Hospice nursing is a unique subset of healthcare that provides end-of-life care to patients diagnosed with a terminal illness. This service is offered either in a specialized hospice center, a hospital, or in the patient’s home. The purpose of hospice nursing is to provide physical and emotional support for patients and their families during an extremely difficult time. In the US, hospice nursing plays a critical role in the healthcare ecosystem.
The American Nurses Association (ANA) issued guidelines on the roles and responsibilities of nurses when providing support and care to hospice patients. They state that nurses must offer thorough and empathetic care for those nearing the end of their lives. Part of this role entails identifying the approach to death and communicating this sensitive information to the patient’s family. To manage symptoms effectively and offer support, nurses should work closely with the entire medical team. These nurses must set up processes for making informed choices that consider medical facts, individual patient wishes, and what is clinically feasible.
To fully understand how nurses can provide quality care to hospice patients, this article will shed light on some of the critical issues impacting hospice nurses in Missouri and, in doing so, acknowledge their incredible contributions to healthcare.
The unique conditions in Missouri affecting nursing care and public health
Missouri offers a rich blend of urban centers, rural areas, and diverse communities. As of 2020, approximately 37% of Missouri’s population resides in rural areas, which face a shortage of primary care providers, impacting timely care and health outcomes. To bridge this gap, Missouri has expanded its telehealth services, making it easier for patients in remote areas to access care. This move assists in primary care provision and facilitates specialist consultations, thereby enhancing the overall healthcare quality.
Furthermore, the uninsured rate in Missouri has fluctuated over the years, with a notable reduction following the implementation of the Affordable Care Act. After years of deliberation, Missouri expanded its Medicaid program in 2021. This expansion has increased access to healthcare for an estimated 230,000 Missourians. It has been a game-changer in reducing the rate of uninsured residents and increasing preventative care visits.
To ensure nursing staff are equipped with the latest knowledge and techniques, Missouri has seen an increase in nursing scholarship programs encouraging individuals to join the field and facilitating advanced education. Grants have been allocated to educational institutions to revamp and enrich their nursing curricula. To deal with staff turnover issues, regulations have been implemented to ensure optimal nurse-to-patient ratios, enhancing care quality and reducing burnout. Initiatives have also been introduced to address workplace violence, providing a safer environment for healthcare professionals.
How nurses can provide quality care to hospice patients
Nurses are indispensable in helping individuals live as fully and comfortably as possible while supporting their families and loved ones. Their skills not only involve medical care but also psychological, emotional, and spiritual support. The following methods and skills enable nurses to provide quality care for hospice patients.
Specialized training and certifications
Before specializing in hospice care, an individual must become a Registered Nurse (RN). This can be achieved through an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). Both paths involve coursework in anatomy, physiology, pharmacology, and patient care, followed by a licensure exam (NCLEX-RN).
To work in this state, interested individuals can look for online nursing programs in Missouri. Institutions like Rockhurst University offer advanced degrees that provide a deeper understanding of symptom management, acute care, and hospice care. The Accelerated BSN at Rockhurst University is the most prestigious in the state, combining online coursework with campus residency and in-person clinical. It sets students up to attain the qualifications and certifications to work with hospice patients.
Various certification programs are designed specifically for hospice and palliative care. Examples include the Certified Hospice and Palliative Nurse (CHPN) designation. Such certifications often require a combination of coursework, clinical experience, and an examination. Ongoing education and advanced nursing practices are essential for nurses to keep up-to-date with the latest best practices in symptom management, psychosocial care, and ethical considerations.
Symptom management
One of the primary roles of a hospice nurse is symptom management, which can include pain relief, nausea control, and breathing assistance. Nurses should be well-versed in pharmacology and other non-pharmacological methods to alleviate discomfort. Close communication with physicians is vital to adjusting medications and treatments as the patient’s condition changes.
Communication skills
Communication is key in hospice care. Nurses must communicate effectively with patients, their families, and the healthcare team. They often act as intermediaries between doctors and family members, understandably conveying medical information. They also facilitate important but difficult conversations about end-of-life choices, do-not-resuscitate (DNR) orders, and spiritual matters.
Family support
Hospice care is not just about the patient; it is also about supporting the family. Nurses can help by offering a listening ear or educational resources. They can guide family members on how to physically care for their loved one, addressing concerns about what to expect as their loved one nears the end of life.
Cultural sensitivity
Being sensitive to a patient’s cultural, spiritual, and religious beliefs is important. The end-of-life phase involves many rites and rituals that may be significant to the patient and their family. A good hospice nurse respects these traditions and accommodates them whenever possible, whether through prayer, song, or other rituals.
Interdisciplinary collaboration
Hospice care is a team effort that includes doctors, social workers, spiritual advisors, and often volunteers. Each team member offers unique skills and perspectives. Nurses are generally the linchpin in this team, coordinating care and ensuring all team members are updated on the patient’s condition and needs.
Becoming a hospice nurse
Becoming a hospice nurse is academically and emotionally challenging, requiring a solid educational foundation and specialized training. This training is indispensable for acquiring the multifaceted skills needed to offer high-quality, compassionate care to patients and their families. From certifications to emotional preparedness, each training aspect contributes to shaping a competent, empathetic, and effective hospice nurse capable of making a meaningful difference in the lives of those they serve.
