More than 1.5 million patients are in hospice care across the country, according to the latest data from the Centers for Disease Control and Prevention (CDC). These are terminally ill patients who require an attentive caregiver to ensure their comfort and quality of life at the end of their lives. While serving in hospice care can be challenging, many nurses are drawn to this work because they have compassion for the terminally ill and their families, and because they favor the intimacy found in hospice settings and patients’ homes.

Serving as a hospice nurse requires high-level nursing skills as well as emotional fortitude. An advanced nursing education can help cultivate these assets. For aspiring and working nursing professionals who are exploring this career path, it may be helpful to start with two questions: What is a hospice nurse? And what does a hospice nurse do?

Hospice care refers to a type of specialized care that is made available to patients who have advanced and life-limiting illnesses. With hospice care, the goal is not recovery, but rather to ensure the patient’s comfort and dignity in their final days.

Hospice care is often conflated with palliative care, but there’s a key distinction between the two. The latter entails specialized medical care for patients living with a serious illness that can potentially be cured, while the former encompasses end-of-life care.

Nurses who enter the field of hospice care typically work in one of two environments: They treat patients either in specialized hospice facilities or in the patient’s homes.

A unique aspect of hospice nursing is that the care provided isn’t strictly limited to the patient. While hospice nurses are tasked with keeping the patient comfortable and improving their quality of life, they may also be called upon to provide emotional support to family members, many of whom are in the early stages of grieving in anticipation of their loved one’s death.

While a hospice nurse’s day-to-day duties vary by patient, their most common responsibilities include:

• Administering medication. Patients who are in hospice care often live with chronic symptoms, including pain and nausea. Part of the hospice nurse’s job is to monitor their medication levels and administer any treatments needed to ensure comfort.
• Monitoring patients’ vital signs. The hospice nurse is tasked with measuring and monitoring patients’ vital signs, which can indicate the progression of their disease and also reveal when additional interventions may be needed.
• Employing therapeutic interventions. To keep patients as comfortable as possible, hospice nurses may also need to employ nonpharmaceutical interventions. These vary by patient but may include things like massage or meditation practices.
• Providing up-to-date information. As a patient’s symptoms progress, family members will naturally want to be kept in the loop. A crucial aspect of what a hospice nurse does involves providing ongoing education and patient updates to loved ones.
• Collaborating with other caregivers. Hospice nurses work as part of a larger team, which may include doctors, other nurses, and spiritual advisers. Collaboration is a key part of the job, as all parties work together to promote patients’ well-being and comfort.

Hospice nursing can be a rewarding career for those who feel a strong call to support the terminally ill. The key steps to becoming a hospice nurse include the following:

• Earn a nursing degree. An important starting point is earning either a bachelor’s or an associate degree in nursing, which can provide a solid foundation in basic patient care principles.
• Become a registered nurse. Following the completion of an undergraduate degree, the next step is sitting for a licensure exam and, ultimately, becoming a registered nurse (RN).
• Gain experience. To succeed in hospice nursing, nurses should have plenty of experience providing direct patient care, particularly with terminally ill patients or those with chronic conditions.
• Seek advanced education and/or certification. Continuing nursing education is a valuable way for RNs to keep their patient care skills sharp, pursue career advancement, and develop specialized skills.

This can be a worthwhile trajectory for any nurses who are drawn to the opportunity to facilitate more intimate relationships with their patients and their patient’s families or to work in private homes or smaller care facilities, as opposed to hospitals. While nursing professionals of various educational levels can be involved in hospice care, nurse practitioners (NPs) play a key role. Hospice NPs are advanced practice registered nurses (APRNs) who specialize in hospice care. Because of their advanced education and training, hospice NPs have greater autonomy than RNs and can provide more comprehensive care, including prescribing medication.

When faced with advanced and life-limiting illnesses, many patients opt to forgo uncomfortable treatments and choose to spend their final days in a more pleasant place than a hospital. Hospice nurses play an essential role in supporting these patients, helping them to be comfortable and to have the best possible quality of life as they approach the end of their lives.

One way to prepare for an effective hospice nursing career is to pursue an advanced education, such as through Regis College’s online Post-Master’s Certificate in Nursing program, which offers multiple specializations, including in adult gerontology. Earning a nursing certificate can equip you with the types of skills you’ll need to ensure patients in hospice care have the best possible experience in their final days.