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How Hospice Nurses Build Trust With Patients and Families

Hospice nurse holding hands with a patient

Around 1.5 million people received hospice care in 2020, according to the Centers for Disease Control and Prevention (CDC). As a hospice nurse, you're responsible for providing comfort and support to patients facing the end of life. 

A hospice nurse ensures that patients and families feel secure, respected, and supported — and trust is the cornerstone of effective hospice care.

Building trust involves enhancing communication, demonstrating compassion, and providing comprehensive support. Let’s explore key strategies to build trust with patients and families in hospice care. 

Understanding why trust matters in hospice care

Patients and families need to feel that they’re in safe, caring hands. This can significantly reduce anger and fear. Trust also ensures that patients and families follow their care plans, which is crucial for managing symptoms and improving quality of life. 

Once a hospice nurse establishes trust, patients and families are more likely to communicate openly about their needs, preferences, and concerns. This leads to more personalized and effective care. 

Trust fosters a strong support system. As a hospice nurse, you want patients and families to feel understood, enhancing their overall experience during end-of-life care. 

Communication approaches for a hospice nurse

In hospice care, you need to be transparent, empathetic, and attentive to the needs and concerns of patients and families. Some trust-building communication approaches:

  • Engage in active listening. This involves fully concentrating, understanding, responding, and remembering what the patient or their family member says. You’re showing that their concerns are valued and understood.
  • Provide clear and honest information. Providing concise information about the patient’s condition, care plan, and what to expect can alleviate fears and uncertainties. 
  • Avoid using medical jargon. This may confuse or overwhelm people who are already emotionally distraught.
  • Regularly update the patient and family about any change in the care plan or the patient’s condition. This helps to maintain transparency, keeping everyone involved in the decision-making process.
  • Ask open-ended questions. This encourages patients and families to share their thoughts and feelings. It facilitates a deeper understanding of their needs and preferences. 

Seven practice changes to build trust in hospice care

1. Demonstrate compassion

Patients and families are dealing with emotional, psychological and sometimes spiritual distress. As a hospice nurse, showing empathy is an important part of your role. That means recognizing and validating the emotions of patients and families. Phrases like, “I understand this must be very difficult for you,” provide comfort and demonstrate that you care. 

Tailoring care to meet the patient’s individual needs and preferences is another way to convey compassion. This includes honoring cultural, spiritual, and personal values.

Providing emotional support through counseling, support groups, or simply being present can help patients and families cope with stress and grief. Small acts of compassion, such as holding a hand or providing a favorite food, can make a significant impact on building trust.

2. Try to build a strong relationship

This requires time, consistency, and a genuine interest in the well-being of the patient and family. Having consistent caregivers helps to build trust. Patients and families feel more secure when they see familiar faces who understand their specific needs and preferences. 

Being reliable and keeping promises fosters trust. If you say you’ll follow up on a concern, or check in at a specific time, make sure to do so.

3. Show respect for the patient’s autonomy

Involve patients in care decisions and honor their wishes. This can include respecting do-not-resuscitate (DNR) orders or other advance directives. 

Educating patients and families about the illness, treatment options, and caregiving techniques empowers them. This builds confidence in the care being provided by you as a hospice nurse.

4. Build rapport by taking the time to get to know the patient and their family 

Sharing a little about yourself and showing genuine interest in their lives helps to build a strong, trusting relationship.

5. Provide comprehensive support

As a hospice nurse, the care you provide encompasses medical, emotional, spiritual and practical support. You’re addressing the holistic needs of patients and families.

One way to do this is with an interdisciplinary team, which includes physicians, nurses, social workers, chaplains, and other specialists. This ensures that all aspects of a patient’s needs are addressed. 

6. Offer bereavement support to families after the patient’s death

Helping families to navigate resources such as financial assistance and legal aid can reduce additional stress. This shows ongoing care and concern.

7. Respect cultural and individual difference

Cultural competence is crucial in hospice care. Patients and families come from diverse backgrounds with unique beliefs, practices, and needs. Obtaining cultural sensitivity training ensures that you respect the cultural differences of the people you care for as a hospice nurse. 

Offering translation and interpretation services bridges communication gaps. It ensures that patients and families feel understood and respected. 

Honoring cultural and religious practices (such as rituals, dietary restrictions, and spiritual beliefs) demonstrates respect and builds trust. Developing personalized care plans, incorporating cultural, spiritual, and personal preferences ensures respectful care. 

Examples of how to build trust 

Imagine this hypothetical case: You’re assigned to care for a patient with advanced cancer. You notice at the initial visit that the man’s daughter seems anxious and overwhelmed. Would you take the time to sit down with her, actively listen to her concerns, and reassure her that she was not alone in caring for her father? 

By providing clear and honest information about her father’s condition and what to expect, you can hopefully alleviate some of the daughter’s fears. Over time, you’ll establish trust, encouraging the daughter to share concerns and collaborate on the care plan.

Now consider this scenario: As a hospice social worker, you’re working with a family who recently moved to the United States. The family has strong cultural beliefs about end-of-life care and is hesitant about hospice services. Do you take the time to learn about their cultural practices and incorporate those into the care plan? For example, do you arrange for a chaplain who speaks their language to visit and provide spiritual support? If you make efforts to respect the family’s cultural values, it can build trust and enhance their experience with hospice care.

As a hospice nurse, you can also build trust through an interdisciplinary team. Imagine you’re caring for a patient with late-stage heart failure. The team meets regularly to discuss the patient’s physical, emotional, and spiritual needs. You manage the patient’s symptoms as the hospice nurse. The social worker provides counseling and connects the patient with financial resources. The chaplain offers spiritual support. This comprehensive approach ensures that all aspects of the patient’s care get addressed, fostering trust and improving quality of life. 

Trust is essential as a hospice nurse

For a hospice nurse, building trust is essential for providing effective, compassionate, and personalized care. You can do this by communicating effectively, demonstrating compassion, and providing comprehensive support. With these solid approaches, you’ll create a trusting environment that enhances the overall experience for patients and their families during end-of-life care.

Incorporating these strategies into your daily practice as a hospice nurse requires commitment and continuous effort. However, the rewards are profound. Trust fosters a supportive, respectful environment. This leads to better outcomes and a more positive hospice experience, where patients and families feel cared for and valued.

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