Hospice Nursing Skills
- In hospice nursing, the patient and family are the focus of care.nursing- helping hands image by Wingnut Designs from Fotolia.com
The skills of hospice nursing involve care given to terminally ill patients who are no longer receiving curative treatment. Care may be provided at a hospice facility, in a hospital or in the patient's home. Hospice care is also commonly referred to as end-of-life care. Patients who are expected to live less than six months are considered hospice patients, according to the National Institutes of Health. - Treatment for a hospice patient is palliative, meaning that measures are geared toward comfort, not cure. The hospice nurse gives treatment to manage nausea, depression, anxiety and respiratory distress.
Of particular concern to patients and families is pain management. Certain illnesses can cause severe pain, such as cancer and AIDS. Nurses assess pain by asking the patient to rate pain using a numeric pain intensity scale, a visual analog scale or the Wong-Baker Faces Scale. The nurse monitors the hospice patient for other signs of extreme discomfort: elevated vital signs, clenched fists or grimacing. The hospice nurse administers medications to keep terminally ill patients as comfortable and pain-free as possible. Other pain relief measures include massage, guided imagery and applying hot or cold near the painful area. The nurse works as part of a team to ensure effective pain management. - The hospice nurse acts as an advocate on behalf of the patient and family. The nurse provides the hospice patient and family opportunities to express feelings and concerns. She listens intently as the patient discusses fears. Hospice nurses also provide patients and families opportunities to express religious or spiritual beliefs. The nurse always respects cultural beliefs and traditions. She also respects the patient's wishes.
Dying with dignity is different for every patient, and nurses advocate so that hospice care and treatment are in line with the patient's individual wishes. The American Nurses Association Code of Ethics for Nurses states, "The nurse respects the worth, dignity and rights of all human beings irrespective of the nature of the health problem. The worth of the person is not affected by disease, disability, functional status or proximity to death." - Nurses caring for dying patients and family often act as a liaison, or go-between, consulting with other health care and social work personnel. The nurse must continually assess the needs and desires of the hospice patient and family. Conflict may arise between the patient's needs and wishes and the family's, or between family members.
Challenges in treatment may also arise, such as pain that is not being controlled with current treatment measures, and infection. The nurse may need to consult with a bereavement counselor to provide psychosocial support to the family before and after the patient has died.
