Hospice nurses have a very crucial role to patients in a hospice bearing in mind that the patients have terminal illnesses. Their main focus is to offer support to patients as they slowly approach their death as well as prove the same services offered to patients in hospitals. They entirely focus on the patients’ final stages of life care. Thus, they provide a practical nursing care all the time in the hospice. A hospice nurse manages the pain and other related symptoms as well as provides aid to patients and their families. It, in the end, helps in a course of demise with dignity. Every patient and folks have an exceptional viewpoint in relation to end-of-life requirements. Therefore, the hospice nurse is trained to formulate a cultural evaluation and offers precise care to a patient.
A hospice nurse also has a role to observe asses and also record the symptoms of a patient. It is because their role also involves working closely with doctors, administering medication, and emotionally supporting patients. By so doing, they accomplish their sole duty of minimizing the pain, thus, making the patients’ remaining days comfortable because the medicine administered does not help the patients to recover. Their treatment is meant to minimize pain and not to cure. Hospice nurses, on the other hand, have a duty to organize and coordinate the care of each patient in the hospice through a physician whose role is to advice the hospice nurse in providing the thorough patient care, evaluating the patients’ state, and also serve as a link between a family and physicians. It is also the role of the hospice nurse to work with a social worker of the patient, a caretaker as well as a physical and speech therapist.
The hospice nurse may assist family members gain knowledge of caring for their loved ones at home or provide the members of the family a break giving care to their loved one. Apart from providing a thorough care, the hospice nurse orders for supplies as well as obtains the required equipment needed by patients being at home and also ensures that the necessary medication is available. The hospice nurse performs patient assessments and creates a plan of care followed by all specialized caregivers.
Apart from helping the patients emotionally, the hospice nurse also offers the Spiritual Support to the patient. Many patients need it as they approach their death. In such cases, the hospice nurse coordinates with spiritual leaders so that they can meet the spiritual needs of that patient as well as those of the family.
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Specialized Education and/or Certification Required or Desired for This Role
A hospice nurse must be a professional nurse who is certified as a registered one. They are required to have a bachelor’s or master’s degree in palliative Nursing. For them to stay updated on education, ethics as well as medications, they should be registered as the members of Hospice and Palliative Nursing Association. This is after sitting for the National examinations Board of Hospice and palliative nursing examinations.
Apart from educational qualifications, the hospice nurse also needs some specific skills bearing in mind that they take care of terminally ill patients. As the hospice nurse needs to have a very strong sense of compassion so as to meet the requirements of patients as well as those of their family members. She should be capable to correspond efficiently in tense situations compounded with sadness, anguish, and grief, through the challenges that life limiting illnesses evoke.
Emotional strength is mandatory for the hospice nurse for her to practice palliative care. It is because this type of nursing requires the strength different from other fields of nursing. At times, even young and teens contact a terminal illness and, as a result of this, the hospice nurse may find herself with children or teen patients. In such cases the hospice needs to offer counseling to them as the reality of death may be a harsh reality to them.
Practice Site(S), Type of Duties, and/or Salary Expected for a New Practitioner
A hospice nurse takes care of terminally ill patients at their homes, in a convalescent centre, or at a nursing home. The annual salary for the hospice nurse in the U.K. ranges from $46,422 to $ 51,790 for a new medical practitioner. Such nurse has different duties set aside to her; and every nurse is supposed to manage her own precise duty. Being a case manager is one of the different duties of the hospice nurse. In this case, the nurse is entrusted with a sole patient and has to cultivate a long term and trust worth bond relations with the patient. Only registered nurses are assigned these duties. They are expected to carry out their duties independently. The hospice nurse links the patient directly to the physician by giving a detailed report concerning him or her. The duty of the nurse in this case is to assess the conditions of the patient, thinking critically and being compassionate to the ill person. This duty entitles being with the patient during the last minutes of the life.
Another duty of the hospice nurse is to admit or take in a patient. This is the usually the first nurse to meet and visit the patient. She is the one in charge of explaining the philosophy of the hospice to caretakers and formulating a plan for taking care of the patient. She assesses the state of the patient. Together with the physician, she coordinates the relevant medications for the patient.
