Which NPs deal with chronic/terminal illness?

allnurses Guide · Jun 29, 2009

The school I just graduated from has a palliative care specialty, and I don't believe any ICU experience is required.

Advanced Practice Columnist / Guide · Jun 30, 2009

I've actually never seen an ACNP-Palliative Care NP combo program but have commonly seen ANP-Palliative Care NP combos. Be aware that there are still no approved certification progams for Palliative Care NP's although there is a Palliative Care RN certification program (through NBCHPN). Many Palliative Care NP's graduated from the traditional NP tracks such as ANP or FNP. Some had post-graduate training in Hospice and Palliative Care. The advantage of FNP's, in this situation, is that they can practice in a setting where even kids are seen. I don't know if you would want to deal with very sick and terminally-ill children as this is definitely a heartbraking aspect of the Palliative Care role. However, be aware that ANP's can see patients ages 12 and above.

You seem unsure of what your future niche will be as an advanced practice nurse. Many have suggested that you shadow NP's representing multiple fields and specialties. I also strongly advice you to do that. There is typically at least one Palliative Care APN in many hospitals and I personally have not worked in a hospital where there is no Palliative Care NP on staff. Use these individuals as a resource to help you make that decision.

Advanced Practice Columnist / Guide · Jun 30, 2009

...and by the way, Joe, realize that you are planning to pursue a specialty field where you'll probably find a lot of nurses with years of experience in Hospice and Palliative Care and have the credentials to qualify them for an advanced practice role in this field. My suspicion is that the demand for Palliative Care NP's are not as great as say Primary Care NP's or those ACNP's who work with acute care specialty practices. That's why you need to get advice from nurses who are in the field and it seems like not many posters here are actually working in that specialty.

... I also wonder what draws you to this specialty as you've mentioned in the past that the other roles you considered seemed boring. Do you have a personal experience to draw from in terms of death and the dying process of a friend or family member? There are a lot emotions involved in this process and as a nurse practitioner who works in the ICU, this is one of the toughest decision for a family to deal with. I've seen fellow nurses cry with family members during these emotionally charged times, is this something you think you will enjoy?

Joe NightingMale, MSN, RN · Jun 30, 2009

I have seen hospice in action...my mother had hospice care near the end of her life, and I was very impressed by the attitude of all of the staff. It was one of the things that propelled me into nursing.

I can't say for certain how I'd react to all of the grief and suffering...but I do have a way with patients. In addition, I've always been interested in the psychosocial aspects of illness, though not in psychiatric illness per se. My research project dealt with how nurses helped patient perceived their hospitalization.

In addition, when I was first looking at nursing school I was interested in the related areas of oncology, pain management, and hospice. I like areas where strong consideration is given to the patient's views and needs. I find I dislike areas where that is less of a concern and treatment is forced (peds, psych).

What I'm looking to avoid in a pracitioner role is one where there is not relationship with the patient, where the psychosocial doesn't even come into it...ie a retail clinic where you never see the same patient twice and consists mostly of minor acute illnesses.