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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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 5 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.

Do most of your patients pass away in their sleep when no one's around?

Asked by Cassieluv over 5 years ago

No not usually, it happens, but most of my patients are general somewhat comatose at the point they start to pass and usually this is predicted and a time frame predicted using the training a hospice nurse receives! Therefore they family is aware and normally at the bedside as they take their last breath. I have had patients pass in their sleep and the family find them. But if its a natural death nothing acute NORMALLY the family is educated by the RN of the sign and symptoms of impending death and know its occurring. Most families also tend to take shifts at the bedside which I personally tell them isn't necessary because often I have seen patients especially mothers not want to pass with their children looking on. Better for family to keep routines as close as possible for the patient sake.

Have you noticed a significant difference in the health of hospice patients when they have frequent family visits compared to when the family barely comes at all?

Asked by SHC55 over 5 years ago

Yes I do! However there are times when someone is ready to pass and they have this close family that for our own selfish reasons we do not want them to leave us, have tendencies to say, "please don't leave me" and these people don't pass as peacefully as I would like. It's my job to educate families on allowing the patient to start their next journey they are tired from this fight. Tell the patient it's okay and you will see them again!! So patients with big families or supportive ones have a higher increased good spirit which keeps them peaceful and calm and reasons to hold on longer!

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 5 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.

Have you ever heard any crazy deathbed confessions or family secrets revealed? What would you do if they confessed to a murder or something? Would you have to report that?

Asked by Janis over 5 years ago

That depends because there are hallucinations which come with impending death! I have had a couple of patients confess to being in love with a spouse that passed prior to them yet they have a new spouse they love dearly. One man confessed to not always being true to his wife but other than that nothing but regrets or wishing they were closer to certain family. Alchoholics wishing they had lived life different and hadnt ran family off. In the case of confessing a murder that would be an obligation on my part to call in social worker and us team together to assess this further. But I'm sure it would have to be reported and investigated.

what profound pieces of advice have patients given you while on their deathbed? any stick out in particular?

Asked by gracie j over 5 years ago

One old man asked me why I remarried twice being such a sweet lady with amazing calling in life.......I told him I was afraid to die alone! In his final few hours he told me while holding my hand that noone dies alone!! Amazing! I had a military vet in a nursing home and I never met any family, as I approached his bedside for a visit he looked at me so lovingly that I asked him what is it? He said I thought you were my wife, she came to see me last night, looked just like the day I bought her wedding dress, she was wearing it, hair black as coke like yours. I said oh my how wonderful did she come to get you? His reply with a sad look on his face was "she says its not time," I have so many!! I learned true love can exist and even on the other side.

Which terminal diseases are the most painful to watch people go through?

Asked by Marty DX over 5 years ago

Honestly usually we are successful in managing all the symptoms necessary that there is not alot of suffering. However, people with bone cancer or colon cancer can be hard to manage pain. COPD patients are difficult or me personally because I always felt as though I was suffocating. I think the worst deaths to witness so far have been cirrhosis when the patient develops esophageal varicese and bleed copious amounts. Although the RN prepares for possibly bleeding out by placing darker sheets on the bed and darker clothing to camouflage amounts of blood in case it happens. The family is educated prior to the potential so they are not shocked.