The third type of duty nurses is acting on behalf of case managers. It is done by visiting nurses who stand in when the help of the nurse is urgently needed, and the case manager is away. The nurses are licensed and closely monitor the patients’ routine care that has been singled out. Their duty is always based on emergency calls particularly to be present during patients’ last moments.
There are also nurses whose duty is to give instructions to patients when they are called upon. This is a nurse who hardly sees the patient. They are called triage nurses. They give instructions in emergence cases when the case manager is absent. They help when the patient calls in, and they give them instructions. These nurses are called upon to give instructions during emergencies. Therefore, their duty requires the one to have excellent communication skills as well as thinking critically. It will help them give the relevant advice to any patient.
Cultural Considerations or Alternative Health Practices that May Differ from Pure “Western Medicine” that May Compliment the Role
The first and most important step that the hospice nurse needs to do is to provide the quality care across different cultures to recognize and study the major cultures within their working environment. Some of cultural considerations in hospice nursing are the unique differences. These are the differences in understanding among different groups of people, within the groups, or even within the individuals themselves. Individuals from the same culture or even religion can have different core beliefs. For example some Muslims accept organ donations while others do not. .In such cases, the hospice nurse should ask the concerned parties about their beliefs in certain areas and find an alternative way of dealing with the situation.
The second cultural consideration is a language barrier. It makes it very difficult for the one to access as well as utilize health care in a hospice. It is because hospice care is founded on a deep and meaningful communication between the nurse and the patient. Patients become frustrated as they try to explain themselves and may eventually give up in communicating other needs apart from the basic ones. In such cases, it is important for the hospice nurse to use interpreters so as that they can interpret the meaning of the patients’ words. She can also use a translator who will aid in communicating the patients’ words written. In cases where accuracy of the information may be compromised then the nurse can rely on a family member for communication.
Another consideration is decision-making. It is very clear, that telling truth and making an informed decision are both crucial aspects of hospice care. Especially, when it comes to deciding on extra-ordinary steps to be taken and other relevant matters in western cultures as well as religion, the individual is considered first. That means that it is the patient to give the consent. While in most traditional religions, the family of the individual is given the first consideration. The family gives consent on behalf of the patient. Decisions concerning the end of life do not involve the patient alone but involves the family, at large. It is a collectivity issue. In such cases, the hospice nurse is supposed to ask the patient to choose the family member to be given that information and also to make decisions on his or her behalf.
Death viewed as a taboo subject is also the cultural consideration in hospice nursing. In many cultures, it is forbidden for the one to openly discuss death. It is also considered uncouth especially for a care giver to inform the patient that he/she is about to die. It makes them hopeless. They also believe that the fate of the person lies in the hands of God and, therefore, nobody can tell when the person is to die. If that is the case then the hospice nurse should find out from the family as well as religious leaders how to discuss the subject of death.
In some cases the caregiver can have patients who are immigrants. It is very common for an immigrant patient, depending on where they come from, to have a different perspective concerning the status of the caregiver. Such patients might find it awkward when asked to make some choices concerning their healthcare. They will also feel uncomfortable when asked certain questions. It is because according to them the physician knows what is good for them, thus, he is supposed to make all the decisions without involving them. In such cases the, caregiver should try as much as possible to understand them. They should also be told an aim of their participation in decision making in the health care. The care givers should be very careful not to force them to answer the questions they are asked.
The perception of pain and suffering as well as requesting for the pain relief is something that differs among different cultures. Culture can really affect the manner in which the patient responds to pain. Different cultures give a different meaning to pain. They also express pain in different ways. In some cultures pain is viewed as something positive. When someone is in pain they believe that it is a clear indication of how the body is fighting to recover. In other cultures, pain is viewed as a test on someone’s faith. Therefore, they will persevere not to request for pain relief so as to emerge winners. On the other hand, some cultures view pain as a punishment. Hence, they are opposed to pain relief because every person has to be punished for a wrong doing so as to serve as a lesson to rest.
Culture can also affect the patient’s initiative in requesting for relief. In some cultures, patients do not communicate directly that they are in pain. They would rather do that in a style they try as much as they can to avoid a public display of emotions as well as confrontation. Thus, they will never request for pain relief openly. Others will wait for the caregiver to ask them if they are experiencing pain before they respond. The hospice caregiver needs to know what is best for the healthcare of the patient in cases like this. They should relief the pain for the comfort of the patient without informing the ill person what medication is intended for.
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