What is a Hospice Nurse Practitioner? (Duties, Steps to Become, & Salary)


Written By: Kasee Wiesen DNP, APRN, FNP-C

In 2021, 1.7 million people received hospice care for at least one day. That is a significant statistic, and hospice nurse practitioners play a substantial role in these patients’ lives. So, what is a hospice nurse practitioner? The hospice NP emphasizes caring for the whole person instead of trying to cure them of their illness or disease. This includes developing individualized treatment plans for each patient, collaborating with other healthcare providers and services, and providing comfort and support for the patient and their family.

Below, you will learn more about hospice nurse practitioners, including what they do, steps to become one, and salary information.



What Does a Hospice Nurse Practitioner Do? – 6 Main Duties and Responsibilities


1. Collaborate with other health professionals:

A hospice NP will collaborate to coordinate patient care. This includes the patient's primary care provider or hospitalist if they are inpatients. You will work closely with other specialties involved, including oncology, pulmonology, cardiology, etc. You will also work with physical therapy, occupational therapy, and other support services such as social work to ensure your patient is receiving the care needed.

2. Perform physicals and assessments routinely:

As a hospice NP you will perform routine physicals and assessments on your patients to ensure the treatment plan prescribed is appropriate—if it is not, you will alter the treatment plan and update those involved in the patient's care.

3. Develop treatment plans:

Developing comprehensive treatment plans for your patients is one of your roles as a hospice NP. This includes prescribing medications for mood and pain, therapies, and other supports such as medical equipment. Yes, hospice patients make the decision not to continue treatments that will prolong life, but they still receive treatment to help keep them comfortable.

4. Prescribe medications:

Prescribing a wide range of medications is another role of the hospice NP. A typical class of medications you will prescribe are pain medications to help keep the patient comfortable. Still, they can also help with other non-pain-related symptoms, such as shortness of breath.

5. Be available to family and answer questions:

As a hospice NP you are a source of comfort and answers for the hospice patient's family. It is essential that you factor time in to ensure you answer questions from the family and explain any changes in the patient's treatment plan.

6. Provide comfort and support to the patient:

Lastly, as a hospice NP, you are a source of comfort and support for the patient. The goal for the hospice NP is to keep their patient mentally, physically, and emotionally comfortable.

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Where Do Hospice Nurse Practitioners Mostly Work? – Top 3 Work Settings


1. Outpatient/Home Health:

As a hospice nurse practitioner you may work in the outpatient setting, which often includes going into patient's homes. This is very common as many hospice patients remain at home or transition back to their house—and one reason for this decision is that it is more comfortable for the patient. You will visit your patients daily or on an as-needed basis to ensure they are comfortable, and the treatment plan meets their healthcare needs.

2. Inpatient/Hospitals:

As a hospice nurse practitioner you may also work in the hospital or inpatient setting. It is not uncommon for patients to initiate hospice care while in the hospital or need hospice care throughout their hospital stay. This supports the need for hospice NPs in the inpatient setting to ensure the treatment plan meets the patient's healthcare needs.

3. Long-Term Care Facilities:

While some patients transition to hospice care at home, others need to be better to do so and instead transition into long-term facilities. As a hospice NP that cares for these patients, you may be affiliated with outpatient hospice organizations or specific to long-term care facilities. In the town where I practice, one of the long-term care facilities has a particular wing for hospice patients who are near death. This space allows the patient to have a large suite to enable the family to be with and even sleep over with the patient, have continuous nursing care, and have quick access to the hospice NP.



What is the Typical Work Schedule and Work Hours of a Hospice NP?


The schedule of a hospice NP varies based on the setting worked. An inpatient hospice NP typically works three or four days a week from 7 am or 8 am to 5 pm, including a specified number of weekends and holidays. I know a couple of inpatient hospice NPs, and they are assigned weekends to work but only have to go in if there are patients on their caseload. Otherwise, they are on call.

The hospice NP working in the outpatient or long-term care setting will have similar hours but may have to take overnight calls a few times a month. I also know a couple of NPs working in this setting, and their call involves clarifying or giving orders, and they rarely have to go to the patient's house.



What Education is Required to Become a Hospice Nurse Practitioner After High School?


To become a hospice nurse practitioner, you must first graduate from an accredited BSN nursing program—this can be achieved through completion of a traditional BSN program or an RN to BSN program. Once you have your BSN, you may then apply to graduate school, specifically a nurse practitioner program—and this can be either an MSN or DNP program.

You will have to declare an NP specialty when applying to graduate school. I recommend family practice or adult gerontology, as the curriculum within these programs will help prepare you to become a hospice NP.



How Long Does It Take to Become a Hospice NP After High School?


Program TypeProgram Length
BSN36 to 48 Months
BSN-to-MSN (NP)12 to 24 Months
BSN-to-DNP (NP)36 to 48 Months



How Much Does It Cost to Become a Hospice NP After High School?


Program TypeProgram Cost
BSN$8,730 - $219,450
BSN-to-MSN (NP)$20,740 - $201,980
BSN-to-DNP (NP)$28,390 - $277,320



What is the Step-By-Step Process of Becoming a Hospice Nurse Practitioner After High School?


