Hospice nurses with elderly patient

Hospice care started with volunteers helping the ill with tasks. It evolved into a network of health professionals working with terminally ill patients. The aim is to provide patients with the needed care.

A Hospice Nurse has training in caring for terminally ill patients in their last weeks of life. The primary role is to keep the patients comfortable and supported. In addition, this care is to help manage symptoms, ease pain, and improve the patient's quality of life. 

Additionally, hospice nurses provide emotional, spiritual, and social support to the patient's family. However, these nurses don't provide treatments to extend life, and there is no expectation of health improvement.

The majority of hospice patients live six months or less. For this reason, most hospice care occurs at patients' homes. Other places include hospice centers, skilled nursing facilities, hospitals, and geriatric nursing homes.

Many people view hospice nursing as difficult and depressing. But most hospice nurses find their job rewarding and an honor to care for patients in their last days. 

Here is a helpful guide to becoming a Hospice Nurse in the USA. The guide includes what to study, how to advance your career, and how much you can make. 

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What Are the Steps to Becoming Qualified A Hospice Nurse?

It takes a particular person with a compassionate heart to become a Hospice Nurse. Therefore, many of the skills and personal attributes of a good hospice nurse come naturally. Hospice nursing requires a lot of emotional strength and mental endurance. 

Hospice care is a high-stress environment for both patients and families. As a hospice nurse, you need to be kind and compassionate. You need the ability to manage grief and not let the loss overwhelm or psychologically weigh you. You also need the ability to talk about sensitive subjects around death. 

The patient and family need to understand and prepare. To qualify, you must also meet specific academic requirements and hands-on experience. Hospice nurses need expertise in patient evaluation and assessment. Furthermore, they need to be clinically capable of;

  1. Responding to bedside emergencies

  2. Managing symptoms 

  3. Provide pain relief

Besides this, you will need relevant hands-on experience.

The essential steps to becoming a qualified Hospice Nurse include;

Attend a Nursing School

A hospice nurse must first become a registered nurse. Then, you must graduate with an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). Both are popular options though somewhat different. 

You will take two years to complete an ADN. However, with ADN, you spend less money and start your career earlier. Specified nursing schools and community colleges offer the program.

On the other hand, a BSN is a 4-year university degree offering a more in-depth education. A BSN also prepares you for future growth in management roles. 

Study and Pass the NCLEX-RN Exam

Upon graduating from nursing school, take the National Council Licensure Examination-RN (NCLEX-RN). The National Council of State Boards of Nursing (NCSBN) administers this exam. A registered nurse must pass this exam before applying for a nursing license. The exam covers patient safety, infection control, and care management topics.

Obtain a Registered Nurse License

Get a Registered Nurse license from the state nursing board. You can only apply for this after passing the NCLEX-RN exam. Some states require application fees, clinical hours, background checks, and references. You can get a database of state requirements from the NCSBN.

Gain Bedside Experience in The Intensive Care Unit

Another critical requirement is that you gain experience in hospice nursing care. However, getting into a hospice position is rare right after nursing school. Therefore, you may need to get a few years of clinical nursing in an area related to hospice care.

Alternatively, take up an entry-level hospice nursing position providing end-of-life care. You can find such care in intensive care units like geriatric and ICU nursing units. You require two to three years of such experience in such environments. 

The experience will expose you to patients requiring immediate assessment, management, and attention. Furthermore, you will learn a lot about compassion and hospice care. You will also gain coping mechanisms essential to face the eventual loss of patients.

Study and Pass a Hospice Nursing Certificate

A Hospice Nursing certificate is optional for hospice nurses. However, to distinguish yourself, it’s advisable to get the certification. Get this from the National Board for Certification of Hospice and Palliative Care Nurses (NBCHPN). 

The Hospice Nursing Certificate shows your knowledge, expertise, and commitment to hospice nursing. The certificate makes you stand out among other candidates. You will also qualify for higher pay and better opportunities for career advancement.

There are two hospice certifications for RNs;

1) Certified Hospice and Palliative Care Nurse (CHPN) 

CHPPN is for experienced pediatric hospice nurses. 

You need at least 500 hours in clinical pediatric hospice in the previous 12 months. The alternative is 1,000 hours in the last 24 months. Like CHPN, HPPC offers this certification.

2) Certified Hospice and Palliative Pediatric Nurse (CHPPN)

CHPPN is for experienced pediatric hospice nurses. You need at least 500 hours in clinical pediatric hospice in the previous 12 months. The alternative is 1,000 hours in the last 24 months. Like CHPN, HPPC offers this certification.

CHPPN is for experienced pediatric hospice nurses. You need 500 hours of clinical pediatric hospice experience in the last 12 months. HPPC offers this certification.

The HPPC provides study tips, books, and a list of study materials for both certifications. The HPPC also recommends a six months preparation time for the exams. 

