Hospice Nursing

Pursuing a Career as a Hospice Nurse

8905_B127_rgbDeath and life are inherently intertwined. While caring for the living is the more typical nursing role, tending to the dying is equally important. Hospice nurses play an essential part in ensuring that a patient's end-of-life experience is managed with dignity and respect.

Hospice nursing involves caring for terminally ill patients who no longer seek treatment to cure their malady and have a life expectancy of six months or less. When a patient reaches the point where the doctors are no longer able to do anything for him/her, hospice nurses provide compassionate and effective support to the the family and palliative care to the patient in order to make their final days comfortable. The role of the hospice nurse is a particularly difficult one because they know from the start that the person they are caring for is going to die. Therefore a hospice nurse must possess a very patient, compassionate, and caring temperment.

Hospice Nursing Duties and Responsibilities

The hospice doctrine states that terminally ill patients have the right to spend their last days in the comfort of their own homes, with their families, and hospice care provides professional medical care as well as supportive social, emotional, and spiritual services to accomplish this.

Hospice Nursing responsibilities involve traditional skills such as observations, assessments, and charting as a guide for the patient's plan of care. Medication management is an important skill critical to the mitigation of patient pain and suffering. The orientation is interdisciplinary, as hospice nurses typically supervise licensed practical nurses and nursing assistants as well as collaborate with physicians, social workers, and home health specialists to provide comprehensive care. Further, they serve as a case manager/liaison between the patient and his/her physician — a role requiring a healthy dose of tact and patience.

Many nurses are attracted to hospice nursing's holistic approach and champion the diversity and autonomy inherent in the work — a perk that affords them practical use of the skills they acquired in nursing school. Hospice nursing takes place in a variety of settings including, but not limited to the patient's home, skilled nursing facilities, group homes, hospice centers, and even in correctional facilities. A typical caseload for a hospice nurse in a home setting involves traveling to and visiting with one to five patients a day. The most common afflictions among these patients are cancer, heart and lung disease, end-stage renal disease, AIDS, and Parkinson's disease.

Hospice nurses help the patient and their family members cope with the dying process both physically and emotionally by explaining what the patient can expect throughout the terminal phase of his/her illness, thus relieving some of the fear of the unknown, by helping the patient stay as comfortable as possible throughout the process, and by helping the patient's loved ones deal with grief and bereavement.

How To Become A Hospice Nurse

In order to become a hospice nurses you must first graduate from an accredited nursing school and then pass the National Council Licensure Examination (NCLEX-RN) to become licensed to practice as a registered nurses (RN). Prospective RNs with no prior nursing degree will need to earn their nursing degree through a traditional campus based nursing school. You have the option of earning an Associate degree in Nursing (ADN), or attending a four year Bachelor of Science in Nursing program (BSN degree). Licensed Practical Nurses (LPNs) have the option of earning their RN degree on campus or online through an accredited online LPN to RN program or an online LPN to BSN program. A BSN degree is not a requirement to become a hospice nurse, but It should be noted that most employers advertisements these days say "BSN Preferred". In addition to meeting the basic requirement to be an RN, many hospice nurses go on to earn a MSN degree (Master's in Nursing Science) that specializes in Hospice or Palliative Care nursing or do post-graduate certificate programs, and a few possess Doctorate degrees in Nursing.

Hospice and Palliative Nurse Certification

The National Board for Certification of Hospice and Palliative Nurses (NBCHPN®) provides specialty certification examinations for all levels of nursing: advanced practice nurses, registered nurses, licensed practical/vocational nurses, nursing assistants and for hospice and palliative care administrators. Applicants for the Hospice and Palliative Nurse Certification examination must hold a current, unrestricted registered nurse license in the United States, its territories or the equivalent in Canada. Examination content is based on the competencies normally achieved through two years of practice in end-of-life care, so the NBCHPN® recommends that candidates should have at least two years of experience in hospice and palliative nursing practice to consider themselves ready to take the Hospice and Palliative Nurse Certification examination. Some hospice and palliative care nurses elect to specialize in areas such as oncology, pediatrics, or geriatrics. Nurses who concentrate in pediatric hospice nursing can take the Hospice and Palliative Pediatric Registered Nurse Certification Examination, and Advanced Practice Nurses can take the Hospice and Palliative Advanced Practice Nurse Certification Examination. Details and eligibility requirements can be found on the NBCHPN® web site.

As advancements continue to take shape in the medical field, hospice will become increasingly recognized for its moral and ethical contributions to society. By endeavoring to ensure that patients are able to make fully informed decisions about the care they receive during a life-threatening illness, hospice nurses will continue to make their mark as advocates of compassionate care.