How to Become a Hospice Nurse

Hospice nurses act as the lead caregivers for patients during the end stages of their lives. Not only do they provide medical care, but they also focus on maintaining the highest possible quality of life and comfort.

They work one-on-one with patients in various settings like patient homes, hospice centers, hospitals, and nursing homes. They establish meaningful relationships with patients, family members, and caregivers while the patients are in their care.

Duties & Responsibilities

A hospice nurse's role is distinguished from other specialties because they don't expect their patients to improve. Instead, the care they give provides an improved quality of life to terminally ill patients.

The goal of hospice nursing is to diminish pain, increase comfort, and provide emotional and spiritual support and education to patients and their families. Hospice nurses perform several tasks to meet this goal, which include:

Medical Services

• Patient patient assessments for hospice admission
• Administering medication & recommended treatments
• Ensuring the availability of medication/specialty equipment
• Maintaining medical charts, patient files, and health records
• Ordering medical supplies
• Providing wound care when necessary
• Responding to emergency calls & providing crisis care

Emotional, Spiritual, and Mental Well-Being

• Arrange spiritual support services
• Evaluating patient needs
• Providing emotional, psychosocial, and spiritual support
• Act as liaisons to caregivers and spiritual guides
• Provide hygiene assistance

Caregiver & Family Support

• Advocate for patients and their families wishes 
• Assist patients and their families with appropriate paperwork
• Create a plan of care for caregivers 
• Provide compassionate end-of-life education to patients and families
• Provide respite care for family caregivers

Skills & Attributes

Hospice nursing is a clinically rigorous specialty. Nurses in this field must constantly assess, evaluate, and respond to patient needs while keeping caregivers and the care team informed.

To meet these requirements, hospice nurses must have excellent clinical and communication skills. Other skills necessary to succeed as a hospice nurse include:

• Empathy & compassion
• Emotional resiliency
• Cultural & spiritual awareness
• Confidence working with little supervision
• Strong interpersonal skills

The average registered nurse (RN) salary in the US is $86,070 a year, or $41.38 an hour, according to the U.S. Bureau of Labor Statistics (BLS).

Hospice nurses nationwide bring home incomes close to this average. ZipRecruiter reports hospice nurse salaries at $87,186 per year, and Indeed posts annual wages of $83,323 based on 8.3K reported salaries.

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Highest Paying Cities for Hospice Nurses

Nationwide, hospice nurses earn the most in the following cities:

City	Annual Salary	Hourly Wage
Novato, CA	$111,936	$53.82
Berkeley, CA	$110,147	$52.96
Renton, WA	$107,048	$51.47
Santa Monica, CA	$106,192	$51.05
Daly City, CA	$104,240	$50.12

Source: ZipRecruiter, Extracted 18 Jan 2024

Hospice Nurse Benefits

In addition to salary, hospice nurses are also likely to receive a range of benefits that may include:

• Discounted childcare
• Medical, dental, and life insurance
• Flexible Spending Accounts (FSAs) or Health Savings Accounts (HSAs)
• Nursing conference reimbursement
• Paid time off and sick leave
• Retirement plans
• Short and long-term disability coverage
• Tuition reimbursement

It takes between four and eight years to become a hospice nurse. This timeline includes earning your registered nursing license, gaining relevant experience, and earning a hospice nursing certification.

The following section explores the path to entering this nursing specialty in detail.

Step 1: Become a Registered Nurse

Before you can specialize in any nursing field, you must earn your RN license. You can become an RN by attending an accredited Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) program. Earning these degrees takes two and four years, respectively.

Some nurses may decide to invest an additional year to earn a Master of Science in Nursing (MSN), which is increasingly preferred by many healthcare employers. After graduating, you'll take the NCLEX-RN exam to gain RN licensure in your state. 

Step 2: Gain 2-3 Years of Experience

Relevant experience in an acute care setting will prepare you for hospice nursing. As you gain experience, you'll learn valuable clinical skills, understand your stress thresholds, and develop the coping mechanisms necessary to work in hospice care.

Ideally, you'll spend two to three years accruing this experience in an Intensive Care Unit, Emergency Department, or another acute care setting. 

Step 3: Get Certified

One way to stand out in the field of hospice nursing is by acquiring professional certifications. The Hospice and Palliative Care Credentialing Center (HPCC) oversees hospice nurse certifications. Currently, they offer two credentials to qualified registered nurses:

• Certified Hospice and Palliative Care Nurse (CHPN)
• Certified Hospice and Palliative Pediatric Nurse (CHPPN)

Advanced practice registered nurses (APRNs) who specialize in hospice care should pursue the HPCC's Advanced Certified Hospice and Palliative Nurse (ACHPN) credential instead. The HPCC engineered this certification exam for Clinical Nurse Specialist (CNS) and Nurse Practitioner (NP) knowledge and skills.

The continued national nursing shortage creates a need for all types of nurses, including hospice nurses. However, there is still remarkable growth in the demand for hospice and palliative care specialists.

The New England Journal of Medicine found that for the first time since the early 20th century, more Americans have chosen to die at home than in the hospital. Additionally, Hospice News reported that more than half of Medicare patients who died in 2018 did so while in hospice.

These changes in where Americans choose to spend their final days indicate a strong, growing need for more hospice RNs and APRNs, ensuring a positive career outlook for this career.

Hospice nurses must complete continuing education units (CEUs) to maintain their RN licenses. Registered nurse CEUs vary by state, so understanding your specific requirements is paramount to ensuring your license renewal goes smoothly. Check out our comprehensive guide of nursing continuing education requirements by state to learn more.

Additionally, the HPCC has certification renewal requirements for hospice RNs and APRNs. If you hold the CHPN, CHPPN, or ACHPN credential, you must recertify every four years. HPCC certification renewal has several steps, including practice and work hour requirements and professional activities like continuing education, volunteering, or publishing.

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Hospice nursing is a unique specialty area, and nurses who are interested in pursuing this career can learn more about the role by seeking guidance from the numerous organizations, societies, and agencies that support this specialized field. These include:

• American Academy of Hospice and Palliative Medicine
• Hospice and Palliative Care Nurses Association
• National Coalition for Hospice and Palliative Care
• National Hospice and Palliative Care Organization
• National Palliative Care Research Center

Also, check out these Nurse.org articles for hospice care tips and news:

• How to Stay Positive When You Work in Hospice
• Joe Biden Thanks Hospice Nurses Who Cared for His Family

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$70,000 - $90,000 Associate Bachelors Hospice Non-Bedside RN