A hospice nurse and a palliative care nurse both play essential parts in providing compassionate care to patients with serious and terminal illnesses. While their primary goal is to improve the quality of life for these patients, their approaches, settings, and specific responsibilities can differ.
Understanding the distinctions between a hospice nurse and a palliative care nurse can help you make an informed decision about which career path to pursue or what kind of care might be most appropriate for a loved one.
Hospice care and palliative care defined
What is hospice care?
Hospice care is a type of care designed for patients who are in the final stages of a terminal illness, typically with a prognosis of six months or less to live. The focus of hospice care is on comfort and quality of life, rather than curative treatments.
Hospice care encompasses providing physical, emotional, and spiritual support to patients and their families. They ensure that patients can spend their final days with dignity and minimal discomfort.
What is palliative care?
Conversely, palliative care is a broader approach that can be provided at any stage of a serious illness — from diagnosis onward and alongside curative treatments. The goal of palliative care is to ease symptoms and improve the quality of life for patients facing critical health conditions. This type of care addresses pain, symptoms, and stress related to the illness, and involves a multidisciplinary team to provide comprehensive support.
Educational pathways
Both hospice and palliative care nurses start their careers by becoming registered nurses (RNs). This requires completing an accredited nursing program, which can be an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). After graduating, they must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to obtain an RN license.
Certification
Specialized certifications boost the qualifications of both hospice and palliative care nurses. Offered through the Hospice and Palliative Credentialing Center, both hospice nurses and palliative care nurses care enhance their expertise with these certifications:
- Hospice nurse: The Certified Hospice and Palliative Nurse (CHPN) credential is available for RNs who have experience in hospice and palliative care. To be eligible, nurses need at least 500 hours of hospice and palliative nursing practice in the past year or 1,000 hours in the past two years.
- Palliative care nurse: Palliative care nurses can also pursue the CHPN certification. Additionally, the Advanced Certified Hospice and Palliative Nurse (ACHPN) certification is available for advanced practice registered nurses (APRNs) with a focus on palliative care.
Scope of practice
Hospice nurses and palliative care nurses share some common aspects of their scope of practice, such as providing holistic care, advocating for patients and families, collaborating with interdisciplinary teams, and adhering to ethical principles. However, there are also some distinctions between them.
Hospice nurse responsibilities
Hospice nurses focus on the end-of-life care of patients. Their responsibilities include:
- Pain and symptom management: Ensuring patients are comfortable by managing pain and other distressing symptoms
- Emotional support: Providing emotional and psychological support to patients and their families during a challenging time
- Patient and family education: Educating patients and families about the dying process and what to expect
- Care coordination: Working with a multidisciplinary team to create and implement a personalized care plan
- Spiritual or faith-based care: Addressing the spiritual or faith-based needs of patients and families, often in collaboration with chaplains or spiritual counselors
Palliative care nurse responsibilities
Palliative care nurses work with patients at any stage of a serious illness. Their responsibilities include:
- Symptom relief: Managing symptoms such as pain, nausea, or fatigue
- Care coordination: Collaborating with other healthcare providers to integrate palliative care into the patient’s overall treatment plan
- Patient and family education: Helping patients and families understand the illness, treatment options, and care goals
- Emotional and psychological support: Addressing patients’ and families’ emotional and psychological needs
- Advance care planning: Assisting patients and their families in making informed decisions about their care preferences and documenting advance directives
Care settings
Both hospice and palliative care nurses have similar work environments, though their roles may differ.
A hospice nurse typically works in:
- Patient homes: Providing in-home care to allow patients to remain in a familiar and comfortable environment
- Hospice facilities: Dedicated facilities that offer specialized hospice care
- Nursing homes: Assisting in providing end-of-life care for residents in these types of long-term care settings
- Hospitals: Some hospitals have hospice units or offer hospice services within their palliative care departments
A palliative care nurse can work in a variety of settings, including:
- Hospitals: Working in palliative care units, oncology departments, or intensive care units (ICUs)
- Outpatient clinics: Providing palliative care consultations and follow-up in a clinic setting
- Long-term care facilities: Offering palliative care to residents in nursing homes or assisted living facilities
- Home healthcare agencies: Delivering palliative care services to patients in their homes
Differences in approach
Hospice is a type of palliative care that is provided to patients who have a terminal prognosis and have decided to forego life-prolonging interventions. Hospice aims to support patients and their families in the final phase of life, by managing symptoms, providing comfort, and facilitating bereavement.
In contrast, palliative care revolves around the relief of suffering and the improvement of patients’ quality of life. It focuses on addressing patients’ and families’ physical, emotional, social, and spiritual needs. Palliative care can be offered alongside therapeutic treatments at any stage of their condition.
Patient and family support
While patient and family support may seem universal, in hospice and palliative care, the level and type of support they offer to patients and their families can be different.
A hospice nurse’s role
Hospice nurses provide extensive support to both patients and their families, including:
- Bereavement support: Offering grief support to families before and after the patient’s death
- Respite care: Providing temporary relief for family caregivers to prevent burnout and stress
- Communication: Keeping families informed about the patient’s condition and what to expect as the illness progresses
- Holistic care: Addressing not just physical symptoms, but also emotional, social, and spiritual needs
A palliative care nurse’s role
Palliative care nurses also provide significant support, such as:
- Symptom management: Helping patients manage symptoms that affect their quality of life
- Decision making: Assisting patients and families in understanding treatment options and making informed choices
- Psychosocial support: Offering counseling and support to help patients and families handle the emotional impact of the illness
- Resource coordination: Connecting families with community resources and support services
Interdisciplinary teams
While hospice care and palliative care share many similarities in their approach, they also have slight differences in the composition and role of the interdisciplinary teams.
Hospice care is delivered by an interdisciplinary team that includes:
- Physicians: These physicians oversee medical care and manage complex symptoms.
- Nurses: Hospice nurses provide hands-on care and coordinating with other team members.
- Social workers: They assist with emotional support, counseling, and resource referrals.
- Chaplains/spiritual counselors: Their roles address spiritual and religious needs.
- Volunteers: They offer companionship, respite care, and various support services.
Palliative care is also provided by an interdisciplinary team, including:
- Physicians: These physicians specialize in palliative medicine and coordinating care plans.
- Nurses: Palliative care nurses manage symptoms and provide patient and family education.
- Social workers: They offer emotional support and help with advance care planning.
- Chaplains/spiritual counselors: Their roles provide spiritual care and support.
- Therapists (e.g., physical, occupational): These specialists help with rehabilitation and improve quality of life.
While both hospice and palliative care nurses share a commitment to improving the quality of life for patients with serious illnesses, their roles, settings, and philosophies of care differ. A hospice nurse focuses on end-of-life care, providing comfort and support during the final stages of a terminal illness. And a palliative care nurse offers comprehensive symptom management and support at any stage of a serious illness.
Hospice Nursing Jobs
Find your next hospice nurse job today!