What is a Hospice Nurse? | Everything You Need to Know

Pursuing a career as a hospice nurse has its rewards and challenges. Hospice nurses are charged with providing comfort and pain relief to those who are suffering from terminal diseases. They are trained to assist both families and patients who have received a diagnosis with an expected lifespan of six months or less.

Challenges of this career include the emotional and psychological difficulties that come with caring for a terminal individual. Due to the delicate nature of the job, a hospice nurse needs to be compassionate, dedicated, and highly educated in the ways to manage pain for those suffering from serious diseases.

What Is a Hospice Nurse?

A hospice nurse works with a specific type of patient. Hospice is a form of care given when all other medical interventions have been exhausted. Hospice patients usually have a terminal diagnosis and will not likely survive the year. The hospice nurse has the role of not only being a caregiver for the terminally ill patient but must also act as his or her advocate. Care provided through hospice nurses is holistic with a strong emphasis on making sure the patient is as comfortable as possible.

Hospice nurses are similar to registered nurses (RNs) because a hospice nurse would have started his or her career as an RN before choosing the specialty. Unlike registered nurses, a hospice nurse will not work with many different patients. Instead, they will provide long-term care to terminally ill patients anywhere from weeks to years.

What does a hospice nurse do?

The hospice nurse’s main focus is making sure the patient’s physical and emotional needs are met. They will take patient vitals, but medical care is only a small portion of what the nurse will do. Hospice nurses work in a variety of settings including patients’ homes, hospitals, nursing homes, and hospice centers. The types of duties performed by a hospice nurse are often dictated by where they work and the needs of each individual patient. Moreover, there are sub-specialties of hospice nurses:

• Visit Nurse – A visit nurse won’t act as the patient’s long-term caregiver. Instead, a visit nurse will be available on days and times when the patient’s assigned hospice nurse is not working.
• Care Manager – The care manager will be the primary go-to person for the hospice patient’s care. Throughout the duration of hospice, the care manager will schedule visits, counsel patients and families, and provide support before and after the patient’s death.
• Liaison – The liaison will work with both patients and hospice organizations. The liaison ensures the patient and family members are getting all the resources available to them. Liaisons also work with hospitals to plan out hospice care for admitted patients.
• Admitting Nurse – The admitting hospice nurse will be the first one to develop a hospice care plan for a patient. They could also be responsible for evaluating the medical needs of the patient and making the appropriate recommendations.

Hospice nursing duties will vary from case to case. Pain management is a large part of hospice nurse care since the goal is to keep the patient comfortable. Another key component is acting as a support person to family members during their difficult time. Besides nursing care, a hospice nurse may even perform household duties to help out such as cooking, cleaning, and personal care.

Why are hospice nurses important?

Hospice nurses are extremely important because they help a person pass away with dignity. They also ensure the person is not alone when he or she passes on. Hospice nurses improve a person’s quality of life after a terminal illness diagnosis. Many of these nurses work in-home and by traveling to the residence. They ensure the patient is comfortable and surrounded by family and friends. Hospice nurses also educate family members on how to respond to any emergencies. Since medical visits will be limited, a hospice nurse will be responsible for reporting on the patient’s condition and getting the right services to assist with his or her care.

How to Become a Hospice Nurse

The main quality of a successful hospice nurse is a grounded person who performs well under stress. Seeing someone in the end stages of a disease can take an emotional toll and a successful nurse will know how to deal with the difficult emotions that come with hospice nurse jobs. In addition, the nurse must be able to demonstrate compassion and know-how to manage the patient’s family stress. It is difficult to see a loved one suffer and a hospice nurse must know how to educate family and caregivers about the needs of the patient while reminding them to practice self-care. Many registered nurses who enter hospice care have a familiarity with terminal diseases, holistic remedies, and pain management.

Hospice Nurse Education and Requirements

A hospice nurse will have a similar educational background as a registered nurse. He or she will attend a degree program, typically a Bachelor of Science in Nursing (BSN) or an Associate of Science in Nursing (ADN). If the nurse plans to pursue a career in hospice care, a bachelor’s degree will give them an advantage when looking for job openings in the field. Nursing courses will cover topics such as pharmacology, nursing fundamentals, patient ethics, anatomy, and physiology. Upon graduation of an accredited nursing degree program, the graduate can take the NCLEX-RN. Once he or she passes the exam, a nursing license is granted.

