What Does a Hospice Nurse Do?

Hospice Nurses Have Differing Responsibilities

Nurse and Elderly Patient

Hospice nurses provide care in a variety of different roles. Hospice care may take place in a hospice institution or the patient’s home—frequently both. It’s based on the belief that every person who is terminally ill or injured has the right to die with dignity and without pain, and that the patient’s family also deserves compassionate care and support.

Each hospice patient is cared for by a team of professionals who provide medical care, pain management, and emotional and spiritual support tailored to the patient’s wishes. Hospice nurses are vital members of that team.

Hospice Nurses' Varying Roles

Hospice nurses include registered nurses and licensed practical nurses. They have a number of important responsibilities and fulfill different roles. During hospice care, you are likely to receive care from nurses who perform these functions.

  • Hospice Nurse Case Manager: A case manager hospice nurse is responsible for assessing and managing a patient's care. Only one case manager nurse is assigned to each patient, to foster a trusting relationship and allow for continuity of care. A hospice case manager nurse is a registered nurse (RN) who must be comfortable working independently. She is the eyes and ears of the hospice physician and so must possess expert patient assessment skills. The case manager hospice nurse is a critical thinker. Hospice nurses have a unique opportunity to share in a patient's last moments, so they must be compassionate and empathetic.
  • Hospice Nurse—Intake or Admission Nurse: The hospice intake or admission nurse is often the first hospice staff member to visit a patient. He or she spends a lot of time with patients and their caregivers, explaining the hospice philosophy and developing a plan of care. Responsible for assessing a patient's need and readiness for hospice, the hospice intake or admission nurse consults with the hospice physician to accept the patient into hospice care. Once the patient is admitted, it's this hospice nurse who does a complete assessment of the patient, orders the medication and equipment the patient will need (with the direction of the hospice physician), and begins the process of patient and caregiver education.
  • Hospice Nurse—Visit Nurse: A hospice visit nurse is one who does not have any case management responsibilities but instead supplements the care provided by the hospice nurse case managers. Visit nurses often are licensed nurses (LVNs or LPNs). They typically visit patients who have immediate needs when their case managers cannot visit promptly. Hospice visit nurses may also be responsible for following up on routine care, such as wound care, that the case manager has implemented. Hospice agencies have visit nurses on-call after hours to visit patients with urgent needs and to attend deaths.
  • Hospice Nurse—Triage Nurse: The hospice triage nurse takes phone calls from patients or their caregivers who are at home. He or she begins the process of assessment and treatment over the phone. In addition to giving the patient or caregiver instructions for symptom management or medical treatment, the triage nurse consults with the hospice physician and notifies the case manager or visit nurse if there's a need for a visit. Because the triage nurse cannot physically see the patient, he or she must have excellent communication skills to get accurate and necessary assessment information from the patient or caregiver. This hospice nurse must be a critical thinker who is able to prioritize efficiently.
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    • Hospice care. National Hospice and Palliative Care Organization. https://www.nhpco.org/about-hospice-and-palliative-care/hospice-faqs.