November honors those who provide end-of-life care with National Hospice and Palliative Care Month. Many nurses in this specialty say the work is emotionally and physically rigorous at times, but an incredibly gratifying area of nursing.
National Hospice and Palliative Care Month focuses attention on the caregivers who are able to help patients and their loved ones navigate the end of life with dignity, companionship, and as much comfort as possible. These nurses can practice in various settings–a healthcare facility, nursing home, or private home.
Nurses interested in this career path will find information and resources through Advancing Expert Care, the combined partnership of the Hospice and Palliative Nurses Association, the Hospice and Palliative Credentialing Center and the Hospice and Palliative Nurses Foundation.
The pace of the COIVD-19 pandemic has rapidly changed the caseload and the pace of hospice nursing. Because of their essential role in end-of-life care, hospice nurses work closely with patients to incorporate treatment of the whole patient. That means they might be prescribing medication, caring for various physical symptoms, and also acting as a knowledgeable source of medical information and comfort for patients and their loved ones. They assemble a care team that could include spiritual or religious members and will work with the patient’s care giving team to ensure that a patient is never alone in the final days and hours.
According to the National Association for Home Care and Hospice (NAHC), 90 percent of Americans want to age in place at home, making the role of a hospice nurse essential for end-of-life care for these patients. For those who wish to age in place, healthcare delivery is especially important. Those who have a disability, are elderly, or have chronic health conditions will depend on home care workers and hospice and palliative care nurses as they come to the end of their lives. NAHC offers nurses opportunities to connect with legislators and advocate for home care and hospice care to remain at the front of patient rights and issues.
If you’re interested in this career, the need for nurses is high and increasing for many reasons. In addition to the impact of the pandemic, members of the large baby boomer generation are getting older, managing chronic health conditions, and often want to age in place. All of these factor are trickling down to a specialty hospice and palliative care nursing workforce that needs more nurses. The roles available in the field are broad. Nurses may have varying levels of direct patient care every day or they may have a managerial role where they are in charge of overseeing the network of care providers for a patient in hospice care.
Patients and loved ones look to hospice nurses to provide a calm and steady presence, but that doesn’t mean they aren’t supposed to cry when a patient dies. Nurses in these roles are deeply compassionate and in tune with their patients. But if you’re considering this career path, you will need to be comfortable with the process of dying and be able to cope with constant loss of patients. The benefits for helping patients navigate the end of life are deep and rewarding.
As November draws to a close, the end of National Hospice and Palliative Care Month also winds down. Many families spent an unsettled holiday weekend without loved ones, either because they wanted to be safe and not gather with people outside their immediate households or they were unable to travel. In many other cases, illness, from COVID-19 or otherwise, prevented loved ones being together. Still other families have suffered the loss of a loved one this year.
As a pandemic continues to move swiftly into every community in the United States, the subject of death and dying and end-of-life care is much more at the forefront in our society right now. As palliative care and hospice nurses see all the time, many families enter into the last stages of a loved one’s life without any real understanding of what kind of care wishes their loved one would like them to follow.
These last two days of National Hospice and Palliative Care Month focus on end-of-life care and advocacy to spread awareness of how discussions about end-of-life preferences and choices need to happen long before they are actually necessary. While many of us aren’t inclined to have such difficult conversations during the holidays, finding a time when you’re able to start the discussion can save confusion and doubt when you need the information. As a nurse, this is a good opportunity to remind your patients of the value of talking about their wishes with their loved ones.
Palliative care and hospice nurses are often able to help guide families during the last months of life as they care for someone with a life-limiting illness. While the patient is given the best care to make them as comfortable as possible, nurses in this specialty also assist families who may be struggling with sadness and uncertainty about their loved one’s condition.
This area of nursing is growing quickly, according to the U.S. Bureau of Labor Statistics, which predicts growing need for palliative and hospice care workers to meet increasing demand. As the baby boomer segment of the American population continues to age, the need for hospice and palliative care will become more pressing.
It’s essential to have enough workers to fill the hospice nursing need, and the National Association for Home Care and Hospice advocates for all the professionals in this industry. As a registered nurse, you can provide case manager services as well as direct medical care. If you’re a nurse practitioner, you’ll have additional responsibility and duties, including prescribing the medications that help your patients manage any pain they may be experiencing. LPNs provide the comforting physical care and companionship so essential during a person’s last days.
If you think this nursing specialty is a good fit for you, getting additional work experience in a palliative care and hospice care setting will help you make a decision. Working with people at the end of their lives is incredibly rewarding for hospice nurses, but the role isn’t for everyone. If you decide to move forward, becoming a certified hospice and palliative nurse (CHPN) gives you the additional education and knowledge you’ll need to be most effective in this position.
A career in palliative care and hospice nursing is rewarding as you help bring a sense of dignity to a patient’s final days.
Although many people don’t like to think about death and dying, it will happen eventually. When it does, those who are fortunate enough to have hospice and palliative care nurses caring for them will understand the importance of these nurses’ roles.
Palliative and hospice care nurses provide care for those who are the end of their lives. They are there for the final transition and use an entire array of medical knowledge and tools, skills, compassion, and life experiences to help in the best ways they can. Hospice and palliative care nurses strive to make patients as comfortable as possible both physically and emotionally. As their physical body shuts down, these nurses can use a combination of medication, music, talk, touch, and companionship to make the process something the patient is comfortable with.
The Hospice & Palliative Nurses Association and the National Hospice and Palliative Care Organization offer resources and education about this nursing specialty. Palliative and hospice nurses often provide education to the public as many people think of nurses as providing life-saving care and aren’t sure what end-of-life care entails. If they haven’t had interactions with hospice care, they may not comprehend all that goes into the nursing practice as someone approaches end of life.
While many find the end-of-life stage difficult to cope with, these nurses often consider it a supreme privilege to be present during someone’s last days. Nurses often develop deep connections with these patients as they try to meet their wishes and help them die with a sense of dignity and control. They also become close to families and even provide guidance and education to help families cope and to make them feel like they can take an active part in offering comfort and acceptance.
Hospice and palliative care nurses deal with grief, often very profound grief, on a daily basis. While the dying patient is coping with life coming to an end, a circle of loved ones is doing the same and trying to prepare for life after the person’s death, while also making the most of the final days. These nurses are especially skilled in managing grief and helping others learn coping skills while they still focus fully on the patient.
Hospice nurses need to take special care to make sure they are also able to cope with profound levels of grief and death in their lives so they don’t get burned out or experience compassion fatigue. Forming strong relationships with other nurses in this specialty is important as is joining professional organizations devoted to hospice and palliative care and even continuing education like certification or additional coursework or conferences. There is much to be learned from others in similar work and hearing how they cope and even what might be a red flag to take notice of. Turning to others and counseling professionals if needed can help nurses stay focused while acknowledging and honoring the challenges of providing end-of-life care on a daily basis.
This career path is one that offers great rewards and hospice nurses are often remembered as a steady presence in a chaotic time.
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