It’s been said that “nurses are the heart of healthcare.”* They’ve also been called angels, godsends, heroes, and agents of compassion — all true sentiments.
In hospice, the role of a nurse takes on an even broader, yet more intimate role for patients with terminal illnesses who often spend their final weeks at home or in a nursing facility. A hospice nurse, referred to as the RN Case Manager, is a key member of the hospice team, administering not only healthcare for patients, but providing many services for the family as well.
Hospice providers like Heart to Heart Hospice use a team approach to meet the medical concerns of patients, while also addressing emotional, mental, psychosocial, and practical needs. In addition to nurses, hospice services include a physician, healthcare aides, volunteers, social workers, and spiritual care coordinators.
In honor of National Nurses Month in May, Heart to Heart Hospice recognizes our top-notch, compassionate nurses! Read the following Q&A to learn what hospice nurses do and how they provide vital services during end-of-life care.
How are nurses involved at the beginning of the hospice process?
Once a doctor has given a terminally ill patient a life expectancy of six months or less, they become eligible for hospice benefits**. Patients and families can choose their own hospice provider. Some referrals are given by hospitals or practitioners, but the final say on provider choice is up to each individual family. During the intake process, hospice patients, caregivers, and staff set up individualized goals for their hospice care plan. This means everything from maintaining independence to pain management to end-of-life planning and advanced directives. Nurses are an integral part of the evaluation and planning process.
What are a hospice nurse’s main medical responsibilities?
A hospice nurse performs many roles. Some families fear that hospice speeds up death, but that is simply not the case. Studies show that terminally ill patients live days to weeks longer on hospice than without. Hospice care is about preparing for a “good death,” transitioning with peace as a disease naturally progresses. Nurses visit hospice patients on a regular basis and provide medical support in these areas:
- Pain and symptom management (palliative or comfort care)
- Helping prevent unnecessary hospitalizations
- Medication reconciliation and needs assessments
- Care plan implementation and management
- Assessments for medical equipment and dietary needs
- Monitoring and treating pressure ulcers (wounds)
- End-of-life care and comfort
How do nurses interact with family and/or caregivers?
Education and training are a huge part of what hospice nurses do. To minimize ER visits and hospitalizations, nurses train families on administering medicines, daily grooming and care, safety measures, and assistance with activities of daily living. Hospice benefits also cover needed medical equipment and supplies, for which nurses provide caregiver training and support. Nurses help instill confidence in caregivers, most of whom don’t have a healthcare background, and caregiving guidance as the dying process progresses.
In addition to medical care and support, nurses often act as a listening ear, friend, and wise guide who’s walked alongside other families in the hospice process. Being in the home, they provide continuity of care and can grow especially close to patients and their family members.
How do nurses interact with other care team members?
Collaboration with team members is vital in hospice care. Nurses provide detailed notes and communication with other members of the hospice team, including social workers, chaplains, physicians, aides, and volunteers. As a patient nears death, visits often increase to daily or even twice a day. Hospice care teams also have regular meetings to go over patient care plans, medical status, changes, and needs.
How often does a hospice nurse visit a patient?
Depending on the care plan, hospice nurses visit patients from one to three times per week. Visits may be more or less frequent based on the needs of the patient. As a patient nears death, visit frequencies increase to meet their needs, often daily or twice a day.
Do families have access to nurses outside of regularly scheduled visits?
Hospice providers offer a 24/7 on-call hospice line, including nights and weekends, 365 days a year. Caregiver questions, concerns, and patient symptom changes can be triaged over the phone and on-call nurses help determine if an in-person visit is needed.
Will a nurse be present when my loved one is actively dying?
Hospice nurses educate caregivers on the signs of active dying. They provide emotional support, answer questions, and offer dignity to the patient in their final days. If at all possible, the frequency of visits may increase and a nurse will try to be present during those final days.
Hospice nurses are dedicated and called to serve families during such a tender time, providing a hand to hold and acting as a compassionate guide.
“A nurse is one who opens the eyes of a newborn and gently closes the eyes of a dying man. It is indeed a high blessing to be the first and last to witness the beginning and end of life.” —Unknown
Testimonials from Our Families
Heart to Heart Hospice provides care, comfort, and dignity to patients in Indiana, Michigan, and Texas. Read some testimonials below from families we’ve served.
“Thank you, Heart to Heart Hospice, for treating my mom with such dignity and kind care in her final weeks of life.”
“There are no words to describe how grateful and how much [our nurse] means to us for that amount of time we had, which was not even a week, but we would have never been able to have my dad at home without her.”
“It was such a blessing and comfort to know that Dad had such great care. The nurses and aides became family and we will always be grateful for all of the staff that took such great care of him! Dad’s pain was well controlled and he was comfortable.”
*quote by Donna Wilk Cardillo, nurse, speaker, author, Career Guru for Nurses
**Patients with terminal illness and a life expectancy prognosis of six months or less may qualify for hospice benefits. For hospice eligibility, patients must stop any curative treatments for their disease, receiving only palliative (comfort) care. Room and board fees are not covered expenses, unless the patient qualifies for general inpatient or respite-level of care. Routine hospice medical care and services are covered wherever the patient calls home.