How to Become a Hospice Care Nurse
March 15, 2021
Hospice care nurses provide patient care to those in the final months of life. Their practice focuses on providing comfort and pain relief rather than invasive remediations. Patients and their families say it's the better way.
"The majority of patients today still die in hospitals," according to Ruth Kleinpell, a professor of nursing at Rush University College of Nursing, even though "hospice care can provide patients and families with a better dying experience." In a 2016 study, published in the journal BMJ Supportive and Palliative Care, Kleinpell advocates moving those nearing the end of their lives from hospitals to the more comfortable home-like setting of hospices. There they can receive care focused more on dying comfortably than on prolonging discomfort.
While nurses of all kinds are focused on quality-of-life issues for patients, the goal of hospice care nurses—also known as hospice care and palliative nurses—is to ensure that individuals benefit from the best possible quality of end-of-life care. That's because hospice patients usually have no more than six months to live; hospice care patients may include those with cancer, heart disease, dementia, kidney failure, or chronic obstructive pulmonary disease. At this point, they're no longer looking for a cure, but rather for comfort, pain management, and emotional support.
While it may be challenging—as well as emotionally draining and physically taxing—to help guide dying people through the final, potentially most painful days of their lives, as a hospice care nurse, you'll have the chance to build connections with your patients and their loved ones. It's not all tragedy, although tragedy is undoubtedly never far off.
Research shows, in fact, that hospice care can help improve patient experiences by:
- Lowering individuals' likelihood of dying in a hospital
- Raising patient satisfaction ratings
- Improving pain control
- Reducing hospitalization time
Hospice care offers opportunities for nurses from registered nurses on up through advanced practice nurses and DNPs.
In this guide to becoming a hospice care nurse, we'll cover:
- The pros and cons of becoming a hospice care nurse
- Kinds of hospice care nurse careers
- The educational commitment to become a hospice care nurse
- Licensure and accreditation for becoming a hospice care nurse
- Further accreditation or education for hospice care nurses
- Typical advancement path for hospice care nurses
- Resources for becoming a hospice care nurse
Pros and cons of becoming a hospice care nurse
Pros of becoming a hospice care nurse
- Compensation: The average compensation for hospice care registered nurses is $69,270 per year, according to Glassdoor.
- Benefits: Most hospice care nurses (71 percent) receive medical insurance, dental insurance (62 percent), and vision insurance (54 percent), while only 27 percent receive no benefits, according to salary-tracking website PayScale.
- Job satisfaction: In a survey of 386 hospice care nurses, Payscale reported a job satisfaction level of 4.1 (on a 1-to-5 scale), a score Payscale classifies as "highly satisfied."
- Job security: The healthcare and social assistance sector is the fastest-growing industry in the US, according to the Bureau of Labor Statistics. The job rate for registered hospice care nurses is expected to increase by 19 percent by 2022.
Cons of becoming a hospice care nurse
- Physical demands: You'll be standing for hours at a time, lifting and carrying patients, and potentially traveling to conduct home visits to provide in-home hospice care. Like most nursing roles, hospice nursing is physically as well as emotionally draining.
- The emotional toll of the work: Painful symptoms, discomfort, and dying will be your patients' reality, and to some extent, your own as well. It can be challenging not to feel affected by your patients' terminal illnesses. Getting to know patients' loved ones and the sadness and stress they're coping with can add up as well.
- Working or being on call at all hours of the day: The job may demand putting hours in during evenings and on weekends and holidays.
Kinds of hospice care nurse careers
Hospice nurses serve in a variety of roles, including:
- Admissions nurse
- Case manager
- Visit nurse
- Triage nurse
- Hospital liaison
Hospice nurses typically work in the following settings:
- Hospice center
- Nursing home
- Patient's home
Skills necessary to become a hospice care nurse
According to Bureau of Labor Statistics, hospice care workers must:
- Be compassionate, organized, responsible, and self-starters
- Set clear boundaries between themselves and patients and their loved ones
- Communicate complex topics, such as medical issues, to patients and their friends and family
- Be team players as part of a larger hospice care team
Educational commitment to become a hospice care nurse
At a minimum, RN hopefuls must complete a two-year associate's degree in nursing. For more significant career growth potential down the line, completing additional education, such as a four-year Bachelor of Science in Nursing (BSN) or a two-year Master of Science in Nursing (MSN) may be worthwhile.
