling and time is needed for the family of the patient during and after their death.
They are in charge of all the logistics and oversee the planning of the patient’s care regimen. The case manager needs to be a very organized, direct individual to stay on top of all the moving parts of a patient’s care plan. Case managers collaborate closely with the patient’s family and family members to determine appropriate care plans and provide emotional and spiritual support during end-of-life treatment.
Visit nurses: the visit nurse is the daily nurse that is thought of when you picture an outpatient hospice situation. The visit nurse is the one going to the patient’s home or room in an inpatient hospice facility to check up on them and provide daily medical attention. They are the most hands on of all the nurses, and probably the one who will get to know the patient and their family the best. They will make daily visits to the patient and will tend to any daily treatments like administer medication, wound dressing, physical therapy, or any other daily medical issues that need tending to.
Visit nurses are responsible for managing symptoms and pain and symptom management for hospice patients and terminally ill patients, ensuring comfort and quality of life. Visit nurses are potentially the most important to the patient and their family. Not only do they provide the necessary medical care for the patient, but they provide a constant support and presence which is very comforting to them.
Triage nurses: the triage nurse is available for any emergency care the patient may require. They will be able to provide more intensive medical care than the visit nurse can, and are able to be on call to address any serious medical concerns that the visit nurse can’t deal with. In an ideal situation, the triage nurse is never needed, but in real life with terminal patients there are usually some critical situations that require the triage nurse.
Sometimes the patient’s condition may be so bad that even in an outpatient plan they will need to be placed in a temporary inpatient care section of a hospital to receive the level of medical attention they require. Triage nurses play a key role in pain and symptom management for hospice patients, especially during emergencies.
Hospital liaisons: the hospital liason’s job is basically what it sounds like. They act as the middleman between the hospital, the hospice program, and the patient and their family. They know all the hospice organizations in the area so they can recommend the best one for each patient’s specific needs.
They help keep the relationship between the hospital and the hospice program stable and ensure smooth communication to avoid misunderstandings. They also work closely with the patient and their family so they understand the process of enrolling in hospice care and to ensure all their needs are communicated and met by the hospice team.
These are the main specialities of hospice nurses, but there may be more nurses, depending on the patient’s needs or the doctor’s preferences. Hospice nurses collaborate with other nurses and other healthcare professionals to deliver comprehensive nursing care and patient care to hospice patients and terminally ill patients.
While the specific duties of hospice nursing will vary depending on what their specialty is, how much help they have, and the needs of their patient, there is one constant across all hospice and palliative nurses: compassion. One of the most important aspects to being a nurse in general, as well as an end of life care nurse is how gentle and understanding they can be with their patients. Emotional resilience is vital for coping with the frequent loss of patients and maintaining healthy emotional boundaries to avoid burnout.
Strong communication skills are essential to provide emotional support and effective patient care to patients and their families, including family members. While the hospice team will have a therapist and a religious counselor, the patient and the family will often look to the nurses to get support and reassurance. The nurses are the ones with the most contact, and it will be the easiest for the patient and the family to build trust with them. As a result, the family will be turning to the nurses for comfort. A good nurse has to know how to provide both medical care and emotional support.
How is a Hospice Nurse Different From a Caregiver?
Hospice nurses are registered nurses who must earn a nursing degree, such as an associate degree, and obtain a nursing license. In addition, nursing experience is required to become a hospice nurse. To become a licensed nurse, candidates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN).
Obviously some caregivers have years of specialized experience, but not all. It doesn’t take much to be considered a caregiver. In a hospice situation, if the patient is staying at home with family, then a family member or a loved one is considered the primary caregiver. A hospice nurse is a registered nurse who had to go through schooling and has experience in nursing.
How Do You Become a Hospice Nurse?
Nursing students interested in becoming a hospice care nurse should focus on developing strong nursing skills, including safety, medication administration, patient testing, communication, and understanding the psychological aspects of patient care, as these are essential for legal practice and effective end of life process support.
There are several nursing programs you can enter to begin your schooling for being a hospice nurse. Depending on the type of hospice nurse you are aiming to become, there are certain educational requirements.
In order to be a certified hospice and palliative nursing assistant (CHPNA) you are required to have a high school diploma or GED. A foundational knowledge of biology, health sciences, and psychological aspects is helpful for those interested in the medical field. You must also have at least 500 hours within the past year, or 1,000 hours within the past 2 years, of experience as a hospice and palliative nursing assistant under a registered nurse in the United States.
In order to be a certified hospice and palliative licensed nurse (CHPLN), you must have attended a college or university and received an ADN or a BSN, or you need to have graduated from a state-approved program in vocational nursing.
Completing a BSN program or ADN is important, and employers prefer candidates who have graduated from accredited BSN programs for advanced roles. Both ADN and BSN programs require a high school diploma or GED for admission. After this education, you need to be a licensed registered nurse or a licensed vocational (practical) nurse in residence, and have 2 years or more of related experience under your belt. After earning your nursing degree, you must pass the NCLEX-RN to obtain your nursing license.
In order to be a certified hospice and palliative nurse (CHPN), you need to have earned an ADN or BSN from a college or university. You need to be a licensed registered nurse in residence, and you need to have at least 2 years of related care settings.
To prepare for hospice nursing, it is important to gain experience in clinical environments such as home health agencies or intensive care units, as this hands-on experience builds essential skills for hospice care. To enhance credibility, hospice nurses can pursue optional certifications, such as the Certified Hospice and Palliative Nurse (CHPN).
In order to be an advanced certified hospice and palliative nurse (ACHPN), you need to have earned either a master’s degree or doctorate in an advanced practice nursing program that includes both clinical and didactic segments. A master’s degree can open up further career advancement opportunities, including advanced practice roles and specialization within hospice and palliative care.
You also need to have a current unrestricted active registered nurse license in the US. On top of this, you need to be a functioning nurse practitioner (NP), or a clinical nurse specialist (CNS). Once you have either 500 hours in the past year, or 1,000 hours in the past 2 years, of experience in hospice and palliative nursing practice, you can apply to take the ACHPN exam. You must keep your certification current through recertification, which is required every four years and involves completing a certain number of clinical hours and professional development activities.
Obtaining specialty certification from organizations such as the Palliative Credentialing Center and the Palliative Nurses Association is valuable for career advancement, as these credentials demonstrate expertise and commitment to the field. Continuing education is also important for maintaining certification and staying current with best practices in hospice and palliative care.
The job outlook for hospice nurses is strong, with labor statistics from the Bureau of Labor Statistics indicating a growing demand for hospice and palliative care professionals due to an aging population and increased need for end of life care. Becoming a hospice nurse requires specialized education, licensure, and experience in end of life process care, as well as compassion and strong communication skills.
Conclusion
Hospice nursing can be a very fulfilling but taxing role. The level of education and training required ensures that the nurses are qualified in every way to help the patient. On top of the formal training, hospice nurses should also be compassionate people, and willing to listen to the patient and their family as they go through such a hard time. Nurses of any kind need to be ready to help their patients in whatever way they need, medically or emotionally.
Learn more at inhomecare.com where you’ll find diverse resources, practical solutions, and compassionate guidance tailored to the needs of seniors and caregivers.