To become a hospice nurse practitioner, you must complete specific steps to be successful. Below, you will find a step-by-step process to achieve this goal.

STEP #1:

Complete your BSN and become a registered nurse (RN). The first step to becoming a hospice NP is to graduate from an accredited BSN program and pass the NCLEX. Once you complete these two steps, you can obtain an RN license in your state of residence.

STEP #2:

Gain experience caring for palliative and hospice patients: While this step is not required, I strongly recommend a minimum of 1-2 years of experience as a nurse. If becoming a hospice NP is your goal, I suggest that this experience includes caring for patients receiving palliative or hospice care.

STEP #3:

Apply to graduate school: Next, apply to graduate/NP school—either an MSN or DNP program. Be mindful that when applying to NP programs, you must declare a specialty, and I’d recommend family practice or adult gerontology if becoming a hospice NP.

STEP #4:

Graduate from an accredited NP program.

STEP #5:

Pass the board certification exam and obtain NP licensure: Once you graduate from an accredited NP program, you must pass the certification exam specific to the specialty selected in NP school. Once you pass this certification exam, you can apply for NP licensure in your state of residence (you must have an active RN license to obtain an NP license).

STEP #6:

Apply to hospice NP jobs: Now, apply to hospice NP jobs. Please note that you can start this step before your accredited NP program graduation.

STEP #7:

Obtain recommended hospice NP certifications: This step is not required, but obtaining the Advanced Certified Hospice and Palliative Nurse (ACHPN®) certification is highly recommended. This helps you stand out from other applicants by demonstrating your commitment, knowledge, and use of evidence-based medicine when caring for patients receiving hospice.

STEP #8:

Lastly, enjoy your career as a hospice NP!



What are the Required or Recommended Certifications for Hospice Nurse Practitioners?


The Advanced Certified Hospice and Palliative Nurse (ACHPN®):

The ACHPN is a certification for advanced practice hospice and palliative care nurses. This certification is optional but highly recommended as it demonstrates the NP's commitment to providing high-quality, evidence-based hospice care.



Are There Any Fellowship or Residency Programs Available for Hospice Nurse Practitioners?


There are multiple fellowship and residency programs available to the hospice nurse practitioner. I will discuss two programs below, but many others are available throughout the United States.

Nurse Practitioner or Physician Assistant Hospice and Palliative Medicine Fellowship (Mayo Clinic College of Medicne and Science-Minnesota):

This is a great fellowship opportunity for hospice nurse practitioners as you will train alongside the physician fellows pursuing hospice and palliative medicine. This one-year program focuses on communication skills, non-pain symptom management, and pharmacology.

St. Luke’s Hospice and Palliative Medicne Advanced Practioner Fellowship:

This fellowship program is one year long and provides the opportunity to train alongside physicians and physician assistants. The interprofessional education and collaboration ensures identical training among practitioners and physicians, leading to consistent and high-quality care.



What is the Starting Salary of a New Grad Hospice Nurse Practitioner?


The starting annual salary of a new grad hospice nurse practitioner is $86,720. This will break down to $7,230 a month or $41.69 an hour. The starting salary is influenced by multiple factors, including the city/state where you work, years of experience as a nurse, and certifications you may have.

Hourly$41.69
Weekly$1,668
Monthly$7,230
Annual$86,720



What is the Average Salary of a Hospice Nurse Practitioner?


The average hospice nurse practitioner salary is $59.52 an hour, which leads to an annual salary of 123,800. The salary of a hospice nurse is influenced by factors such as working in a rural community versus an urban community, years of experience, and whether you work full-time versus part-time.

Hourly$59.52
Weekly$2,381
Monthly$10,320
Annual$123,800
(Source: Nursingprocess.org)



What is the Salary by Level of Experience of a Hospice NP?


As I have mentioned above, the salary of a hospice nurse practitioner is influenced by years of experience as both a nurse and a nurse practitioner. An entry-level hospice nurse practitioner has an average annual salary of $86,720, compared to the yearly salary of a hospice nurse practitioner with 5-9 years of experience, which is $120,750. The annual average wage of hospice nurse practitioners with 20 years of experience or more is $164,070.

Level of ExperienceHourlyWeeklyMonthlyAnnual
Entry-Level$41.69$1,668$7,230$86,720
1-4 Years of Experience$49.29$1,972$8,540$102,520
5-9 Years of Experience$58.05$2,322$10,060$120,750
10-19 Years of Experience$64.67$2,587$11,210$134,510
20 Years or More Experience$78.88$3,155$13,670$164,070



What is the Average Salary of a Hospice NP by State?


