Jenna Applebach

Home Health Care Reflection Log

For my home health care rotation, I worked with Hospice of Big Rapids. Although I
gained some more experience in this area, I am not so sure I would want to work with hospice in
the future. Working with patients who are dying is not the most appealing to me.
The common ages of the clients were generally age 60 all the way up to age 99. The level
of prevention addressed primarily included tertiary prevention, as the people who were being
cared for were in the process of dying. At this point, only medications that helped them to feel
more at comfort were provided, as well as supplemental oxygenation. The nurses, in this this
setting, primarily assess the patients physically as well as take and record their vital signs. They
perform catheterizations as needed. They ask the clients questions about their health and any
areas of concern as appropriate. They also refill any medications that may be running low and
provide emotional support to family members and their clients as needed.
The nurses in this setting typically collaborate with other hospice nurses who are caring
for the same clients as well as physicians who are overseeing the pharmacotherapy of the clients.
They may even collaborate with social workers. In order to become a hospice nurse, the
licensure needed includes, of course, an ADN or BSN as well as certification under the National
Board for Certification of Hospice and Palliative Nurses.
Typical sources of funding for hospice nursing include Medicaid, Medicare, and private
health insurance for for-profit hospice companies. Non-profit hospice companies are financed
primarily by donations from their corresponding communities. Nurses provide care to vulnerable
populations in this setting in that their care includes all terminally-ill people, including the poor.
There is no discrimination. Hospice care is a right to all who seek its services, regardless of
socioeconomic background. In this case, the poor would be a vulnerable population.

Jenna Applebach
The types of nursing skills I performed included therapeutic communication with family
members and physical assessments. Otherwise, I was not allowed to chart on any of the clients or
record any other information. The main insight I gained about hospice nursing is that these
nurses must be very emotionally stable, as they get to know the terminally-ill clients and their
families quite well and the death of the client can sometimes be difficult to deal with. Also, these
nurses must be very good at therapeutic communication. They must help to console upset family
members. They must also be very good at communication and teaching in general, as they are
expected to teach quite a bit to the family members about the care of the terminally-ill client. I
know, for a fact, that I do not want to work as a hospice nurse. At least, not towards the
beginning of my nursing career. I may feel differently about it in the future, however.