Nursing Specialties

Hospice Nurse

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What is a Hospice Nurse

 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). 

What does a Hospice Nurse Do?

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 Nurse

What skills does a Hospice Nurse need?

Hospice nurses often work away from the hospital environment, so they cannot just ask another nurse to come and check their patient. They must be confident in their abilities. They need strong IV skills if pain medication is administered via that route. Patients nearing the end of their lives may have subtle physical changes and vital signs that the hospice nurse must accurately detect. 

 

Hospice nurses must be able to supervise and coordinate other home care staff such as CNAs, bereavement support, and social workers. They educate and provide emotional and spiritual support to the patient and family members. And ultimately, they must know how to pronounce a patient when they have died.

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What skills does a Hospice Nurse need?

Hospice nurses often work away from the hospital environment, so they cannot just ask another nurse to come and check their patient. They must be confident in their abilities. They need strong IV skills if pain medication is administered via that route. Patients nearing the end of their lives may have subtle physical changes and vital signs that the hospice nurse must accurately detect. 

 

Hospice nurses must be able to supervise and coordinate other home care staff such as CNAs, bereavement support, and social workers. They educate and provide emotional and spiritual support to the patient and family members. And ultimately, they must know how to pronounce a patient when they have died.

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Hospice Nurses

Work settings for Hospice Nurses

Hospice nurses work in their patients or families’ homes, nursing homes, assisted living facilities, hospital hospice units, and skilled nursing facilities.

Common Cases Hospice Nurses Encounter

  • Cancer
  • Pain management
  • Dementia/Alzheimer’s disease
  • Heart and Respiratory Failure
  • Organ failure
  • Progressive chronic diseases
  • Pediatric end-of-life patients

How to Become A Hospice Nurse

  1. Complete an Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) degree: takes two-to-four-years based on the program
  2. Pass the NCLEX-RN exam and apply for your RN license after graduation
  3. Work one to two years in the hospital or a skilled nursing facility
  4. Apply to hospice positions through your Visiting Nurse Service (VNS), a community agency, or a hospital setting. 
  5. Become certified as a Certified Hospice and Palliative Nurse (CHPN) after meeting the prerequisites and gaining work experience.

How to Advance Your Career As A Hospice Nurse

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.

Education Requirements & Helpful Certification

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.

Average Salary For Hospice Nurses

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.

Ideal Personality Traits

  • Empathetic
  • Comfortable with end-of-life decisions
  • Confident nursing skills
  • Strong patient advocate
  • Independent practice
  • Patient and flexible
  • Excellent communicator


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Hospice Nurse

Hospice nurses work with terminally ill or near end of life patients (hospice patients) and their families. Hospice care provides 24/7 supportive care for those with six months or less to live. Their focus is on helping the person live as comfortably and as independently as they can in their final days by providing pain management, emotional, psychosocial, and spiritual support.

Education Requirements

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.

How to advance/career pathway

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.

RESPONSIBILITIES

  • Provide care for elderly or terminal patients of any age
  • Patient assessments: vital signs and physical exams
  • Wound care and preventive skin care to prevent breakdown
  • Medication administration: pain and secretion management
  • Supervise and coordinate other home care staff: CNAs, bereavement support, and social workers 
  • Educate and provide emotional and spiritual support to the patient and family members

MOST COMMON CASES

  • Cancer
  • Pain management
  • Dementia/Alzheimer’s disease
  • Heart and Respiratory Failure
  • Organ failure
  • Progressive chronic diseases
  • Pediatric end-of-life patients

How to become a

Hospice Nurse

  1. Complete an Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) degree: takes two-to-four-years based on the program
  2. Pass the NCLEX-RN exam and apply for your RN license after graduation
  3. Work one to two years in the hospital or a skilled nursing facility
  4. Apply to hospice positions through your Visiting Nurse Service (VNS), a community agency, or a hospital setting. 
  5. Become certified as a Certified Hospice and Palliative Nurse (CHPN) after meeting the prerequisites and gaining work experience.

The Pros

  • Develop close relationships with hospice patients and their families
  • Manage the care of one patient at a time
  • Being your patient’s primary advocate
  • Make independent but collaborative decisions with the hospice team

The Cons

  • Can be stressful dealing with death, feelings of attachment, and loss
  • Possible isolation from newer medical trends since focused on end-of-life care
  • Workload can be heavy at times leading to fatigue
smily face illustration

Personality Traits

  • Empathetic
  • Comfortable with end-of-life decisions
  • Confident nursing skills
  • Strong patient advocate
  • Independent practice
  • Patient and flexible
  • Excellent communicator


piggy bank illustration

Average Salary

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.

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Certifications

Hospice and Palliative Credentialing Center (HPCC)

  • Certified Hospice and Palliative Nurse (CHPN) 
  • Certified Hospice and Palliative Pediatric Nurse (CHPPN)
  • Advanced Certified Hospice and Palliative Nurse (ACHPN)
  • Certified in Perinatal Loss Care (CPLC)
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Work Setting

Hospice nurses work in their patients or families’ homes, nursing homes, assisted living facilities, hospital hospice units, and skilled nursing facilities.