So you’re thinking about becoming a hospice nurse? Here’s what you need to know before you make the leap.
First, let me start by saying that hospice nursing is not for everyone.
While hospice is arguably the most rewarding nursing job that I’ve had, it is also the hardest job I’ve had.
Working with patients who are at the end of life can be emotionally draining. Additionally, the strict regulations from Medicare make hospice care and documentation exhausting.
At times, it can feel like the majority of your time is spent documenting when all you really want to do is spend time with your patient and their loved ones.
Secondly, hospice nurses must accept that they can’t “fix” the patient.
All too often, this is a difficult position for both nurses and medical professionals to embrace.
Furthermore, the truth is that you will be caring for patients who are in the last phases of their journey and this can be sad.
The emotional and physical toll this has on nurses often leads to burnout and compassion fatigue.
Hospice nurses need to learn to take care of themselves when they are providing hospice care.
Now that I’ve completely depressed you and darn near talked you out of it, I want to reassure you that it is not all doom and gloom.
Remember, I said that hospice nursing is the best nursing career choice I have ever made. So, here’s what you need to know.
Cons (In no particular order.)
1. Lengthy Documentation
Honestly, hospice documentation is lengthier than anything I ever experienced in a nursing home or hospital.
It can take hours to complete a hospice admission.
For example, in the hospital, your admission assessment contains a review of systems and some other fundamentals.
On the contrary, hospice admissions require you to complete an assessment that contains legal forms such as an election of benefits, and you will need to document items that support the admission based on disease-specific criteria.
Medicare guidelines are stringent!
For the sake of time, I am not going to go into the hospice item set (HIS) and other items required during a hospice admission.
Just trust me, hospice documentation is among the top dissatisfiers of hospice nurses.
2. Your patients are at the end-of-life
While it is rewarding to help patients transition to end-of-life, watching patients die can be a bit of a drag.
This is especially true when you spend time getting to know them and their families over several months and they pass away.
At times, special bonds and attachments can occur between nurses and their patients.
This can make it even more difficult for hospice nurses.
3. No set work location
Hospice care is provided in any setting that the patient calls home.
As such, your work location can vary from patient to patient.
For example, you may have patients in the nursing home, assisted living, home, or even the hospital.
This can be difficult for nurses who are used to clocking in and spending their day surrounded by their peers.
Sometimes, hospice nurses function more like lone wolves. You may encounter a situation where you don’t have easy access to someone else to help you out.
For instance, it is not unusual for nurses to be by themselves when they visit the patient.
4. Traveling (Vehicle Wear and Tear)
While some nurses love being on the road and driving, others complain that the time they spend traveling between patients is a huge time suck.
More often than not, nurses find themselves driving while trying to call doctors, pharmacies, and other team members to coordinate care.
You will need to invest in a reliable vehicle and keep your car well maintained.
This can include tires, oil changes, and other routine maintenance.
Tip: Make sure the hospice agency has some sort of mileage reimbursement or car lease program.
My suggestion: Keep your playlist up to date and subscribe to a couple of good podcasts.
Hospice Nursing Pros
1. Variety
One of the biggest pros of hospice nursing is the variety in the patients that you care for.
While the largest population of patients on hospice are cancer patients, there are so many other types of patients as well.
According to NHPCO Facts & Figures report, some common diagnoses for hospice patients include cancer, heart disease, stroke, respiratory disease, and kidney disease.
If you are looking to use all of the nursing skills that you learned in school, then hospice is the right place for you.
It is exciting to have so many different types of patients that you can help.
2. Career Advancement
There are so many different roles that nurses have in hospice.
Furthermore, there are opportunities for advancement because once a nurse knows hospice is for them, they are more like to stay.
Additionally, the hospice field continues to evolve and there are several options for advanced training and certification.
Hospice nurses also receive specialized training in pain and symptom management that makes them experts in end-of-life care.
Examples of hospice nurse roles include:
- Nurse Case Manager
- Visit Nurse
- Triage Nurse
- On-call Nurse
- Weekend Nurse
- Transitional Nurse Liaison
- Sales and Marketing
- Clinical Supervisor
- Clinical Director
- VP of Nursing
- Quality Improvement Nurse
- Quality Assurance Director
- Nurse Educator
- Nurse Practitioner
3. Great Relationships
Not only do you build great relationships with your patients and their families, but you can also build strong relationships within your team. Usually, hospice is mission-minded work and there is a strong sense of camaraderie among team members.
Additionally, members of the hospice interdisciplinary team have a tendency to take care of each other.
It is not unusual for a hospice chaplain to reach out to a staff member who had experienced the death of several patients in a short amount of time.
Teamwork is one of the cornerstones of hospice.
4. Helping people
Overwhelmingly, nurses are inspired and fueled by helping others. I would say almost to a fault. But that is not my point.
My point is that as a hospice nurse, you will have a big impact on the lives of others. You will have the rare privilege of helping patient and families cope during one of the most difficult times during their lives.
Conclusion
Finally, hospice nursing while very challenging can be extremely rewarding both personally and professionally. When you compare the pros and cons, the reasons to work as a hospice nurse far out weight the cons. Your opportunities for education and training are endless and the joy that you can experience from helping others is priceless.
Understanding these roles should help you decide if making the leap to hospice is right for you.
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