The Nurse's Role In Hospice Care

This author’s personal perceptions concerning patients facing a lingering terminal illness, have been shaped by over 20 years of critical care nursing experience. Facing death and illness on a daily basis requires self-examination and a high degree of comfort with one’s own mortality, limits and values. Constant exposure to the fragility of life forces respect for the whole person and the people who love them. A general approach to patients who are actively dying is to allow them to define what they want and need during this time. The nurse’s role

Hospice exists in the hope and belief that, through proper care and the encouragement of a caring and sensitive team, patients and their families may be free to achieve some level of mental and spiritual preparation for death that is comfortable to them. The goal is to help

Death is inevitable. It is one of the only certainties in life. Regardless, people are often uncomfortable discussing death. Nyatanga (2016) posits that the idea of no longer existing increases anxiety and emotional distress in relation to one’s mortality. Because of the difficulty in level of care for end-of-life patients, the patient and the family often need professional assistance for physical and emotional care. Many family caregivers are not professionally trained in medicine, and this is where hospice comes into play. Hospice aims to meet the holistic needs of both the patient and the patient’s family through treatment plans, education, and advocacy. There is a duality of care to the treatment provided by hospice staff in that they do not attempt to separate the patient’s care from the family’s care. Leming and Dickinson (2011) support that hospice, unlike other clinical fields, focuses on the patient and the family together instead of seeing the patient independent of the family. Many times in hospitals, the medical team focuses solely on the goal of returning the patient back to health in order for them to return to their normal lives. They do not take into account the psychological and spiritual components of the patient’s journey and the journey that the family must take as well. For treatment of the patient, Leming and Dickinson agree that hospice does not attempt to cure patients, and instead concentrates solely

Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care.

Registered Nursing takes skilled and hard working people. There are many jobs in the Nursing field. To name a few, there are: Hospice Nurses, Long Term Care Facility Nurses, ER Nurses, Pediatric Nurses, Geriatric Nurses, Acute Care Nurses, etc. Hospice Nurses are jobs taken by people that are strong hearted and strong willed. I had an experience with a Hospice Nurse in a job shadow. I went to the houses of her patients instead of a facility. We went to three different houses to take care of her assigned residents. Her patients loved her very much and she did her job with love and care. Three days after my experience with her, one of her residents passed away. They had a great patient and nurse relationship. She was filled with sadness and I also felt sad for the resident’s family and other caregivers that cared for him. Hospice patients are only said to live about six months or less. Not all residents pass away after six months, some live longer. Hospice care is given to patients that are dying, but hospice can also go on pause because the patient becomes more independent. The job of hospice nurses is to take care of the resident nearing the time of death, not to cure their diseases. My job shadow said that it is always sad when her patients go, but she knows that they are not suffering like they were when they were living. The National Hospice and Palliative Care Organization states, “Hospice care professionals and volunteers provide services that address all of the

Nurses: Assist the patients and families to cope with the end-of-life process such as assessing and

To begin, there are many aspects of helping patients that are dealing with grief, loss, death, or dying. Whether the patient has lost someone that was close to them or they themselves are dying, the situation is quite fragile. Some important aspects that may help when handling these patients are knowledge about the different cultures and their beliefs and traditions, different factors that have an impact on grief, and how to communicate with people living on the edge of life. These are all extremely important matters when it comes to such a sensitive situation.

The first hospice care was established in 1974. A hospice must make physician, nursing, drugs, and medical supply services available 24/7. It must have social workers and counseling services available to the patient and the family. Hospice also provides therapy and homemaker services when needed in order to be qualified under Medicare certification. Hospice is a combination of special services for terminal ill patients. Beside the medical service, hospice care also supports patients and family psychologically and spiritually to put their emotional suffering at ease. The psychological suffering can weight more than physical suffering. Many terminal ill patients cannot accept the bad news and living under emotional distress. Certified chaplains can work with people from different religions, they focus on the world-view of the patient and family. Using patient personal goal as the measurement, chaplains are the

Hospice is compassionate care provided to patients facing terminal illness or illness for which there is no cure. These patients are diagnosed with an illness from which they will never recover and usually have a life prognosis of six months or less (Hospice Foundation of America, 2014). The goal of hospice care is improving quality of life and managing the symptoms of disease and the dying process. The care hospice offers is focused on pain management and emotional and spiritual support for both the patient and family (National Hospice and Palliative Care Organization, 2012). Hospice care can be provided in many different settings, often the patient’s own home. Hospice care can also be provided in hospitals, nursing homes, long-term care facilities and free-standing hospice centers and is available to patients of all ages (NHPCO, 2012). A patient receiving care in a hospice program has a team of healthcare individuals that can consist of the patients own physician, nurses, home health aides, clergy, social workers, and speech and physical therapists (NHPCO, 2012). Usually, a care plan is developed by the hospice team and care of the patient is provided by family members with the support of the hospice staff (NHPCO, 2012). Nurses make regular visits to the patient and family and are on call 24/7. Once enrolled in a hospice program hospice covers everything that will be needed to care for you, from medications to manage pain to

Dying is a process that involves the entire family; that is to say, the family that is defined by the person. The nurse must be aware that this is not only an individual process but a family process. This involves recognizing family dynamics and communication patterns and facilitating healthy interactions.

Death is inevitable at some point everyone must face it. Whether it is the death of a family member, friend, or a family pet, people are forced to deal with the death. Nurses however have more frequent encounters with death than the average person does. When a patient dies in a healthcare setting his or her nurse is obligated to deal with that as well. They must find ways to cope with the increased amount of death that

Depending on the field that the nurse works in, interacting with a dying individual may or may not happen. If a person is taking care of a dying individual it is important to know some basic etiquette so that the person or their family will not be offended by any actions of the staff. It is customary to address the family of the dying person instead of directly telling the person that their time is almost done, though it is ok to tell the patient the seriousness of their illness. (Children’s) the family then can inform the person in their own way. It would be ideal for the person to be able to pass in their own home but that is not always possible.

    At some point in a terminally ill person 's life, there comes a time when all treatment options have been exhausted, and patient comfort is the number one priority. During this process, hospice care comes into play to ensure quality of life of a patient. Pain management and supportive services are provided to anyone who is willing by Medicare, and other government assistance programs, for individuals and families that cannot afford private home care. These services are provided by a trained group of professionals, including; Doctors, Nurses, Counselors, Social workers, Physical therapists, Volunteers and Chaplains. There are different types of hospice

Gilda also witnessed her mother struggle with cancer, and watched the Hospice nurses and staff provide care and support to Gilda’s mother and family, and ultimately decided that she too wanted to assist people cope with grief and loss and the end of process. On the other hand, both Michele and Pamela started their careers in the medical field outside of Hospice and found their way to the Hospice program with time and experience. Pamela believed that there was a need for LPN is within the Hospice agency, and started her work as an LPN working with Hospice patients in their homes. Michele started as a nurse when she started working for Hospice and after a few years, she was promoted to a care provider liaison, working with and advocating on behalf of Hospice patients who reside in assisted living facilities.

But this may be what is necessary to begin the grieving process. In a case study published in the journal RN, the authors tell about a program designed to meet the unique needs of oncology nurses. This program was implemented at St. Jude’s Children’s Research Hospital in Memphis, Tennessee. As a part of the program, the staff members who have cared for a patient are allowed to participate in a bedside memorial service. After the patient’s family has left the hospital, the chaplain will conduct a service for any of the employees who cared for that patient (Puckett, Hinds & Milligan, 1996). This would help nurses to accomplish the first of the four tasks of mourning-to accept the loss.