Author: Peter Abraham, BSN, RN

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Peter Abraham is a seasoned nurse committed to supporting nurses, caregivers, families, and patients in their learning, growth, and well-being journey. His extensive nursing career includes practical experience as a cardiac telemetry nurse in a dynamic cardiology unit at a Magnet-awarded teaching hospital. Additionally, Peter has served as a second-shift RN supervisor, managing an entire building in a Skilled Nursing Facility/Long-Term Care (SNF/LTC) setting with 151 residents. Notably, during the initial wave of COVID-19, the facility achieved an impressive near-100% recovery rate before the completion of Operation Warp Speed.

Peter's nursing career also extends to rural home hospice care. As a visiting hospice registered nurse case manager, he provides compassionate care to patients in various settings, including private homes, personal care homes, assisted living facilities, skilled nursing facilities, and hospitals. His dedication to compassionate care led to the establishment of the Peter Abraham Wound Care Scholarship, which offers education in wound care. This scholarship, associated with the theme of "Wound Care: Enhancing Healthcare for the Aging Population," underscores Peter's commitment to improving care for those in need.

Peter is the author of Empowering Excellence in Hospice: A Nurse's Toolkit for Best Practices, Holistic Nurse: Skills for Excellence, Compassionate Caregiving, and the Dementia Care Essentials series on Amazon. His work aims to provide valuable resources and guidance for hospice care professionals, ensuring that patients and their families receive the best possible support during challenging times.

Beyond his hands-on care, Peter also writes articles to empower caregivers, family members, and fellow nurses in end-of-life care. His passion for helping others is deeply rooted in his love of Christ Jesus. To learn more about Peter, you can listen to an interview by Marie Betcher, RN, on her Hospice Explained Podcast Series, as well as subscribe to his YouTube channel at https://www.youtube.com/@NursePeter

Understanding Terminal Restlessness

Navigating the final days of a loved one's life can be a challenging and emotional journey. One of the signs that can be observed during this time is known as terminal restlessness. As someone deeply rooted in hospice care, I have witnessed various manifestations of this restlessness. Understanding its types, causes, and management strategies is crucial for providing compassionate end-of-life care. This article aims to illuminate the different kinds of terminal restlessness, identify reversible causes, and discuss effective management techniques. By equipping caregivers, families, and healthcare professionals with this knowledge, we can ensure that terminally ill individuals experience comfort and dignity in their final days.
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Is it hard to work in the field of hospice?

People often say to me, "It must be challenging to work in hospice." Unfortunately, due to HIPAA regulations, I cannot share photos of the events that occur. However, let me share a poignant moment from today—a dying individual's final wish was to feel the warmth of the sun on their face one last time. And we made that wish come true. This seemingly simple gesture held immense significance for both the patient and their family.
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Time Management Tips for New Visiting Nurses

One of the main challenges of new nurses is time management. In a hospital or nursing home setting, you often have coworkers to rescue you in a pinch in case you are overwhelmed; on top of having nearby coworkers, most orientation programs, as well as nursing schools, focus on time management skills in a facility setting. Yet what about time management as a visiting nurse — in home health or home hospice or both? Let me share with you my wisdom and experience in time management in the field of a visiting nurses to hopefully help you have more time for life compared to work — a better work-life balance.
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Tips for new hospice nurses doing an admission

If you are a new nurse to hospice, one of the tasks you probably dread is doing an admission especially if you have scheduled visits the same day as the admission. I would like to share with you some tips that when applied may help lower your stress level, and help you remain on time even in cases where you have three to four visits including recertification to do the same day.
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Early detection of COVID-19 in the elderly

These are my experiences as a registered nurse caring for geriatric patients in a long-term & rehab care setting where I was the house supervisor responsible for up to 151 residents along with managing the second shift healthcare staff. By now, you’ve probably had your temperature checked ad nauseam as you visit different locations. Yet, is checking the temperature of your elderly loved ones a good way to know if they may have COVID-19? Are you aware that according to Vital Signs in Older Patients: Age-Related Changes, “older patients are less able to mount a fever response.” Most of my geriatric patients did not have a fever when they contracted COVID-19, and most remained afebrile (without fever) through their stay in the COVID unit. What’s a more reliable sign of potential COVID-19 infection in the elderly?
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DNR and the Terminally Ill

Navigating conversations about Do Not Resuscitate (DNR) orders with terminally ill patients and their families can be challenging yet crucial for ensuring that the patient's wishes and comfort are prioritized. The decision between opting for DNR or full code often involves delicate emotions, medical considerations, and ethical concerns. In this article, we will delve into a methodology that has proven effective in facilitating these discussions, particularly in the context of hospice care. Drawing from years of experience and successful outcomes, we'll explore approaches that prioritize compassion, clarity, and patient-centered care. Additionally, we'll reference valuable resources to enhance understanding and guide these critical conversations.
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INFJ and being a hospice nurse

As an INFJ, I’m almost constantly introspective. Today, I was helping with an emergency where one of our wonderful on-call nurses was in a car accident. During my visit with a patient I admitted yesterday who is transitioning towards actively dying, I was in bewilderment in my mind about how comfortable and peacefully patient I am when I’m around the terminally ill and their family.
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Common Misconceptions about Morphine and End-of-Life Medications

Morphine is a crucial medication in end-of-life care, but it's often misunderstood. This article debunks common myths about morphine use in hospice, addressing concerns about addiction, hastening death, and sedation. Learn the truth about morphine's role in providing comfort and dignity for terminally ill patients.
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End-of-Life Decisions: Don’t wait until it’s too late for advanced directives

Advanced Directives
Autonomy, the right to receive or refuse medical treatment is a crucial element of health care ethics (American Nurses Association (ANA), 2011; Plakovic, 2016). Nurses are involved in helping patients and families be aware of when end-of-life is occurring, and in educating the patient and family about end-of-life legislation that helps guide everyone committed to continue the right of patient autonomy when the patient is no longer able to express their wishes. Before the Patient Self Determination Act, we had the famous cases of Karen Ann Quinlan and Nancy Cruzan who were, from a point-of-view, forced to suffer for ten or more years of futile treatment (Miller, 2017). Now, we have advanced directives that allow patients to express their wishes while they are able, yet we still have ethical dilemmas when either those needs are expressed vaguely or not at all. It is in the best interest of the patient and the patient's loved ones for advanced directives to be utilized and kept up to date.
Read MoreEnd-of-Life Decisions: Don’t wait until it’s too late for advanced directives
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