Most common meds in Hospice/Palliative care?

shellebelle212 · Oct 24, 2015

They said they will train me btw, so it's not an issue for them that I have no experience. I want be be a fast learner though, and meds are something I always struggled with so I need extra study time!

turnforthenurse, MSN, NP · Oct 24, 2015

Just a shot in the dark, but....pain and nausea medications.

quiltynurse56, LPN, LVN · Oct 24, 2015

I know that our hospice residents get Roxanol and Ativan as the main meds. Maybe some Senna S. Most other meds are DC'd. Just stating what happens with hospice that I have seen so far.

vampiregirl, BSN, RN · Oct 24, 2015

Typically the meds mentioned above. Also knowing what symptoms these meds address. For example - roxanol can be used for pain, dyspnea, and restlessness. Ativan is used for anxiety, restlessness, air hunger, and nausea. We also use atropine 1% ophthalmic drops sublingually for for secretion management.

Also understanding the importance of bowel regimens and being able to display critical thinking skills to address symptoms. Understanding nutrition and hydration needs as a patient approaches end of life (many family members are worried about starving their loved ones to death).

Hospice/ palliative care is an amazing area of nursing. Reputable companies provide awesome training and resources because this is a very different area of nursing. We look for compassionate staff w/ a willingness to learn and excellent critical thinking skills when considering new hires.

My most valued and often used resource is the "Primer of Palliative Care" by the American Academy of Hospice and Palliative Medicine.

If you get this position, I would recommend joining the HPNA (Hospice and Palliative Nursing Association) - they are also a wonderful resource.

4boysmama · Oct 24, 2015

roxanol, ativan, bowel regimen meds (senna, colace, bisacodyl, lactulose, etc), lasix and zaroxolyn, fentanyl patches, levsin, albuterol/duonebs, compazine/nausea meds, seroquel, and diazepam. most common diseases you'll encounter; cancer in all it's forms, chf, copd, renal, liver, and alzheimer's. those cover 98% of my case load, less common are ms, als, and parkinson's.

read up on symptom management for nausea, anxiety/agitation, insomnia, and make sure you understand the normals in terminal disease - lack of appetite/anorexia, incontinence, skin integrity management, and psychosocial support

JustCat · Oct 25, 2015

most injectable and sub lingual pain medications. ie: Morphine, Dilauded, Roxanol, Ativan just to name a few. Seeing more frequent use of methadone especially in bone ca and mets to bone. Best thing to remember.. as hospice nurse you are there for your patient to help increase and make quality of life possible. Forget the quantity. You are there for the families and friends to assist them with the grieving process, just as much as your patient. Typically, the patient has and will accept (not always made peace with) the diagnosis and certain outcome. The family is a different story altogether.

apowell1625 · Oct 30, 2015

Most previous medications are dc for hospice pt especially if pt is on continuous care due to pt not tolerating swallowing well . Most of the medications given are pain medications like morphine and ativan sl .

nutella, MSN, RN · Oct 30, 2015

It really depends on what your role would be. Working as a LVN in hospice limits your role and I do not think you would case management. Also, the hospice program sometimes includes palliative care, which does not fall under the hospice benefit but plays by the rules of traditional home care when it comes to notes, certifications, resumptions and so on and forth.

In hospice care you need to be well versed in all medications used for comfort (pain, nausea, anxiety, bowels, congestion and so on). In my agency we have standing orders, of which I have a copy so I can look up medications and their standing orders at any point. If they are outside of the standing orders I have to call the MD. Within the standing orders there is room for dose increases for some medication and you would need to know how to increase those medications appropriately. Since you are a LVN this may not be your role and you may have to call the RN case manager for that.

In my agency there is also a palliative care program, the hospice nurses do both. There is a huge role for LPN in palliative care. They still work under the RN CM but there is a larger variety of tasks because those patients are not on hospice and they often take a lot of medications, are very sick in general, can have wounds, and so on..

Things to ask in an interview is:

- Do you limit hospice to strictly hospice patient or do you also have palliative care patients in the same program? (which is something that is great for our patient as when they are not ready for hospice but need home care nursing we sign them up for palliative and bridge them over to hospice when they are ready and want hospice)

- how long is your orientation?

- what is the number of visits per day?

- weekend/holiday rotation? Perhaps only RN rotate but in larger places LPN have to rotate as well.

I definitely recommend that if you are seriously considering home care to spend at least half a shift with a clinician on the road. In reality this kind of work is not for everybody. I love being out in the community but you have to be super organized and proficient in computer documentation or you will spend too much time with documenting and organizing...

Good Luck!