Hospice Nursing

LPN_2005/RN_10 · Sep 23, 2009

I used to work in hospice as a CNA and LPN. The role of the hospice nurse is to make to individual as comfortable and pain free as possible. Most are very scared, so you will be there for them on a emotional level as well. I really loved hospice nursing, it was most of the families that really tested me and made it very difficult to do everything possible to make their loved one pain free, comfortable, and at peace with dying.

Yesterday I rode with an LPN that works at the hospital that I work at, who has recently gone full time with a local Hospice Care agency. I really enjoyed the day, and they are really recruiting me for the new office that they have recently opened in my area (which is closer that my current job by about 30 miles & garunteed 40 hrs/wk). I enjoyed the flow of the day, the independence and the time with patients. BUT...I guess I really don't understand what the Hospice nurses goal is. What exactly is the purpose of hospice care when the patient is not actively dying? I would really appreciate the input of anyone who is currently in this field. It would just give me a better understanding & help me determine if this would be something I would want to do.

kenyohunt1 · Sep 23, 2009

The goal of the hospice nurse is varied. We are there to provide end of life care, but we also wear many hats. Sometimes you are the chaplain when that is needed and you are at the bedside, sometimes you are the family mediator, sometimes you are the person that there to provide companionship. Your role may not always be medical in nature. A family that has a loved one that is dying goes through many changes as anyone of us could imagine, so u may have times where it seems the family is blocking the loved one from having a "good death" but many times this is not the case, you also have to try and figure out the family dynamique and then you are better able to understand how to treat the family and the patient. Even though you are there for the patient the families will also become your clients as well. Gaining trust with the family goes a long way in being able to treat your patient appropraitely. So I guess my point is to say you will become many different people in our role as ospie nurse, but all those roles intergrate to make you the best you can be for that patient and family.

ladnewnurse · Sep 23, 2009

I appreciate these responses, but keep them coming. I want as many responses as I can get. Want to learn as much as I can before I make the decision to change jobs!:loveya:

tewdles, RN · Sep 24, 2009

Most hospice RNs are case managers...that means that even when the patient is not actively dying you as the case nurse are managing their care. In a nutshell...the case nurse oversees the hospice care, makes sure that all knowledge deficits are addressed, keeps the supplies and meds in the home in adequate quantities, assess frequently to anticipate new symptoms, present the patient at IDT meetings, interact with all other disciplines to insure that patient and family needs are being met. Mostly when the people are not actively dying we keep them comfortable, as active as possible, and we ENJOY the heck out of them. We visit and help them celebrate their lives. We revisit their joys with them. You get very practiced at listening to patients and families and discovering what is most important to them. You then find ways to nurture those "important" things. In my humble opinion, the best thing we do is to use our skills to help people live a good life for a spell longer, then we use those skills to make sure that they don't suffer (to the best of our ability) when the end is near. It often seems that the efforts at the end are as much for the families as for the patient. It is good work. It is very fulfilling and rewarding.

Luv2BAnurse · Sep 24, 2009

Not what you were asking, but thank God for Hospice nurses. My father was discharged Tuesday last week to home with Hospice, he died peacefully in his sleep Saturday 9/19. This "peacefullness" and ability to be pain free, as well as being home where we all wanted him to be (including him) would not have been possible without the care from those dear nurses. They were there to not only care for dad, but to guide the family, explaining what was going on.

ladnewnurse · Sep 24, 2009

Most hospice RNs are case managers...that means that even when the patient is not actively dying you as the case nurse are managing their care. In a nutshell...the case nurse oversees the hospice care, makes sure that all knowledge deficits are addressed, keeps the supplies and meds in the home in adequate quantities, assess frequently to anticipate new symptoms, present the patient at IDT meetings, interact with all other disciplines to insure that patient and family needs are being met. Mostly when the people are not actively dying we keep them comfortable, as active as possible, and we ENJOY the heck out of them. We visit and help them celebrate their lives. We revisit their joys with them. You get very practiced at listening to patients and families and discovering what is most important to them. You then find ways to nurture those "important" things. In my humble opinion, the best thing we do is to use our skills to help people live a good life for a spell longer, then we use those skills to make sure that they don't suffer (to the best of our ability) when the end is near. It often seems that the efforts at the end are as much for the families as for the patient. It is good work. It is very fulfilling and rewarding.

Thank You, this one really helped. What is an IDT meeting?

ladnewnurse · Sep 24, 2009

Not what you were asking, but thank God for Hospice nurses. My father was discharged Tuesday last week to home with Hospice, he died peacefully in his sleep Saturday 9/19. This "peacefullness" and ability to be pain free, as well as being home where we all wanted him to be (including him) would not have been possible without the care from those dear nurses. They were there to not only care for dad, but to guide the family, explaining what was going on.

Wow, you all are really convincing me to look into this very hard and long. It really sounds like a rewarding and fulfilling aspect of nursing. Thank you all so much.

jessiern, BSN, RN · Sep 24, 2009

Wow, you all are really convincing me to look into this very hard and long. It really sounds like a rewarding and fulfilling aspect of nursing. Thank you all so much.

I work med-surg, but we also have a hospice program. The hospice nurses visit daily, and stay with the patient once the end is near. I have always been amazed at the hospice nurses. They know their patients well, and are masters at providing comfort and compassion. A good hospice nurse can ease a families anxiety almost the minute she walks in the door. I admire them probably more than any other branch of nursing.

tewdles, RN · Sep 25, 2009

IDT stands for InterDisciplinary Team. A hospice team is, philosophically, headed by the patient or caregiver/POA. The remainder of the team consists of the hospice professionals. The RN case manager is responsible for seeing that the POC developed by the team is carried out in a timely fashion. The physician does not "direct" the care but is a valued member of the team, as is the pharmacist (often a pharm D.), MSW, Pastoral Care, Volunteer Coordinator, and Bereavement. It is a professionally fulfilling way to practice nursing.