Working with Hospice Patients

To work with Hospice patients requires a lot of compassion and patience. As a nurse you have to be strong and confident.  You have to somewhat shut off your feelings or you will be crying on all your cases.I usually say to myself I have to be the strong one and remember why I am there. I am not only there as a nurse for the patient,but I am there to provide support to the family too. During this time , you will see different attitudes and moods coming from the family.It is the only way they know how to cope with the situation. Some might be angry, sad and some might even tell you how to do your job. I do not take anything personal. Sometimes you might even be in the middle of a family feud.
Sometimes you have to be strong for the family or teach them how to be strong. I educate them on the dying process and I keep them up to date on the condition of their love one.
My role is to keep the patient comfortable and pain free during their transition.We do not use the term dying out of respect for the family.I provide ADL, Vital signs and monitor the patient very closely by documenting his or her condition including the vital signs every1-2hrs.
Once the patient respiration falls below 12, I notify the RN in charge of my patient. When the patient expires, I do the post mortem care and the RN pronounces the time, the date and notify the physician and the funeral home chosen by the family.The RN completes all the paperwork including the paperwork for the funeral home.
I also do my final notes.
The funeral home comes to pick up the patient and then I can leave and end my shift for the day.
I really enjoy it, I have learned so much and the experience is amazing.My passion is to help the sick and helping patients or clients during their transition.

My toughest case was when I worked in long term care.I  workedwith this patient for a while.During her transition, the family couldn't make it to be there with her on time. They all lived either out of state or an hour or two away.After her postmortem care was completed by the CNAs, I sat with her and held her hand until she took her last breath with a smile.That moment really touched my heart, I shed a few tears.