Palliative care
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The Role of the Advance Practice Nurse in Palliative and Hospice Care
What is the difference be hospice and palliative care? What is the role of the Advance Practice Nurse in both hospice and palliative care? Are Advance Practice Nurses reimbursed for Hospice and Palliative care?
Resources
Please review the following Web resources:
Hospice Referral and Care: Practical Guidance for Clinicians
End-of-Life Care: Improving Communication Skills to Enhance Palliative Care
Principles of Effective Pain Management at the End of Life
A National Framework and Preferred Practices for Palliative and Hospice Care Quality
How Do I Bill Commercial Insurers for Palliative Care Consultations?
SAMPLE ANSWER
Palliative care is a type of care that mainly deals with relieving symptoms that are associated with chronic illnesses such as cancer. On the other hand, hospice care is a special type of care that focuses on supporting a patient with his/her family while at the same time focusing on relieving symptoms in the patient and providing comfort from various aspects such as pain and fatigue. Both palliative and hospice care aim at administering to patients a number of aspects such as medications, quality care and symptom relieving through a single program. However, there is some difference in the two types of care.
The number of hospice care programs is more than that of palliative care programs. Hospice care, which usually relies upon the family caregiver and a visiting hospice nurse, is administered at home and is overseen by hospice professionals. This happens after the patient is referred from the primary care physician. Palliative care on the other hand is made up of doctors, nurses and other practitioners in the medical care giving field. It is usually offered at the at the health facility where the patient receives first treatment and such facilities include hospitals, nursing homes and extended care facilities. (Wolfe, Hinds & Sourkes, 2011, pg 190)
For one to be put under hospice care, he/she must be in a condition that makes him/her considered being at a terminal stage. However, there are no time restrictions in palliative care and the patient can receive this treatment at any stage of illness. (Wolfe, Hinds & Sourkes, 2011, pg 190)
Hospice programs focus more on availing care that provides comfort to their patients than aggressive disease abatement. In comparison, the treatment offered in palliative care is aimed at prolonging life. (Wolfe, Hinds & Sourkes, 2011, pg 189)
Advance practice nurses play a pivotal role when it comes to providing both palliative and hospice care. In providing palliative care, the role of advanced practice nurses extends beyond their wide knowledge in care giving and evidence based practice to improved communication skills that enhance the providing of quality palliative care to patients through the process of making critical decisions that are informed. Their roles also include facilitating education programs to both the patients and their families and providing psychosocial-spiritual care. In general the presence of advance practice nurses enhances the access to palliative care. (In Ferrell, In Coyle & In Paice, 2015, pg 1084) In hospice care, the main role of advance practice nurse is to ensure that the day-to-day welfare of the patients are met and such can include things such as ensuring that all the patients are provided with their meals and medication and they leave in hygienic conditions. Advanced practice nurses are also expected to ensure that the nurses in hospice programs provide a conducive environment to their patients since most of them are usually in a vulnerable state. It is also the work of advance practice nurses to ensure that the family members of patients are educated on how to ensure that the patients live comfortably. (DeNisco & Barker, 2013. pg 81)
Over the recent years, many healthcare facilities have been adopting the palliative care programs despite the fact that most insurance companies do not cover for these services. In such facilities, advanced practice nurses have continued to provide palliative care although they are not reimbursed for these services since the insurance companies do not cover these services. However, organizations such as Center to Advance Palliative Care (CAPC) are working to overcome this challenge by sourcing for funds to oversee the delivering of palliative care. Health facilities that have received these funds have been able to reimburse their advance practice nurses. In the case of hospice care, the nurses receive reimbursements. (Cowen & Moorhead, 2014, pg 203)
References
Cowen, P. S., & Moorhead, S. (2014). Current Issues In Nursing. London: Elsevier Health Sciences.
DeNisco, S., & Barker, A. M. (2013). Advanced practice nursing: Evolving roles for the transformation of the profession. Burlington, Mass: Jones & Bartlett Learning.
In Ferrell, B., In Coyle, N., & In Paice, J. A. (2015). Oxford textbook of palliative nursing.
Wolfe, J., Hinds, P. S., & Sourkes, B. M. (2011). Textbook of interdisciplinary pediatric palliative care. Philadelphia: Elsevier/Saunders.
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