Nurses pursue standards on multiple fronts
Members of the Pittsburgh based-Hospice Nurses Association (HNA) voted in June to change the organization’s name to the Hospice and Palliative Nurses Association, paralleling a similar change last year for physicians in the American Academy of Hospice and Palliative Medicine. Meanwhile, HNA and several other nursing-related groups are proceeding on a number of fronts to bring added definition to the specialty of hospice nursing, while a few nurses attempt to carve out an additional niche for the advanced practice nurse in hospice care. (See related story, p. 92.)
HNA’s new bylaws take effect in October. "We want to make sure that expertise in palliative care is shared among nurses. There is not a nursing organization currently for palliative care," explains HNA president Susan Mann, RN, CRNH, vice president for medical and nursing services with Hospice Inc. in Wichita, KS. This name change does not affect HNA’s sister organization, the National Board for Certification of Hospice Nurses (NBCHN), also in Pittsburgh, formed by HNA to develop and supervise the certification examination that allows hospice nurses to carry the credential CRNH (certified registered nurse, hospice).
NBCHN, which offers its next certifying exam Sept. 20, will soon conduct a role delineation study, to gather data on how hospice nurses actually function in the field, says Mann. But its name is not likely to change, "unless the role delineation study tells us that there’s no difference between palliative care nursing and hospice nursing."
Meanwhile, the nurse section of the National Hospice Organization’s National Council of Hospice Professionals (NCHP) has drafted a set of Guidelines for Nursing in Hospice, which may soon go to NHO’s board of directors for approval. "Four years ago, the social work section of NCHP developed national guidelines for social workers. NHO then asked other disciplines in the council to develop like guidelines," explains Cindy Yocum, RN, CRHN, director of clinical services for Valley Hospice in Steubenville, OH, NCHP’s nurse section leader.
While HNA’s Standards of Hospice Nursing Practice and Professional Performance were published in 1995 and subsequently endorsed by the American Nurses Association (ANA), NHO’s guidelines are "a little looser. We’d hope that hospice agencies would choose to use them as a guide for nursing practice within their agencies," Yocum says. The guidelines touch on such issues as the scope of nursing services, caseloads, education, and salary requirements, as well as complementary therapies .
NHO’s nursing section has also been active in drafting another document for schools of nursing nationwide, Guidelines for Curriculum Development on End-of-Life and Palliative Care in Nursing Education. Primary authors are Yocum and Nancy English, PhD, RN, CCS, of Hospice of Metro Denver. HNA representatives and other nurses had input in developing these draft guidelines, which have also been shared with ANA and with the American Society of Deans of Nursing, "which is interested because they recently received a big grant to look at curriculum development," Yocum says.
Hospice executives have expressed frustration in hiring new nurses who have received little or no education in hospice and other end-of-life issues. The goal of the draft guidelines is to answer what is distinct and essential knowledge for hospice nursing and palliative care, as well as appropriate professional training. The document touches on such issues as the caring relationship, the human response to dying, and their relationship to nursing theory.
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