The tests are online-based and consist of 150 questions covering the following topics;

  • Assessment and planning

  • Pain and symptom management

  • Advocacy

  • Education

  • Practice issues

Additionally, the CHPPN exam includes child and family-centered care.

Consider Studying for An MSN to Improve Job Prospects

Improve your job prospects by pursuing a Master in Nursing (MSN). An MSN can propel you to a managerial, leadership, or administrative position.

Can you Become a Hospice Nurse Online?

There are online programs for Hospice Nursing courses. Students can achieve the same academic goals from both online and on-campus programs. Like on-campus programs, online-based schooling prepares nurses for entry-level practice. 

The online program also prepares nurses for their NCLEX-RN exam. Furthermore, it socializes them to a professional role.

Online schooling provides flexibility, allowing students to juggle between studies, work, and other responsibilities. Nursing students in rural areas without classroom programs are beneficiaries of such programs. These students can access a wide range of academic opportunities.

Online hospice nursing care courses include the following topics:

  1. Cultural issues

  2. Ethical considerations

  3. Symptoms management

  4. Hospice care

  5. Palliative leadership 

  6. Spirituality

Nursing programs, however, require some lab work and in-person clinical work. You, therefore, need onsite clinical experience in palliative nursing. You can complete these at hospices or hospitals near you as approved by your school.

What is the Difference Between a Hospice Nurse and a Registered Nurse

A Registered nurse (RN) and a hospice nurse (HN)are medical practitioners. A significant difference between these two is the care they provide their patients.

An RN performs various duties, including hands-on care in medical settings. RNs form the backbone of the healthcare system in the USA. 

They work directly with doctors, other healthcare professionals, and patients. Their duties include; managing care, controlling safety and infection, and providing basic care. 

Generally, RNs have to graduate from nursing school and pass NCLEX-RN exams. Nursing programs are either the associate ADN or BSN level. A Registered Nurse can specialize further by taking a master's or doctoral degree. After that, they become advanced practice registered nurses (APRNs).

A Hospice Nurse is an RN with specific qualifications and experience. A hospice nurse must complete an ADN or BSN and pass NCLEX-RN exams like an RN. To specialize, a Hospice Nurse needs to pass a Hospice Nursing Certification.

A Hospice Nurse works with terminally ill patients nearing their end of life. These nurses help such patients with pain management and general comfort. 

Hospice nurses further offer emotional support to both the patients and their families. Unlike an RN, Hospice Nurses work to alleviate symptoms instead of providing care that extends life.

What Positions Can You Progress to From Being An HN?

You can transition from an HN to a managerial or leadership position. However, you require additional training and years of experience. You can pursue a Master in Nursing (MSN) to improve your prospects.

The first two years involve gaining experience for certification as a hospice nurse. 

You can expect a full hospice care certification five years out. After that, the accreditation will bring higher earnings, and responsibilities may change a little. 

After ten years of experience, your salary levels off. Then, you can transition to leadership or administrative roles, taking you out of the field. Your work will involve making decisions that affect patients on a different level.

Do your HN Exam Qualifications Expire?

Yes, HN exam qualifications expire, and one needs to recertify every four years. The recertification involves several steps and benchmarks such as;

  • Practice hour requirements. A hospice nurse must complete a given number of hospice care hours—at least 500 in the last 12 months or 1,000 over the previous 24 months.

  • Participation in professional development activities. These include online classes and conferences.

  • Continuing education activities. Hospice Nurses need to complete a Situational Judgement Exercise (SJE). SJE ensures that the nurse can handle clinical situations in hospice nursing.

How Much Does HN Make

Hospice Nurses enjoy a steady salary and job security. Given their role and academic requirements, they make a higher salary than triage nurses. 

The national average annual salary of a hospice registered nurse is $70,717.94. Earnings, however, differ from the national average due to;

  1. The state you are working

  2. Level of education

  3. Years of experience

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How Long Will It Take to Become a Hospice Nurse?

To become a hospice nurse, you must first become a registered nurse. You will need at least two years to earn an ADN degree. If you choose to pursue BSN, it will take you four years to graduate. Afterward, you need to get certified as a hospice nurse. Therefore, you require one year of experience in hospice care. 

The requirement is at least 500 hours of hospice nursing experience for certification. Less experience may present difficulty in demonstrating sufficient knowledge to pass the examination.

Society treats death as an unthinkable, taboo topic. Not all nurses can thrive in hospice given the roles. Some nurses try for a few months and become disoriented. 

To prepare for working with hospice patients, a hospice nurse needs to be okay with the idea of their death. Once they break that barrier, it's easy to turn their thoughts to palliative care.

Hospice nurses help terminally ill patients find comfort in their last days. The death of a patient, however, can hit hard. But, nurses find peace in knowing that the patient died as comfortable as they could make them. In addition, they find it fulfilling to help patients fulfill their wishes and die with dignity. 

Some patients may not have any visitors. You may need to befriend them, read to them, or listen to them talk about life or the impending death. The goal is to provide kindness, empathy, and comfort. 

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