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Hospice Nurse Career Overview: How to Become a Bastion of Strength for People During their Last Days


Registered Nurses make it their mission to help patients through the most challenging times. Whether a person is battling a disease, an injury, or some other type of suffering, nurses care for them on their road to recovery. Unfortunately, not every patient can see the light at the end of the tunnel. For some, it is clear and inescapable that this battle will be their last. Hospice Nurses help them get through this final fight with as much comfort and dignity as possible. 


Thus, their mission is slightly different than that of other Registered Nurses. Their care isn’t aimed at helping people regain their health. Instead, it is intended to meet people’s physical, emotional, and spiritual needs in the final stages of life. It is a noble and emotionally-charged pursuit reserved for the strongest and most resilient nurses. While the job revolves around end-of-life care, its ultimate goal is to make the transition from life to death as painless (physically and emotionally) as possible -  for patients and their families. 


If you’re considering a career as a Hospice Nurse, you’ll find everything you need to know about this unique nursing profession in this guide, from how to become a Hospice RN to salary prospects and job duties.


Let’s start unraveling how to get and what you can expect from a career in palliative nursing care. 


What Is a Hospice Nurse?


A Hospice Nurse is a Registered Nurse who specializes in providing nursing care to individuals in the final stages of a terminal illness. They work with patients during the end-of-life process offering nursing care, emotional support, and practical guidance. More pointedly, that means that in addition to hands-on medical attention, Hospice Nurses listen and address a patient’s concerns, offer encouragement and comfort in tough times, and help them navigate their final days as pain-free and heart-full as possible.  


Another thing specific to hospice nursing is that you rarely care only for the patient; your attention extends to the entire family. These may be their last moments together, so offering guidance to the family suffering from an impending loss is just as much a part of your job. Your support for the family of a terminally-ill patient helps them process their feelings better, making you invaluable to both patients and their loved ones. 


The extremely sensitive nature of the job means that a career as a Hospice Nurse is not for everybody. In this profession, you need incredible emotional resilience because it’s not easy having a job where you see death every day. 


Compassion and empathy are indispensable for Hospice Nurses, just as much as patience is. You’ll often deal with patients in pain or suffering, and you must remain patient, calm, and understanding even when their anguish is dispersed on you. Additionally, it’s imperative always to display high cultural sensitivity in this specialty. You important to be respectful and sensitive to the patient’s practices and beliefs, even when they don’t match yours. 


How to Become a Hospice Nurse?


The minimum educational requirement to become a Hospice Nurse is to be a licensed Registered Nurse. Thus, on average it can take anywhere from two to five years to become a Hospice RN. Let’s walk through the step-by-step process of pursuing a career in hospice and palliative care. 


Step One: Enroll in a Nursing Program


To embark on a career as a Registered Nurse, regardless of which specialty you choose down the line, you first have to enroll in an accredited nursing program. Depending on your ambitions, budget, or time availability, there are several schooling options that’ll get you one step closer to that coveted RN license. 


You can enroll in an Associate’s Degree in Nursing program, and once you complete it, you will be eligible to sit for the NCLEX-RN. This type of program usually takes around two years. It is still recognized as the minimum requirement to gain RN licensure. 


A second option, and by far the most recommended, is to enroll in a Bachelor’s Degree in Nursing program. A BSN takes longer to complete, around four years. However, it prepares you significantly more in-depth for a future nursing career. Because they spend a longer time studying and gathering knowledge and experience, BSN RNs are associated with better patient outcomes and a higher quality of care. That makes them more in demand and offers them higher job stability and access to more career advancement opportunities


Increasingly, the preference for BSN nurses is taking the healthcare profession by storm. According to a study by the AACN, over 77% of employers strongly prefer hiring nurses with a baccalaureate degree. Plus, as of 2020, more than ⅔ of the RN workforce had earned a BSN or higher degree as their highest level of nursing education. Thus, enrolling in a BSN program guarantees you will be a lot more competitive in the job market than your ADN-trained counterparts. 


If you want more tips on picking the best nursing program for you, check out our guide on the subject. 


