I remember having some nurses tell me that nurses who go into hospice lose their skills because they are dealing with people who are dying. Little did they know that hospice nurses often need to think far more critically than other nurses. Let's outline some key areas as a .

Case-Based Approach

A case-based approach to learning critical thinking skills is essential for hospice nurses. It involves asking questions about the patient's situation to determine the information they have and need. Hospice nurses must be detectives, gathering clues and piecing together a picture of the patient's physical, emotional, and spiritual needs.

Nursing Process

The nursing process is a fundamental principle for developing critical thinking skills for hospice nurses. It involves five steps: assessment, , outcomes/planning, implementation, and evaluation. Hospice nurses must understand this process as a lived experience in the learning environment to provide quality patient care.

Continual Learning

Hospice nurses who demonstrate critical thinking understand the importance of continuous learning. They take advantage of every opportunity to ask questions, learn new skills, and implement knowledge into daily practice. They are open-minded and always looking for ways to improve their patient care.

Autonomy and Decision Making

Hospice nurses must be able to think critically to make decisions independently and interdependently. They must be able to weigh the benefits and risks of different interventions and make the best decision for their patient. Hospice nurses must also have the psychosocial skills to interact with terminally ill patients and their families, considering cultural and personal beliefs and preferences.

Symptom Management

Symptom management is a critical aspect of , and hospice nurses must use their critical thinking skills to manage a patient's symptoms for comfort. They must know which interventions are appropriate for different symptoms and be able to adjust treatments based on the patient's response. They also need to communicate effectively with other care team members to ensure a coordinated approach to symptom management.

Revocation and Death and Dying

Hospice nurses need to be able to think critically when a patient revokes or when death is imminent. They must know how to emotionally support the patient and their family during this challenging time. Hospice nurses must also be able to coordinate care with other healthcare professionals and provide bereavement support to the family after the patient's death.

In summary, critical thinking is essential for hospice nurses to provide safe, quality care to terminally ill patients. It involves a case-based approach to learning, understanding the nursing process, continual learning, autonomy, decision-making, symptom management, revocation, and death and dying. As a , I know how challenging it can be to provide end-of-life care, but with critical thinking skills, we can provide comfort, support, and dignity to our patients and their families.

Resources

The Value of Critical Thinking in Nursing

Clinical Reasoning, Decision making, and Action: Thinking Critically and Clinically

18 Simple Tips to Improve Critical Thinking in Nursing

Why Critical Thinking Skills in Nursing Matter (And What You Can Do to Develop Them)

Top 30 FAQs About Hospice: Everything You Need to Know

Understanding Hospice Care: Is it Too Early to Start Hospice?

What's the process of getting your loved one on hospice service?

Picking a hospice agency to provide hospice services

Medicare — Find and compare hospice providers

Providing Comfort During the Last Days of Life with Barbara Karnes RN (YouTube Video)

Preparing the patient, family, and caregivers for a “Good Death.”

Velocity of Changes in Condition as an Indicator of Approaching Death (often helpful to answer how soon? or when?)

The Dying Process and the End of Life

The Last Hours of Life

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Gone from My Sight: The Dying Experience

The Eleventh Hour: A Caring Guideline for the Hours to Minutes Before Death

By Your Side, A Guide for Caring for the Dying at Home

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