Hospice Nurse

Hospice Nurse

TranquilityRN

Tuscumbia, AL

Female, 40

I have been a hospice Registered Nurse for about ten years. Hospice is similar to home health except specializing in care of the terminally ill, dying patient. A hospice nurse provides palliative care for the patient during their last months, weeks, days, or hours so they may pass in the comfort of their home and with their loved ones present. I provide comfort and dignity for the the patient and comfort for the caregiver. Following the peaceful passing of the patient I provide postmortem.

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Last Answer on March 26, 2014

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How did you feel with the passing of your first patient? Were you braced for it, or was it devastating?

Asked by BelleKow over 4 years ago

The particular employer I took my very first hospice job with, prepared me best they could. Hospice is truly a calling and is not for everyone. It was a very surreal experience, however, mixed with emotions. I was excited to fulfil my calling, be a rock for those left behind, yet I was full of empathy and sympathy and sadness. The reward of the love and respect I gained from being that important role brought an overwhelming calmness and gratitude and peace over me.

Do most of the patients in hospice know they are going to die soon? For those that do, what percent are scared, and what percent are at peace with it?

Asked by paula.t.lyons over 4 years ago

Yes they do. This is usually discussed between physician and patient prior to the referral to hospice being made. It is still a challenge for the hospice nurse to help the patient cope with this fact at admission and for a short period after. Noone wants to die and most people are scared not to die but of the unknown. That's a hospice nurses job to explain and ensure the patient that all things will be discussed with them until they are unable to make their own decisions. Also to answer any questions honestly. It's important to explain death and dying to the caregivers and patient and ensure the patient of your competence and experience and that they will NOT die in pain. Most people are afraid and yet become very accepting and at peace with this fact closer to death. I personally have had a few patients that were never afraid and these families often were the once that had celebrations of life versus copious amounts of tears upon the passing of the patient.

if you're the only one present when a patient passes away, how do you go about telling the family?

Asked by Bradbury451 over 4 years ago

I was usually not the only person present unless it was someone who had no family whatsoever or family that was not active in their lives. Unfortunately that happens more than one may think. Part of the job of a good hospice nurse is using your talent and training to recognize signs and symptoms of death and from these estimating the time frame that the patient may pass. Therefore, the nurse calls the family to be with the patient to be with them in their final minutes. It can happen and in this case I would call family and congregate with them and explain that their loved one passed and that they did so peacefully. At this point your primary focus is comfort for the family left behind.

Seen any instances where families act selfishly or just generally crappy toward their terminally ill relative?

Asked by Tulsa Gary over 4 years ago

More times than one would want to think. One that stands out was a gentleman and his common law wife of nearly twenty years was having seizures and as I ran towards his bed to relieve his symptoms with a hope of peaceful passing his son stopped me and the children two against two began to quarrel about calling an ambulance! The SO was holding his living will up and said that their father didnt want this.....one called 911 and one was fighting trying to get the phone and everyone yelling!! I yelled at this point and everyone got quiet and I said "I took an oath to be a patient advocate, hang up the phone and you sir move so I can take care if your father!!" I did what my patient needed and thank goodness I wa able to stop paramedics before initiating CPR due to him being a DNR. The family was thankful later but still unfortunate ! And I have seen families fighting over material things before the patient passes! Breaks my heart when nurses fail to educate the family so well that death is not a surprise and they beg the patient not to leave them!! The dying patient needs to be given permission to go.

Can a patient refuse hospice care, even if his family ordered it?

Asked by Gregg over 4 years ago

Patient can refuse it absolutely!! Usually that's because if not accepting the shape they are in and/or fear of dying. I have went and admitting a patient later that has refused when they finally accept the inevitable or when the patient is non responsive at the request of family members.

Does working in such an emotionally draining environment affect how you interact with your loved ones when you get home (for better or worse)?

Asked by Jenny Shakes over 4 years ago

Yes after three years of on call 7 on and 7 off, which on call is rarely good news or a minor issue, I found it having effects on me emotionally. Dealing with death daily and nightly and caring so deeply definitely had its effects on me. For good it really makes me thankful and appreciative my family are safe and healthy at this time. It also enables me to see things that we take for granted. However, it also effects my home life in a negative way in such a manner that I may be at a ball game etc and that call comes in that patient or tht family may need me and that pulls me from my family! They understand and admire what I do but need me just the same. On call is hard being a single mom also!! I find it very helpful to maybe every three years or so take a break from hospice until that point you miss it so bad that you can refrain from getting back to it.

What obligations do hospitals and insurance companies have when it comes to prolonging the life of a very old person? If a senile 95-year old's health is deteriorating, can her family demand that a hospital operate to try and keep her alive?

Asked by Seb_Krauss over 4 years ago

Well any hospital or health facility is obligated to keep a patient alive. Families can over ride living wills in some instances, which is unfortunate. However, hospice patients are usually at home or in an inpatient hospice facility and have opted for hospice benefits and also have desire to no longer have life prolonged and resist the inevitable death. Normally hospice patients and the family is very educated about the hospice philosophy and what's to come that they choose to die at home and remain a DNR. Do Not Resucitate.