From its small-scale, community-based roots, hospice care in America has evolved into a competitive, highly-regulated industry. Hospice nurses today often find themselves challenged by increased patient caseloads, faster-paced work environments, and ever-growing documentation demands. This article addresses these issues through the lived experience of the author, a registered nurse who has worked "at the bedside" with terminally ill patients for over two decades. It also touches upon some of the additional challenges associated with delivering hospice care "after hours," and in non-traditional settings such as nursing facilities and acute-care hospitals. The author concludes that it is still possible to successfully navigate the complexities of end-of-life care in the 21(st) century without losing one's "hospice heart."
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