Nightingale College’s BSN Program is an excellent option for aspiring nurses who want to advance their nursing skills. Not only is it designed to prepare prospective learners to apply for RN licensure and pass the NCLEX-RN, but it will also deliver the strongest foundation to build a nursing career. It follows a blended format, combining online didactic instruction with on-ground supervised field experience. 


If you started your nursing journey with an ADN, you can advance your education and career with a fast track bridge program. Nightingale College’s RN-to-BSN program is the best option for ADN-trained nurses who want to further their degree while maintaining a job. It’s 100% career-friendly and online, allowing you to juggle school and work. You can complete it in as few as 12 months, so you’ll get your BSN before you know it!


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Step Two: Get Your RN License


Enrolling and completing a nursing program, either ADN or BSN, is only the first step in your nursing journey, and you will only get your Registered Nurse license once you complete Phase Two of the process: passing the NCLEX-RN


The NCLEX-RN stands for the National Council Licensure Examination [for] Registered Nurses and is a five-hour computer adaptive test that nursing graduates must pass to be licensed as Registered Nurses in the US. It tests your knowledge and preparedness to be a practicing nurse. While not a simple endeavor, a quality nursing program will equip you with the knowledge and skills necessary to ace it without problems. 


Step Three: Gain Experience


Once you become a fully-fledged Registered Nurse, your career as a Hospice RN can get off the ground. Update your nursing resume with the skills most recommended for this sensitive job; prep for upcoming job interviews, and you’ll find a meaningful career you’ll love soon enough. 


It is also encouraged to spend two to three years working in an acute care setting before switching to a career in palliative care. That will help enhance your nursing skills and prepare you for the high-need environment that also applies to hospice nursing.


Step Four: Consider Certification


Once you have a few years of experience in palliative care, consider getting certified as a Hospice RN. Certification is not mandatory for Registered Nurses, but it is an excellent way to improve your competitiveness in the field and prove you’ve achieved the highest level of expertise in your specific area of nursing. 


Hospice Nurses interested in certification can become Certified Hospice and Palliative Nurse (CHPN®) by passing an exam offered by the Hospice and Palliative Credentialing Center. To be eligible for the HPCC CHPN Examination, you should fulfill the following requirements:


  • Hold a current, unrestricted registered nurse license in the United States.
  • Have at least 500 hours of hospice and palliative nursing practice in the most recent 12 months or 1000 hours in the most recent 24 months before applying for the examination. 


Once you pass the certification exam, the credential will be available for four years, after which you’ll have to apply for renewal. 


What does a Hospice Nurse Do?


As we’ve already mentioned, a Hospice Registered Nurse does not have curative duties. Nevertheless, their job responsibilities are as rigorous and extensive as they are for all nursing specialties. In this section, we will go through the tasks and duties that make up a Hospice Nurse’s day: 


  • In collaboration with other medical professionals, social workers, and therapists, they develop an end-of-life care plan for the patient ensuring the patient’s needs and wishes are met.
  • Hospice Nurses will closely follow the pre-established care plan guaranteeing that a patient’s last few months or days are as comfortable, stress- and pain-free as possible.
  • They will compassionately educate, provide guidance and support to the family and other caregivers on how to best care for the patient while the nurse is not present.
  • The Hospice Nurse will provide physical and emotional support to the terminally-ill patient.
  • They continuously assess and manage the patient’s pain and symptoms
  • They will administer medications prescribed by doctors to alleviate pain or symptoms.
  • They will perform wound care and perform treatments and therapies to help the patient feel as good as possible during their last days. 
  • They maintain accurate and detailed records of all the care they provide. 
  • They assist with patient hygiene, helping them bathe, groom, or dress.
  • They facilitate communication among patients, family, caregivers, and other healthcare team members.
  • The hospice RN coordinates with the patient and other individuals (loved ones, doctors, etc.) to meet the patient’s needs.
  • They will advocate for the patient and their family’s wishes as they manage many decisions related to end-of-life processes. 
  • They respond to emergency calls when a patient’s state worsens unexpectedly.
  • Provide bereavement support to the patient’s family after the patient’s death.


How Much Do Hospice Nurses Make?


Working as a Hospice Nurse is a rewarding job in more ways than one. Of course, the feeling of doing such meaningful work is invaluable, but the good news is that financially, this profession is also a compelling option for aspiring RNs. 


