Hospice Nurse

What is a hospice nurse?

A hospice nurse is part of the nursing profession. There are different roles a hospice nurse fulfills based on education and certification. Some are licensed nurses, such as those who are registered nurses. Others are certified nursing assistants (CNAs). Regardless of level, each is prepared to provide special care for people who are terminally ill and their families.

What certifications and training do hospice nurses have?

Registered Nurses (RN)

Are licensed to practice nursing in the state where they work.

• They may have a Bachelor’s or Associate’s degree education.
• They have usually worked in an acute care setting, such as a hospital, before becoming a hospice nurse.
• These nurses participate in special training about caring for people who are terminally ill and their families. They also have special types of nursing skills such as wound or intravenous care.

Advanced Certified Hospice and Palliative Nurses (ACHPN)

Are RNs who have a Master’s or Doctoral degree and are licensed in the state where they work.

• They have advanced training and practice in hospice and comfort care.
• They provide guidance for complex care.
• These nurses are typically responsible for staff education and may fulfill administrative functions for their employer.

Certified Hospice and Palliative Care Nurses (CHPN)

Are registered nurses who are licensed to practice in the state in which they work.

• They have advanced training in hospice and comfort care.
• They have passed a test and other requirements to become certified.

Certified Hospice and Palliative Licensed Nurse/Vocational Nurses (CHPLN)

Are licensed practical or vocational nurses. These terms vary by state.

• These nurses also have special training to provide hospice care. They too pass a test and fulfill requirements to become certified.
• The CHPLN is typically supervised by an RN, who may also be certified.

Unlicensed hospice nursing staff include

• Home Health Aides (HHA) who have prior experience caring for people in other healthcare settings. They often have cared for people who are very ill or dying.
• Certified Hospice and Palliative Nursing Assistants (CHPNA) who are CNAs with extra experience and training in hospice care. They pass a test to become certified.
• Unlicensed staff are supervised by a licensed nurse who is approved by the state to do so.

What does a hospice nurse do?

Hospice care is often complex. Nurses are there to hear the concerns of family members and friends as well as those of their patients.

They provide education for caregivers and support staff such as home health aides. In addition to this, there are nurses with special functions based on a patient’s needs and who assure that care is planned well right from the start.

What are the different types of Hospice Nurses?

The Admission Nurse

Is responsible for assessing a person’s nursing needs. This includes care prescribed by a physician.

• The nurse assures that a person is eligible for hospice care and then meets with the patient and/or family to plan next steps.
• Part of this role includes guiding a person’s plan of care and making sure needed equipment and supplies are available.

The Nurse Case Manager

Oversees the details of a person’s care that includes:

• Coordinating aspects of care with a patient’s care team.
• Supervising unlicensed nursing staff.
• Meeting with the family to assure all needs are being taken care of, including those for after their loved one passes.

Visit Nurses

Routinely fill in for the Nurse Case Manager, often providing specialized nursing care.

• Frequency of visits is part of the patient’s care plan with visits increasing as needed.
• Sometimes these are nurses who perform specialized care like wound care or showing caregivers how to administer medications.

Triage Nurses

Are available when there is a home emergency or a family needs advice. This can be a defined hospice role or fulfilled by nurses who are on-call and educated about triage care.

Where do hospice nurses work?

Hospice nurses work in a variety of healthcare settings. They may be employed by a Healthcare Network or a Home Health and Hospice Agency. In their role with their employer, they may visit patients in various settings, including:

• Hospitals where they work with other nursing staff to assure comfort care measures are in place.
• Serving the same function in long-term care or elder care facilities.
• Working at hospice homes as well as in patients’ homes.
• Moving their services from one setting to another, such as from home to hospital. This is based on the patient’s and family’s needs and wishes.

How often does a hospice nurse visit?

Hospice services and nursing care adhere to Medicare guidelines.

• A registered nurse must visit a person’s home every 14 days to assess the quality of care and level of need.
• Visit frequency is decided by the patient’s care team and family. Increased visits happen when needed.
• Caregivers know they can reach a nurse day or night when a person’s condition changes.

What makes a good hospice nurse?

Hospice nurses choose this professional setting because they value a person’s wishes to pass in comfort at home. Their work requires that a nurse is prepared for this work that is emotional as well as physical.

What skills and traits make an effective hospice nurse?

• Hospice nurses rely on personal traits as well as special skills to provide effective hospice care. These include:
  • Compassion with the ability to accept differences between people and families.
  • Clear communication, both written and verbal with the ability to adapt to various communication styles. Reflective listening skills are a benefit to providing effective care.
  • Astute observation skills to be aware of caregivers’ needs as well as those of patients.
  • Clear thinking, including on one’s feet, so to speak. This means being able to make thoughtful, well-informed decisions when in person, on the phone, or via text.
  • Awareness of the value of self-care in order to have the resilience needed to continually care for people who are terminally ill.
• Care for Family Caregivers by actively engaging them in decision-making for their loved one. The nurse provides information, support, and attentive understanding for those in the primary caregiving role.
• Care for a Patient’s Family by assuring their emotional and basic needs are met.
  • This can include assuring that social worker visits are in place, as well as bereavement services.
  • The nurse is attuned to each family member, being sure that resources for meals and personal time are in place.
• Care for Patients as they visit with a person to learn about their last wishes.
  • They may advocate for a patient with those in caregiving roles.
  • The nurse assures that services and those providing them are meeting the patient’s needs.
  • Nurses communicate with other care team members to assure that each person’s physical, emotional, and spiritual needs and wishes are met.

How long does it take to become a hospice nurse?

Some hospice settings prefer that a nurse have two years of acute care experience before becoming a hospice nurse. The nurse then participates in training, most of which is on the job. A nurse becomes certified after completing additional training or education and taking a certification exam. This also requires that the nurse demonstrates various competencies or skills.