Advice for RN starting in home hospice care???

TheHungryThing · Mar 8, 2016

Good for you for going into hospice nursing. I have SO much respect for hospice nurses!

Are you familiar with "caritas nursing" (also known as caring science?) It isn't specific to hospice, but lends itself very well to end of life care. It is focused on science-based delivery of truly wholistic care (and is by far my favorite nursing theoey.) There are some great books on Amazon, or you can learn more about it at Watson Caring Science Institute |

I have never worked as a hospice nurse (outside of clinicals in school,) but I have cared for many dying patients in critical care. I have also experienced hospice care first hand while I cared for my terminally ill parent. In both my personal and professional experience, nurses who have the best impact are the ones who take the time to slow down and align themselves with where a patient is at on that particular day. (In caritas nursing this is called "attunement.")

Hospice nursing is unique in the role nurses play. While it isn't technical in the same way ICU or OR nuraing is, hospice nurses need to have a really large tool box for dealing with people in all stages of grief & illness. Each person on each day requires a unique, individualized approach to meet their personal and physical needs.

Becoming really competent in pain management is also really helpful for end of life care. Family memebers don't always know how to recognize whether or not their loved one is "comfortable" at the end of life. For example, they might undermedicate their loved one becaus they don't want them to be totally snowed and lose interaction, or they may be distressed by thinking that the irregular breathing pattern is painful. Being able to tell them what is a normal part of passing vs what is likely pain can help empower and comfort them.

In general, a good understanding of the pathophys of dying can be a great help explaining (and treating) the symptoms your patients will have.

nutella, MSN, RN · Mar 9, 2016

I love the wealth of info and wisdom offered by the many experienced RNs on these forums and I am so grateful to all those who do take the time to respond. I was wondering if any experienced hospice nurses can offer some advice/guidance/wisdom/good reference sheets or materials to a RN starting in hospice care??
I tried to look up books and other reference materials on hospice nursing to get more educated (since nursing school barely touched upon it) but I'm finding that there aren't that many and thought it would be better to hear it directly from the professionals out there right now. Thanks in advance!

Home hospice or working in a hospice house is not like CMO in the hospital... just saying because in home hospice you will get more serious about symptom management.

The "bible" for hospice and palliative care nursing is the core curriculum :

HPNA

just make sure you get the latest edition (4.edition) because the newest one has some additions. The core curriculum tells you everything you need to know in theory. It is the book to prepare for the specialty certification. If you are totally dedicated - there is also work book.

Check out the professional association:

HPNA

if you become a member, you get a discount on books , courses, conferences...

They have a journal as well.

Check out this:

http://geriatrics.uthscsa.edu/tools/Hospice_elegibility_card__Ross_and_Sanchez_Reilly_2008.pdf

print and laminate or protective sleeve - this printout tells you all about hospice eligibility.

Good luck!!

KHT · Mar 11, 2016

Thank you so much!!! Much appreciated!

4boysmama · Mar 16, 2016

I keep the Hospice Companion symptom management book in my bag, it's great for looking up treatment for off-the-beaten track symptoms