StateHourlyWeeklyMonthlyAnnual
Alabama$50.89$2,036$8,820$105,860
Alaska$55.56$2,223$9,630$115,570
Arizona$57.96$2,318$10,050$120,550
Arkansas$51.13$2,045$8,860$106,350
California$75.49$3,019$13,080$157,010
Colorado$55.59$2,223$9,640$115,620
Connecticut$62.77$2,511$10,880$130,560
Delaware$57.56$2,302$9,980$119,720
Florida$52.66$2,106$9,130$109,530
Georgia$55.11$2,204$9,550$114,630
Hawaii$61.25$2,450$10,620$127,400
Idaho$56.20$2,248$9,740$116,890
Illinois$58.39$2,336$10,120$121,450
Indiana$58.11$2,324$10,070$120,870
Iowa$61.19$2,448$10,610$127,280
Kansas$53.31$2,132$9,240$110,880
Kentucky$52.17$2,087$9,040$108,520
Louisiana$56.43$2,257$9,780$117,380
Maine$56.48$2,259$9,790$117,470
Maryland$57.12$2,285$9,900$118,810
Massachusetts$66.21$2,648$11,480$137,720
Michigan$54.32$2,173$9,420$112,980
Minnesota$61.18$2,447$10,610$127,260
Mississippi$55.98$2,239$9,700$116,430
Missouri$54.03$2,161$9,370$112,380
Montana$57.26$2,291$9,930$119,110
Nebraska$56.79$2,272$9,840$118,130
Nevada$65.03$2,601$11,270$135,270
New Hampshire$60.04$2,402$10,410$124,890
New Jersey$68.38$2,735$11,850$142,240
New Mexico$61.85$2,474$10,720$128,650
New York$67.53$2,701$11,710$140,470
North Carolina$54.63$2,185$9,470$113,640
North Dakota$54.39$2,176$9,430$113,140
Ohio$56.06$2,243$9,720$116,610
Oklahoma$58.12$2,325$10,070$120,880
Oregon$65.04$2,602$11,270$135,290
Pennsylvania$57.55$2,302$9,980$119,700
Rhode Island$59.79$2,392$10,360$124,370
South Carolina$52.10$2,084$9,030$108,360
South Dakota$55.19$2,208$9,570$114,790
Tennessee$47.42$1,897$8,220$98,630
Texas$59.51$2,380$10,320$123,780
Utah$55.19$2,208$9,570$114,790
Vermont$55.67$2,227$9,650$115,790
Virginia$55.84$2,234$9,680$116,150
Washington$64.73$2,589$11,220$134,630
West Virginia$50.98$2,039$8,840$106,040
Wisconsin$57.86$2,314$10,030$120,350
Wyoming$55.01$2,200$9,540$114,420



What is the Job Outlook Like for This Career?


The job outlook for a hospice nurse practitioner is excellent, with more than 44% growth between 2022 and 2032. This is exceptionally higher than many careers, which may be due to the growing and aging population.

Providers, including nurse practitioners, are more comfortable initiating the conversation about hospice care and the benefits of this specialty for patients and families. I have seen hospice consulted more in my career—by family practice and other specialties—leading to an increased need for hospice nurse practitioners to meet patients' demands and healthcare needs.

2022-32
+44.54%



Useful Organizations and Associations


1. American Academy of Hospice and Palliative Medicine (AAHPM)

2. National Hospice and Palliative Care Organization (NHPCO)

3. National Association for Home Care & Hospice

4. Hospice and Palliative Nurses Association (HPNA)




My Final Thoughts


Hospice nurse practitioners play an essential role in our healthcare system. They care for patients in their most vulnerable state, providing comfort, support, and care to patients and their families. The impact that these providers leave behind is often life-long, and I cannot count the number of times I am told by family members who have lost a loved one that the hospice NP and hospice team were such a blessing during a challenging time.

After reading the above, I hope you can answer the question, what is a hospice nurse practitioner? You should now have a strong understanding of what a hospice nurse practitioner is, including what they do, steps to become, and salary information?



Frequently Asked Questions Answered


1. On Average, How Much Does A Hospice NP Make Per Hour?

The average salary of a Hospice nurse practitioner per hour is $59.52.

$59.52


2. On Average, How Much Does A Hospice NP Make Per Week?

The average salary of a Hospice nurse practitioner per week is $2,381.

$2,381


3. On Average, How Much Does A Hospice NP Make Per Month?

The average salary of a Hospice nurse practitioner per month is $10,320.

$10,320


4. On Average, How Much Does A Hospice NP Make Per Year?

The average salary of a hospice nurse practitioner per year is $123,800.

$123,800



List of Sources Used for This Article


1. https://www.statista.com/statistics/339851/number-of-hospice-patients-in-the-us-per-year/#:~:text=In%202021%2C%201.71%20million%20Medicare,focuses%20on%20caring%20not%20curing.
2. https://www.advancingexpertcare.org/hpcc/credentials/achpn/
3. https://college.mayo.edu/academics/health-sciences-education/nurse-practitioner-or-physician-assistant-hospice-and-palliative-medicine-fellowship-minnesota/curriculum/
4. https://www.slhn.org/graduate-medical-education/residencies-and-fellowships/hospice-palliative-medicine-advanced-practitioner-fellowship


Kasee Wiesen DNP, APRN, FNP-C
Kasee Wiesen is a practicing family nurse practitioner. Her nursing background includes emergency medicine, pediatrics and peri-op. Education is a passion of Kasee’s, and she has taught BSN, RN-BSN and DNP students, and has enjoyed every moment of it!