Hospice of Westchester

The Hospice Nurse is a core service on the hospice and palliative care team. The RN case manager will work hard to make sure everything you need is in place: adequate staff, equipment, supplies and medications. The nurses on the interdisciplinary team becomes the "eyes and ears" of the primary physician.

The hospice and palliative nurses distinguish themselves from their colleagues in other nursing specialty practices by their unwavering focus on end-of life care. By providing expert management of pain and other symptoms, combined with compassionate listening and counseling skills, the nurse promotes the highest quality of life for the patient and family. Regardless of the setting, the hospice nurse strives to achieve an understanding of specific end-of-life issues from the perspective of each patient and his or her family. Hospice and palliative care includes 24 hour nursing availability.

Hospice nurses typically practice in the homes of terminally ill patients; however, some also work in inpatient hospice units. Hospice nurses also visit patients who are enrolled in hospice and living in a variety of long term care settings (e.g. nursing homes, assisted living and group homes).

SPECIALTIES
Many of the nurses at Hospice and Palliative Care of Westchester are specially trained for example in oncology, pediatrics, cardiac, pulmonary care and geriatrics. Some of the nurses have been accredited as a Certified Hospice Nurse.

ASSESSMENTS
The hospice nurse performs professional assessments of his/her patients, creates nursing plans of care, performs many skilled nursing procedures, provides all necessary aspects of nursing bedside care, supervises LPN’s and home heath aids, and performs many other tasks as needed. The primary focus of the nurse is to assures that all of the patient’s needs are met

LICENSED PRACTICAL NURSES AND HOME HEALTH AIDE SERVICES
Under the direction of the Hospice Nurse, an LPN or Aide can assist in providing care for the patient. The LPN can perform all nursing procedures. The LPN's and Aides can administer medications to patients only when directed by the RN. The Aide is limited in giving only pre-poured medications, they are not able to give injections or adjust doses. Aides may assist the patient in general activities of daily living such as bathing, feeding, dressing. They also help in maintaining skin integrity by the use of lotions, back rubs and positioning. If a crisis or change in condition occurs, the hospice aide is specially trained in hospice care and knows when to report changes to the RN. The nurse will give instruction to the family on how to administrator medications to their loved one.

PAIN AND SYMPTOM MANAGEMENT
Often one of the greatest fears of the Hospice patient and their family is that a patient may experience unbearable pain. At the heart of Hospice, is a focus on pain control and symptom management that helps patients make the most of their remaining days. The Hospice nurses and the Medical Director are well versed in the latest pharmaceutical options and the best medical delivery modalities to manage pain and control other symptoms. The primary nurse is skilled in assessing and managing pain symptoms in ways that allow patients to remain as pain free and alert as possible. Most pain can be effectively controlled with medications. Hospice patients are instructed to follow a specific around-the-clock pain medication schedule, which when complied with, generally achieves good outcomes in the goal of remaining pain free. Also, a patient's level of pain will frequently decrease when anti-anxiety drugs are prescribed in conjunction with analgesics. If patients are unable to swallow medications, hospice professionals prefer to use other methods other than injectibles, IVs or pumps. Quite effective, these preferred methods are also easily administered by caregiver and are less painful. Caregivers are instructed in preventing skin breakdown (pressure ulcers). If patients are unable to turn and develop pressure ulcers on the skin, the Hospice nurse may use special dressings that can be left on the compromised area and order specialized mattresses to assure comfort for the patient.