Palliative Care Specialty Questions

OK....hospice care encompasses 'palliative' or 'comfort' care - always. However, there are palliative care programs that have non-hospice patients (Kaiser Permanente has a Palliative Care Program designed to help patient's who are undergoing aggressive treatment of their disease while affording them optimal symptom management by the Palliative Care team...also makes it easier to transition those patients to hospice care if the treatments are deemed ineffective after a time). So, you can receive palliative care while treating a serious illness and you ALWAYS receive palliative care as a hospice patient (who has a disease that is deemed to be non-curative). I am a CHPN, which is a Certified Hospice and Palliative Care Nurse. This certification is specific to this field of nursing and demonstrates proficiency in this specialty field. It is typically advised for nurses to work in the field of hospice and/or palliative nursing for at least 2 years before they sit for this certification. It is not designed for someone new to this care philosophy to sit for the exam before gaining real-life work experience.

I hope this is helpful for you. Best of luck to you in your nursing practice.

That pretty much says it. I am a Hospice nurse turned Palliative Care nurse, but I am on the Inpatient team. We also do Outpatient Palliative Care in the homes. We get most of our OP referrals from the Oncologist to assist with symptom management while her patients are receiving treatment and we bridge these patients into our Hospice program. We also get referrals from our Home Health team for managing pain usually, either chronic or acute. In the hospital I get referrals from the units to help families with end of life decisions, from docs for help with symptom management or to transition them to Hospice because they are not quite on the page. Our IN team consists of my doc, myself, MSw and Chaplain. We usually try to make the initial contact together but I am the only Palliative Care member who does not do other work for the hospital. So we help care for patients anywhere on the life scale from onset of symptoms until Hospice come in, some teams follow to death especially in house. We don't because we can do inpatient Hospice as we are hospital based. Sorry for rambling, this is my favorite topic to discuss. Hospice is still dear to my heart but I enjoy, at my age, not having to drive so much now.

Shrinky...I appreciate your job! When I was doing the acute inpatient hospice nursing care at a hospital in Ann Arbor I worked closely with the Palliative Care team. That team consisted of MDs, NP, RNs, and MSW. They provided the palliative consultation and insight for patients in the hospital who required better symptom management. When that hospitalized patient needed hospice they called me. We often provided that hospice care for them right there in that inpatient setting if their life span was expected to be 72 hours or less. What did surprise me was that this palliative care team were not routinely utilized for other services provided by that health system on that campus. For instance, there is a rather nice dementia facility there but the palliative care team provides no care to patients there. The only time those folks get palliation of symptoms is when they are progressed enough in their decline to be certified for hospice services. That always seemed like a huge mistake to me, so many dementia patients have comfort issues that are not adequately addressed.