Hospice nurses support and assist patients and their families in the end-of-life process. Nurses who work in this field require a calm, empathetic style to gently deliver care to these very ill patients, who usually are in the last six months of their lives. Hospice nurses must anticipate when to step in to increase the patient’s comfort with respiratory support and pain medication to neither hasten nor delay the person’s final hours. Their primary goal is to optimize the person’s quality of life and provide compassionate support to the family on a 24/7 schedule.
Hospice nurses guide their patients and families down a frightening and uncertain path and develop close relationships with them. Everyone looks to them for reassurance of what to expect. They are strong leaders of the hospice team and direct CNAs on what care to administer, arrange for any equipment needed, and stay in communication with physicians on the status of the patients. Hospice nurses may provide spiritual support as they become the confidant of secrets only told at this time of life. They are experts on managing any concerning symptoms that arise and assisting the person to die with dignity.
Hospice nurses often receive advanced training to improve their skills. Some become advanced practice registered nurses (APRNs) who specialize in hospice care and get certification as an Advanced Certified Hospice and Palliative Nurse (ACHPN).
Hospice nurses perform some of the same activities as other nurses, but their focus is on providing care to ease a patient’s passage at the end of their lives. Some hospice nurses work in different roles such as admission nurses or case managers who coordinate the entire hospice team.
General activities may include:
• Recording vital signs
• Administering medications, particularly pain medications
• Provide oxygen support via cannula or mask
• Monitor the patient’s status
• Wound care or skin care, especially if the patient is incontinent
• Alerting the medical team to any significant changes that need attention
A hospice nurse also can pronounce a patient, confirming their death. Afterward, they attend to the body, dispose of unused medications and supplies, contact the rest of the medical team, and contact the hospice office to make arrangements for the funeral home.
Hospice nurses work in their patients or families’ homes, nursing homes, assisted living facilities, hospital hospice units, and skilled nursing facilities.
You can advance your career by getting an MSN or doctoral degree with a hospice care focus. Alternatively, you can become a Nurse Practitioner (NP) and earn certification as an Advanced Certified Hospice and Palliative Nurse (ACHPN) or a Clinical Nurse Specialist (CNS) and become an educator or manager.
Hospice nurses must be BCLS certified. They often become Certified Hospice and Palliative Nurses (CHPNs) or Certified Hospice and Palliative Pediatric Nurses (CHPPN)
You can apply for a Certified Hospice and Palliative Nurse (CHPN) or Palliative Pediatric Nurses (CHPPN) after 500 hours of hospice and palliative nursing practice in the previous 12 months or 1,000 hours within 24 months before applying for the examination.
Hospice nurses typically make between $65,831 - $100,950, with a median salary of $79,183, according to Salary.com.
The May 2021 Bureau of Labor and Statistics report shows which states have the highest and lowest wages for nurses. They do not list by nurse specialty, but hospice nurse salaries would likely follow suit. The highest-paid states are California, Hawaii, and Oregon. The lowest-paid states are South Dakota, Alabama, and Mississippi.
