Running head: HOSPICE 1

Hospice
Kathy Le
California State University, Stanislaus

Hospice
The author had the opportunity to follow a hospice home-team nurse for a ride-along

experience. This paper will compare and contrast the precepts of palliative care with the hospice

model of care. It will also discuss the authors experience with a specific patient based on

physical well-being, psychological well-being, social well-being, and spiritual well-being.

Another point that will be addressed in this paper is the role of the nurse in providing quality

end-of-life care. Finally the paper will analyze how this experience has affected the authors

views on end-of-life care.

Compare and Contrast
Palliative care and hospice are similar when it comes to care for dying people (National

Caregivers Library, 2016). Hospice provides palliative care for the terminally ill and palliative

care provides comfort care for the seriously ill. These two programs differ in care locations,

timing, payment, and treatment. There are more hospice programs than palliative programs.
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Hospice has round-the-clock care in the home, nursing homes, hospice facilities, and

occasionally hospitals. Palliative care is often located at home, hospitals, nursing homes, and

extended care facilities. Both also differ in timing because hospice requires the patient to be

terminal or within six months of death to be eligible, while palliative care can be received at any

time. The hospice program mainly covers payment for hospice, and the palliative care is covered

by regular insurance. The hospice program also treats patients with comfort care, rather than

palliative cares comfort and life-prolonging therapies (National Caregivers Library, 2016).
Different Levels of Well-Being
The authors patient was a 67 year old male with stage four lung cancer and a stage three

abdominal wound. His physical well-being, psychological well-being, social well-being, and

spiritual well-being are not all completely met. The patient experiences pain that is unrelieved

by his painkillers and violently coughs during the night. He also has an infected wound, which is

currently being treated with antibiotics. His physical well-being is not the best it can be and he is

certainly not physically comfortable. According to Waldrop, one of the major physical concerns

of people with cancer includes pain (2015). His psychological well-being is not the best it can be

ether. He likes to stay in his bed all day and isolate himself. Waldrop also stated that cancer

patients have the fear for death (2015). Psychologically, he may want to stay in his room all day

because he is afraid to face what else life has in store for him. Socially, his likes to isolate

himself. His daughter stated that her birthday party is next week, and has been trying to

convince him to come celebrate. Although, she says that he did not want to go and be

surrounded by all those people. People with cancer are also suspected to have altered

interpersonal relationships (Waldrop, Meeker, & Kutner, 2015). This is clearly illustrated with

this cancer patient. Spiritual well-being was not observed in this visit. There was no chaplain

and the nurse did not assess his spiritual well-being. Another thing Waldrop stated is that cancer
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patients can struggle with deep existential reflections (2015). However, this was not addressed

in the authors visit due to lack of nursing assessment. Overall, the patients well-being needs a

lot of improvement and comfort measures.

Role of the Nurse
The role of the nurse in providing end of life care include providing comfort and

improving the quality of life (Mizell, Washington-Brown, & Russell, 2014). The interventions to

do this can include pain management, symptom management, spiritual assessment, cultural

considerations, and coping strategies (Mizell et al., 2014). The author observed most of these

nursing roles from her hospice experience. There was a lot of pain management involved. The

hospice nurse always assessed pain and assessed to see if their current pain medication was

working for them. If the pain medication was not working for them, then she would contact the

nurse practitioner to collaborate on what kind of pain medication dosage the patient should be

on. Symptom management was also observed from the hospice nurse. She assessed for

symptoms of dizziness, edema, constipation, bloody septum, and low blood pressure on the lung

cancer patient. The hospice nurse did not assess the spiritual aspects of the patient. When the

author addressed the nurse about the subject, the nurse stated that not many patients need help

with spiritual aspects. She said that the chaplain mainly deals with that and is not widely used by

the patients either. The nurse also did not assess culture in the observation. When asked about

this, the nurse stated that the patient and family members initially bring up the cultural needs in

the earlier visits. The patient observed did not have any special cultural needs. The nurse

addressed coping strategies when she asked the patient and family members if they had any

concerns or questions. However, the patient and family stated that they did not have any

concerns or questions.
This experience has definitely affected the authors views on end of life care. Now the

author understands the role of hospice care for the patient and the nurse. End of life care is no
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longer seen as a scary process in the authors eyes. The authors stigma about hospice being all

about death and depressed people has changed. The author now sees that hospice is a

comfortable transition into the end of life. The hospice nurse was cheery and outgoing, not at all

like the author expected her to be. In the authors honest opinion, she assumed that the nurse

would be tired and depressed from being surrounded by death all the time. The author learned to

acknowledge when she is stereotyping unfamiliar fields of nursing, and set it aside until she has

observed it. This is the most important thing the author has learned from this experience.
References
Mizell, D., Washington-Brown, L. J., & Russell, A. (2014). Transitioning RN to BSN Students

from Acute Care to Hospice Care Nursing. ABNF Journal, 25(4), 103-109 7p.
National Caregivers Library. (2016). Hospice vs. palliative care. Retrieved from:

http://www.caregiverslibrary.org/caregivers-resources/grp-end-of-life-issues/hsgrp-

hospice/hospice-vs-palliative-care-article.aspx
Waldrop, D., Meeker, M., & Kutner, J. (2015). The developmental transition from living with to

dying from cancer: Hospice decision-making. Retrieved from:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4747045/