The need for hospice care nurses is ongoing and growing. According to the National Hospice and Palliative Care Organization, in 2011 a record number of dying people in the United States (they estimate more than 1.65 million patients) received end-of-life care with hospice. Hospice nurses are involved in both inpatient and outpatient hospice care.
Whether in an inpatient situation or -- more commonly -- giving home-based care, the nurse is usually the primary contact for the patient and the family using hospice services. As the primary contact nurse, you might be speaking with the social work team, the doctor or other clinical staff, the psychologist, and the chaplain on a daily basis. You might also help to coordinate volunteers and direct care staff. If you are working with a family with few resources, you might even make referrals for services like reduced-price cremation or burial services.
Comfort is usually considered the cornerstone of all care in hospice. Of course, you will be addressing pain management with your hospice patients, but you will also be providing interventions to help clients deal with shortness of breath, constipation and other side effects of narcotics, anxiety and incontinence. Hospice nurses must also be aware of proper skin care so very ill patients do not develop breakdowns. Skin breakdown makes proper skin care harder and can lead to infections.
Psychosocial Patient Needs
In addition to providing for their client's general physical comfort, hospice nurses have to address emotional needs of the patient. You will need to give information as needed and requested about the patient's diagnosis. You will have the responsibility of explaining to the patient and the family what their disease course and dying process might look like, and help address fears they have of that course. You will need to help patients address their fear of dying, support them in completing any unfinished emotional tasks before they die, and help them navigate any social or spiritual distress.
Treating the Entire Family
Hospice and palliative care treats the whole family. You will need to talk through advanced care planning, especially with the person who is the patient's health care proxy, explaining to them the different choices for care. You might have to deal with conflict between family members about care choices and general conflict as well. You might have to teach family members how to care for their loved one (instructing them on how to give a bed bath for example) as well as encourage self care for the caregiver.
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