As with all nursing professions, the size of the paycheck is determined by many factors. How much you make working in hospice can vary based on the location, employer, years of experience, level of education, and so on. According to ZipRecruiter, on average, the salary of a Hospice Nurse stands at around $80,530


Where Do Hospice Nurses Work?


Hospice nursing is a unique profession, meaning that the work environments for practicing nurses will differ. 


The desire to spend one’s last days at home, amid everyone and everything they love, is entirely normal for terminally-ill patients. Because the job of a Hospice Nurse is always centered around making the patient as comfortable as possible, for the most part, you’ll be caring for patients in their own homes. However, Hospice Nurses can also work in hospice centers, hospitals, or nursing homes


In addition to being open to working in diverse settings, you should also be flexible with your schedule. Sometimes, you may have to work weekends or holidays when the patient requires around-the-clock care. Unexpected situations may also arise, like a sudden worsening of the symptoms requiring your presence on a patient’s side even though you didn’t have a visit scheduled. 


What Are the Pros and Cons of Hospice Nursing?


Working as a Hospice Nurse is not for everyone, so before committing, you should figure out if this job is the right fit for you. A great way to see if you’re cut out for palliative care is by making a list of pros and cons and deciding if the former outweighs the latter. While the benefits and challenges of hospice nursing can be very subjective, there are a few ones that are universally acknowledged:


Pros of being a Hospice Nurse


You’ll make a difference in people’s lives. Your care and attention genuinely leave a mark on the lives of patients and their families. You provide comfort and support during a patient’s last days, making sure the final stages of their life journey are filled with dignity and attention to their needs. It is a time when patients are most scared and vulnerable, and having a hospice professional on their side will truly make a difference. 


Also, you’ll be a guiding light for the patient’s family and loved ones, helping them navigate the most challenging time in their life. People working in hospice care say that you never only treat the patient - you treat the entire family. And that’s one of the most rewarding feelings. 


Because of the closeness with patients and their families, you’ll build close and meaningful relationships with the people in your care. 


Another essential benefit of this career track is professional growth and development opportunities. You can advance your education, get certified and climb higher on the career ladder.


One more plus is excellent job outlook and security. According to the National Hospice and Palliative Care Organization, the number of people who received hospice services in 2020 was over 1,72 million. In 1990, that number was only 210,000. So, the number of people in hospice care, as well as hospice providers, is increasing exponentially, which implies that more and more nurses will be required to meet the demands of the industry. 


Cons of Working as a Hospice Nurse


Hospice nursing is a very emotionally demanding profession. Dealing with end-of-life issues is emotionally challenging for everyone, and nurses are not exempt from feeling overwhelmed by the cruelty of disease and suffering. 


Working in this field is also physically demanding. You may have to stand for long periods, lift or move patients, and conduct frequent home visits. There can be the need to work nights, weekends, or holidays or be on call to cover shifts. 


Also, due to understaffing in some organizations, you may have limited time to spend with each patient because you have a large caseload. 


Each of these could lead to burnout, a serious concern among nurses. You must take good care of yourself, your well-being, and your mental state to be the best nurse for your patients and their families. 


Learn how to recognize the symptoms of nursing burnout and how to combat it


It is crucial to carefully consider the pros and cons of a career in hospice nursing. It can be the most meaningful and rewarding field, but is it the best for you? Don’t take this decision lightly.


Are You Ready to Embrace This Career?


Working in hospice is one of the most challenging and rewarding paths for aspiring nurses. Saying you work with dying people is a grave understatement of the job. You do so much more than that. You help terminally ill patients, and their families enjoy quality of life. You make sure that people on their deathbeds never feel deserted. Instead, they feel cared for; they have an advocate and feel comforted. You help their loved ones during the most heartbreaking times. The impact your care leaves on people is indisputable and invaluable. 


It’s not an easy job, but if you got to this point and still see yourself working in hospice, you may have just what it takes for it. And we would love to help you become the strongest, most compassionate, and most professional Hospice Nurse you can be. 


Enroll in Nightingale College’s BSN program today. 


If you’re already a Registered Nurse and want to advance your education and career, our RN-to-BSN program will help you reach new professional heights! Together, we can make the most significant difference in the field of hospice nursing care! 


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