A hospice is a healthcare facility that focuses on providing palliative care to terminally ill patients. As palliative care is all about alleviating the symptoms of an illness or disease rather than fighting it, being a hospice nurse requires compassion, tact and strength of mind. You are expected to play a major role in helping to provide a comfortable, relaxing home from home environment for patients and family alike. The concept has extended beyond the confines of purpose built hospices and a hospice nurse may now work in dedicated palliative wards in hospitals and clinics, nursing homes or even in a patient’s personal home.
The philosophy of a hospice is based on treating the patient as a whole. The goal is to enable terminally ill patients to live each remaining day comfortably and free of pain and to provide emotional support plus help with social and spiritual needs. Aggressive pain control methods are common. Uniquely, the level of comfort and pain relief is actually defined by the patient or, when incapacitated, by the patient’s family.
Working as a hospice nurse means working in an interdisciplinary team where each of you is working towards a common goal compared to a hospital or clinical environment where care is usually provided with a multidisciplinary approach with each aspect of care treated by a different practitioner, specialist or department.
To be able to be a hospice nurse, you must first be a registered nurse. As a registered nurse you will have gained qualification through one of these three routes:
You can then go on to apply for the certification of hospice nurses but not until you have worked in a hospice setting or role for two years.
Currently the average salary of a hospice nurse is $49,000 but this can vary between states and according to demand and experience. Government statistics show that hospice nurses can earn up to $32/hour.
Once you have committed yourself to being a hospice nurse, the scope for career advancement is not as wide as with some other disciplines of nursing but there is the opportunity to move from RN to be a hospice nurse case manager and then perhaps onwards to join the senior management team running the facility. As the hospice philosophy is becoming more accepted and more roles for hospice nurses are created, the scope for moving within the hospice discipline will increase. In a palliative care unit of a hospital or clinic there may be different opportunities depending on how the entire staff is structured. If you want to take a slightly different route after gaining hospice experience, but with new qualifications required, you can consider working as an occupational therapist, paramedic or a physician’s assistant.
Registered nurses in a hospice are responsible for the coordination of all aspects of the patient’s care and making sure that symptoms are addressed and managed. The RN is responsible for identifying changes in the symptoms or how the patient is reacting to treatment and passing the observations on to the lead physician along with recommendations for changes and improvements.
It is the duty of a hospice nurse to recognize that emotional and spiritual needs are being met and this is done in direct consultation with the patient and the patient’s family.
If a patient is receiving hospice care at home the RN will visit regularly to ensure the home care is being carried out effectively. They will consult with the family to keep completely up to date with the patient’s situation and will recommend any changes to either medication or physical therapies.
Whatever the duty being performed, the needs of the patient are paramount. If you have compassion in abundance, patience and ability to help people through stressful and emotional situations, then you have the qualities to become a great hospice nurse.