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 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.