An associate's degree will help you get your foot in the door, while a bachelor's degree is usually key for attaining greater responsibility, managerial roles, and higher pay. An MSN helps candidates advance to specialized positions, such as nurse practitioner (NP). NPs earn $91,000 per year on average, and provide much of the same care that physicians provide. Your income should increase at every advance in level of education.
Online RN degrees for associate's, bachelor's, and master's programs are also an option. There are accelerated BSN and accelerated MSN programs that deliver both degrees in five years. If you have an associate's degree and are already an RN, you can get your BSN or MSN more quickly in an RN-to-BSN or RN-to-MSN program.
Licensure and accreditation for becoming a hospice care nurse
General licensure and accreditation requirements for becoming a registered nurse
Licensure is required for RNs in all 50 states, DC, and U.S. territories. According to the Bureau of Labor Statistics, to become licensed, nurses must:
- Graduate from an accredited nursing program
- Pass the National Council Licensure Examination (NCLEX-RN)—to be eligible to take the exam, your program needs to be approved by your state board
Nurses may also have to pass a criminal background check or meet other state-specific requirements.
Licensure and accreditation requirements for specializing in hospice care
Once the above requirements are met, most RNs who want to become hospice care specialists gain work experience for at least one to two years in an acute care setting, becoming familiar with health assessments, pain management, and taking vital signs, according to the Center for Hospice Care Southeast Connecticut.
Up next? the National Board for Certification of Hospice and Palliative Care Nurses (NBCHPN) offers six certifications to those hoping to specialize in hospice care nursing. Each has its own requirements:
- Certified Hospice and Palliative Care Administrator (CHPCA)
- Certified Hospice and Palliative Pediatric Nurse (CHPPN)
- Certified Hospice and Palliative Nursing Assistant (CHPNA)
- Certified Hospice and Palliative Licensed Nurse (CHPLN)
- Certified Hospice and Palliative Nurse (CHPN)
- Advanced Certified Hospice and Palliative Nurse (ACHPN)
To be certified as a hospice and palliative care nurse, for example, you must:
- Accrue 500 hours of hospice and palliative care nursing practice within a 12-month time-period or 1,000 hours within a 24-month timeframe
- Pay a fee: Up to $415 for the initial certification
- Pass the CHPN exam
Typical advancement path for hospice care nurses
To move beyond entry-level nursing roles and progress professionally, nurses should plan on gaining experience, getting good performance reviews, and seeking out continuing education opportunities. Staying competitive, while also developing leadership, communication, and negotiation skills, can help nurses advance to roles with increasing responsibilities, including from assistant clinical nurse manager, charge nurse, or head nurse to more senior roles, such as assistant director or director of nursing, vice president of nursing, or chief nursing officer. Nurses can also use their expertise to transition into business roles, advising on marketing, consulting, policies, quality assurance, and more.
Resources for becoming a hospice care nurse
Hospice care professional resources
Since the 1980s, the Hospice and Palliative Nurses Association has served as the national professional organization for those specializing in hospice and palliative nursing. Check out the organization's:
Resources to read before applying and starting nursing school
If nursing is a path you're interested in pursuing, check out additional resources from our team here at Noodle.com to help you on your way to selecting a nursing program and beyond, including getting the most out of your degree.
- What I Wish I'd Known Before Beginning Nursing School
- Is an Online RN Degree the Right Choice?
- How Can I Pay for Nursing School?
Resources to read before starting nursing school
Thinking beyond nursing school
- Why Get a Master of Science in Nursing: Top 8 Reasons
- An Intro to What a Master's Degree in Nursing Can Do for You
Hospice care is not for everyone. Even by healthcare standards, caring for the dying is a stressful, draining profession. But the benefits of hospice are real. According to a National Institute of Health study led by Susan Miller of Brown University, hospice care exceeds hospital care in pain management, the number of hospitalizations, overall cost, and family satisfaction with end-of-life care. For those with the courage to face death daily, hospice nursing is undeniably a profession that makes a difference in people's lives.
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