A hospice is an establishment that focuses on providing the best quality of life and comfort to chronically ill patients. Nurses play a vital role in delivering high-quality care. They work hard to ensure patients are as comfortable as possible by paying attention to small details and working gently with them. However, physical care isn’t all there when it comes to nursing in hospice. There is so much more to it.
Have you ever depended on someone? I mean, really depended on them. Have you ever trusted someone to be in charge of every aspect of your life? What time you wake up, when and what you eat, what medication you drink, and to care for you on your death bed. It’s a scary thought to process. Allowing someone into the intimate details of your everyday life and trusting them completely.
As a nurse, this is a responsibility we do not take lightly. We are protectors, providers, companions, medical aids, and for some – we are family. You might confuse the role of a Hospice nurse with that of a Hospital nurse. Although some duties are similar, the difference is that Hospital nurses cure and save. While hospice nurses do not postpone death, nor do they rush it. They wait patiently with you, keep you company, and make sure you are well taken care of for as long as possible.
Hospice nurses have many physical roles to fill. After all, to keep someone comfortable and maintain a high quality of life, you need to prioritize physical wellness. The care of personal hygiene, positional comfort, and providing sustenance all belong to this category. It might also include skin care, wound care, physical exercise or stretching, and the occasional foot rub. Patients are often frail and have a heightened sense of pain. Nurses, therefore, treat them gently, with patience and care. Knowing their patients intimately is a hospice nurse’s specialty. They go beyond solely understanding their medical needs and familiarize themselves with their preferences, likes, and dislikes. For instance, a patient may hate the taste of pain medication, so the nurse will crush it into some yogurt to make it bearable. Similarly, if a patient is not allowed sugar, the nurse may turn a blind eye to the occasional sweet treat because they understand that sometimes, chocolate can be the best medicine for a heavy heart.
Other critical parts of fulfilling the role of a hospice nurse include pain management and dispensing medication. Pain, nausea, and anxiety treatments are given as prescribed to keep patients comfortable, calm, and relaxed. Hospice nurses also communicate and work closely alongside the patient’s primary care doctor to ensure the patient is as comfortable as possible. They also discuss treatment plans with family members or next of kin and map out an action plan to ensure their loved one is comfortable and pain-free.
Most people think this is where it ends. However, a nurse’s role can be more intricate. Anyone could provide physical care, but a Hospice nurse provides it while keeping the patient’s physical, spiritual, and emotional dignity and peace intact. They provide the highest quality of care while ensuring the patient feels needed, important, respected, and in control. Most importantly, they spiritually and emotionally support and help a dying person come to terms with the fact that this is the end.
The role of a hospice nurse is greatly underestimated when it comes to spiritual care. Spiritually they assess whether the patient needs comfort or encouragement, regardless of religion or sect. They encourage trust by putting their own perceptions aside to be present and make a personal connection. By intimately understanding a patient’s beliefs, values, and morals, the nurses can help them pray and meditate or contact a spiritual leader on the patient’s behalf.
A hospice nurse’s greatest role and responsibility is emotional well-being. During end-of-life care, happiness can be a scarcity. Patients wish they could have done more or changed the outcomes of certain relationships or situations. Most wish they had more time or just another chance at life. Few are content. Emotional support is a crucial part of providing quality care.
Understanding someone’s situation and providing emotional support without ever going through the same thing is quite a challenge. Listening to their concerns and quieting their fears is imperative. Nurses remind them that they are not alone, and by giving them their full attention and compassion, they quickly ease the patient’s distress. Sometimes a simple touch or hug is enough. Hospice nurses have a special approach when it comes to comfort. It is solemn work, and keeping things light-hearted or even joyful in a somber environment is part of their expertise.
A big part of emotional support includes advocacy for the patient. Advocacy refers to fighting for a patient’s wishes and choices and ensuring they get the treatment they want and deserve. Hospice nurses work hand in hand with the interdisciplinary team and discuss complex medical terminology or treatment plans with the patient to ensure that they can make an informed decision regarding their treatment. Patients might become non-verbal due to cognitive decline or not want to hurt their loved one’s feelings by going against their wishes or choosing a different treatment. So the nurse will act as a mediator between the patient and their family to ensure that everyone respects and honors the patient’s wishes and care plan, even though they might disagree with it.
Emotional support may start with the patient, but it ends with their families. Nurses often quiet the fears and anxiety of family members as well. Hospice nurses understand better than most what it’s like to deal with grief. Families of hospice patients are likely to experience depression and anxiety. They may feel uncertain of what life would be without their loved ones. Nurses impart wisdom by educating families on the end-of-life process and what to expect—answering their questions honestly and tactfully, advising on how to reassure their loved one, taking care of their mental well-being, and coping with saying goodbye.
Nursing in hospice is so much more than simply feeding and bathing. Nurses’ skills, empathy, and dedication to patient care allow patients to live out their final days with dignity and surrounded by love. It is profound and meaningful work that makes a difference when it matters most. It’s a humbling and challenging experience to love and care so much for someone, to be the sole provider of their needs, to remind them who they are, and to be their family.
When I was a student, my first experience with death and hospice care was when I had to sit next to an unconscious patient’s bed and wait for him to pass. And without ever knowing it, that patient taught me, in its entirety, what it is to be a nurse. You must be there when it’s difficult, when it’s sad, when there’s hope, when it’s tough, and when it’s the end.
That is the role of a Hospice nurse.
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