Continuing credit courses are needed annually to keep a nursing license current. When taking their first nursing job, prospective hospice nurse should look for relative field experience, such as jobs working with cardiac patients or oncology patients or finding a job at a hospice center.

To be board certified as a hospice nurse, two years of clinical experience is required. After this point, you can take a hospice nurse certification examination from an agency such as the Center to Advance Palliative Care and the Hospice and Palliative Nurses Association. Certification is usually optional for hospice nurses, but it will demonstrate to employers that the applicant has field experience.

Nursing assistants, registered nurses, advanced practice nurses, and pediatric palliative nurses have the option to earn certifications as well. Testing is usually done quarterly with the certifying agency providing preparation materials to registered individuals. Courses and examinations will cover topics such as disease progression, care planning, pain assessment, and ethics.

Hospice Nurse Salary and Career Outlook

There are numerous opportunities for hospice nurses. Since the job is emotionally challenging, not all registered nurses will choose to pursue this type of care. Hospice care can be offered virtually anywhere, including the home. However, some patients remain in nursing care facilities, hospice centers, or hospitals while under the care of a hospice nurse. The nurse will have to be flexible with the different types of care arrangements for each patient.

During hospice, medical visits are limited, so long shifts aren’t usually required unless the nurse has a heavy caseload. Daytime shifts are available so that hospice care nurse visits don’t disrupt any other family members. Emergencies can arise with hospice patients, so late-night calls are possible. A hospice center may have rotating shifts so that a nurse is available 24/7 at the facility.

How much do hospice nurses make?

Being certified as a hospice nurse offers financial rewards. A certified hospice nurse will earn a slightly higher salary than an RN. A registered nurse has a median wage of $71,730 annually, according to the Bureau of Labor Statistics. In comparison, a certified hospice nurse will make an average of $82,000 or more each year. Hospice nurses can advance in the field by becoming care managers or nursing supervisors which will open the door to even higher salaries.

It is not unusual for hospice nurses to move into different types of care. Since the job is so emotionally taxing, a nurse may find another specialty is a better fit or a nice respite. However, hospice care will give the nurse experience in the symptoms and stages of serious illnesses. This could be helpful if the nurse decides to become a nurse for an oncologist or cardiologist.

Job growth in the nursing field is increasing at an accelerated rate when compared to all other industries. Nursing positions will expand by as much as 15 percent over the next decade. This growth is attributed to an increased aging population—a factor that will also impact the number of hospice nurse positions available.

Hospice Nursing Resources

Hospice Nurse FAQs

How can a hospice nurse manage stress levels?

Hospice care is a very stressful vocation. To best manage stress, the nurse must take adequate vacations and time away from the job. Good nutrition, plenty of rest, and exercise are natural ways to manage stress. Confiding with other hospice nurses can also help manage the complex emotions that come with the job.

Do hospice nurses attend deaths?

An agency may have an on-call schedule for their hospice nurses. The hospice nurse scheduled for the on-call shift will be expected to go to any emergency appointments and attend any deaths. When a patient passes away, the hospice nurse will support family members as they make arrangements. Family members often become close to hospice nurses and rely on them for support during difficult times.

Are there advanced degrees for hospice nurses?

Hospice nurses can choose to pursue a master level degree in palliative care. The difference between palliative care and hospice care is that the disease for the former can be serious, but not necessarily terminal. Like hospice care, the focus is providing pain relief and stress relief for the patient and family members. Palliative care courses focus on patient care and knowing how to present them with choices about their future medical care.

Helpful Organizations, Societies and Agencies

Joining a network to connect with other hospice nurses is essential. Hospice nursing is a very high-stress position and connecting with other people in the profession can be incredibly helpful. Also, organizations can provide nurses with publications related to their specialization and the option to take courses to learn more about sub-topics in hospice care.

• Hospice and Palliative Nurse Association
• National Hospice and Palliative Care Organization
• American Association of Critical Care Nurses

Scholarships

Looking for some financial aid to get you started? Check out our guide and scholarship!

List of Programs

Interested in becoming a hospice nurse? Check out our list of the Top BSN Degree Programs in the United States.

Now What?

If you have any questions about hospice care and becoming a nurse in the field, please reach out. RNtoBSNProgram posts detailed reviews and rankings of nursing programs on campus and online to find the best fit for each individual. Prospective hospice nurses can research degree programs to kickstart their careers.