Hospice Nurse: Duties, Salary, and How to Become One

Often called end-of-life care, hospice care provides treatments and assistance to patients who have six months or less left to live. Dealing with heavy issues like terminal illness, grief, and death can take a toll on hospice nurses. It’s unsurprising that becoming a hospice nurse requires plenty of compassion and emotional strength. But it can also be one of the most rewarding of health care professions, in that hospice nurses can help patients carry out any big dreams (such as a wedding or even picking up a crafting hobby) before the end of their lives.

Hospice care is most similar to palliative care. While hospice care tends to come after a diagnosis is made that the patient does not have much longer to live, palliative care encompasses life-prolonging therapies. 

This article will guide you through what a hospice nurse does and how to become one.

What is a hospice nurse?

A hospice nurse is a registered nurse (RN) who cares for terminally ill patients near the end of their life, helping them die as comfortably and dignified as possible, usually in their own homes.

Tasks and responsibilities

Hospice nurses provide compassionate care for patients, including spiritual and psychosocial support on top of regular nurse duties. Their responsibilities include:

• Monitoring vital signs: Checking on a patient’s health daily, including monitoring their vital signs several times a day and record any symptoms or potential medical concerns.

• Administering medication: Providing prescription drugs, IV drip, or shots for patients to make them feel better rather than get better.

• Spiritual support: Hospice nurses offer kindness and assistance in helping patients and their families navigate inevitable death and loss. Supporting a patient’s spirituality, such as cultural, religious, or lifestyle rituals, can help patients feel calm and connected as they accept that they are nearing the end of their lives.

• Psychosocial support: A hospice nurse provides mental, emotional, and social support to patients and families in a professional manner.

• Connecting with patients’ caregivers: Keeping family members abreast of what will happen is a part of a hospice nurse’s job. They educate caregivers on the patient’s conditions, medications, and how to cope during difficult times.

Skills and personality of a hospice nurse

Hospice nurses are strong in mind and emotion, as they must support patients and their families in approaching death. According to one study, hospice nurses are significantly more assertive, imaginative, forthright, free-thinking, and independent than traditional nurses [1]. 

In addition to the technical skills needed to be a nurse, hospice nurses should have the following skills and abilities:

• Ability to work independently

• Communication skills

• Compassion

• Creativity

• Cultural sensitivity

• Emotional strength

• Empathy

• Leadership

• Patience

A hospice nurse becomes close to patients, getting to know them on an intimate and personal level. While the subject of death is heavy, it can also be an extremely rewarding career path—hospice nurses encourage their patients to live the fullest life in their last days. That can include helping patients take their last (dream) trip, go to their grandchild’s wedding, or get married [2]. It takes a specific kind of person to become a hospice nurse, but it is a job that can be filled with beauty and dignity.

Where they work

Hospice nurses tend to work one-on-one with patients in the patients’ homes, private care facilities, or hospitals caring for the terminally ill patients in their final days.

Hospice care vs. palliative care

Both hospice care and palliative care provide similar types of services, including making sure the patient is comfortable and relaxed. However, palliative care can be given at diagnosis and continue throughout treatment, while hospice care begins after disease treatment ceases—when it is clear that the patient will not survive the illness and has a limited amount of time to live.

Salary and job outlook 

Salaries for hospice nurses can vary depending on the type of facility or organization they’re working with, how much experience they have as a hospice nurse, and where they are located. 

The average annual salary for hospice nurses in the US is $79,547, according to ZipRecruiter [3]. The US Bureau of Labor Statistics lists $77,600 as the median salary for registered nurses, with a 6 percent job growth rate between 2021 and 2031 [4]. Because hospice nurses are simply RNs with a specialization, their salaries and the factors that might make them higher or lower (such as location or level of experience) are similar.

How to become a hospice nurse

If you’re interested in a career path that allows you to help patients feel calm and fulfilled in their last days of living, then you might consider becoming a hospice nurse. It involves a slightly slower pace than an RN but the work tends to require more emotional attachment.

1. Become a registered nurse (RN). 

To become a hospice nurse, you must first become a registered nurse. That means you’ll need to earn either a Bachelor of Science in Nursing (BSN) or an Associate Degree in Nursing (ADN), which typically require four or two years respectively. Then, you must pass the National Council Licensure Examination (NCLEX) exams and get licensed in the state you want to practice in. 

Read more: How to Become a Registered Nurse (RN)

2. Gain work experience.

Typically, you’ll want to have at least 1-2 years of clinical nursing experience as an RN before diving into hospice care. As a hospice nurse, you’ll still be in charge of monitoring vital signs, managing symptoms, and other technical nursing tasks, but there will be an additional layer of preparing terminally ill patients for their last months or weeks. 

Possessing a strong foundation of routine nursing tasks and responsibilities allows you to shift into helping patients feel better. Often you’ll administer medications for pain relief, rather than for curative reasons. You may have discussions with patients about what will make them feel most fulfilled before dying. This type of care requires intuition that’s only possible when you know the basics of nurse care very well.

3. Get certified.

To become a hospice nurse, you’ll need to get a certification offered by the National Board for Certification of Hospice and Palliative Care Nurses (NBCHPN). The following certifications are available for roles within hospice and palliative care for registered nurses:

• Advanced Certified Hospice and Palliative Nurse (ACHPN)

• Certified Hospice and Palliative Nurse (CHPN)

• Certified Hospice and Palliative Pediatric Nurse (CHPPN)

The most common certification for hospice nurses is the CHPN. If you have an advanced degree, such as for a nurse practitioner, you qualify for the ACHPN.

Explore palliative care with Coursera

Whether you are interested in hospice or palliative care, the Palliative Care: It's Not Just Hospice Anymore Specialization from the University of Colorado may be appealing to you. You’ll learn the basic strategies and techniques for supporting patients with serious or terminal illnesses and be prepared for a fulfilling career in health care.