Inpatient Hospice Questions

[sdalec]

Hello!

I'm looking to connect with anyone with experience with inpatient hospice as an NP.

Some general questions I have:

Any practice tips? Pearls of wisdom? In particular, I am concerned with meeting regulatory requirements, but in general any advice is appreciated.

Can someone do inpatient hospice and separately do palliative consults, or is this a conflict of interest?

I am not sure what my questions are yet, but thought I'd see if there are other inpatient hospice providers out there who may have advice or things they wish they knew.

Thank you!

 

[JBMmom, MSN, NP]

I have not practiced inpatient hospice/palliative myself, but I did shadow the team a while back. I'm at a smaller community hospital and our team is a NP, a LCSW and a RN navigator with a medical director as collaborating physician. They do all palliative and hospice consults and for patients transitioned to inpatient hospice, they take over as attending service for orders with hospitalist consults. (Or sometimes they stay on hospitalist service and are the consulting team, I think they collaborate with the attending to determine which way it goes.) There isn't a conflict of interest I'm aware of between palliative consults and hospice, they are often called in to provide goals of care clarifying conversations for families. Sometimes those meetings result in a plan for inpatient hospice and sometimes they result in continuing more restorative care goals but with more acknowledgment for the family that things are complicated medically and may require continued re-evaluations. 

[Tegridy]

Varies a lot as above some hospitals admit inpatient hospice under palliative/hospice and some say on hospitalist census but are listed as inpatient hospice. I honestly don’t know why hospital medicine has to stay involved but for some reason at some places they do….