How to Become a Hospice & Palliative Care Nurse

What the role is

A hospice and palliative care nurse manages serious-illness symptoms and supports patients and families, but the two settings are distinct. Palliative care is comfort-focused care delivered at any stage of a serious illness, given alongside curative or disease-directed treatment, in hospitals, clinics, or homes. Hospice is end-of-life care for patients certified as terminally ill (a Medicare prognosis of 6 months or less if the illness runs its normal course), where the focus shifts entirely to comfort and curative treatment stops. The day-to-day work is pain and symptom management, goals-of-care conversations, family education and grief support, and close coordination with an interdisciplinary team. It's relationship-driven, often home- or community-based on the hospice side, and emotionally heavy in a way nurses describe as both draining and deeply meaningful.

Why nurses make this move

• Depth over churn: real time with patients and families instead of a 6-patient floor assignment turning over every shift.
• Mastery of pain and symptom management, a transferable, respected clinical skill set.
• Settings that fit different lives: home hospice, inpatient hospice units, or hospital-based palliative consult teams.
• Work many nurses call the most meaningful of their careers, with a strong sense of purpose and patient impact.

How to transition (even with no direct experience)

1. 1Get the distinction straight first, because interviews start here: palliative care is comfort care at any illness stage given alongside curative treatment, while hospice is end-of-life care for patients certified with a roughly 6-month prognosis where curative treatment has stopped.
2. 2Decide which setting fits you: hospital-based palliative consult teams (acute, fast-paced, alongside active treatment) versus hospice (home, inpatient unit, or facility, relationship-driven, end-of-life). The hiring paths differ.
3. 3Lean on the experience that counts: med-surg, oncology, ICU/critical care, ED, and home health all map well. Any end-of-life care, comfort care, or family-communication work you've done is directly relevant.
4. 4Reframe your resume around symptom management, goals-of-care and difficult conversations, family education, and interdisciplinary coordination, the core of the role.
5. 5Apply to hospice agencies and palliative care programs directly; many hire nurses without prior hospice experience and train them on the hospice-specific clinical and regulatory pieces.
6. 6Be honest with yourself about the emotional load. It's real, repeated loss is part of the job, and the nurses who last build deliberate self-care and lean on the team's bereavement support.
7. 7After about two years and once you meet the practice-hour requirement, sit for the CHPN to formalize your expertise; it's earned in the role, not required to start.

Breaking in when you don't have the experience yet

Stepping-stone roles that get you in the door:

• Oncology nurse: You already manage serious illness, complex symptoms, and goals-of-care conversations, the closest direct overlap with palliative work.
• ICU / critical care nurse: Comfort care, withdrawal-of-care, and supporting families at end of life are routine, and they read as directly relevant to hospice and palliative hiring.
• Home health nurse: Autonomous, home-based, family-centered care closely mirrors home hospice, the largest hospice setting.
• A hospital-based palliative consult team: An inpatient on-ramp that lets you build palliative skills alongside active treatment before moving to hospice, or as a destination in itself.

Clinical experience that transfers

• Oncology (you already manage serious illness, symptoms, and goals-of-care conversations)
• ICU / critical care (comfort care, withdrawal-of-care, and family support at end of life)
• Med-surg or ED (broad symptom management and high-acuity exposure)
• Home health (home-based, autonomous, family-centered care that mirrors home hospice)

Certifications

CHPN (Certified Hospice and Palliative Nurse), HPCC

The RN-level specialty credential from the Hospice and Palliative Credentialing Center (HPCC). Requires a current, unrestricted RN license plus 500 hospice/palliative practice hours in the most recent 12 months or 1,000 in the most recent 24 months. Certified for 4 years, then renewed via the HPAR accrual and a situational judgment exercise. Not required to start; earned once you're in the role.

ACHPN (Advanced Certified Hospice and Palliative Nurse), HPCC

The APRN-level credential, for experienced palliative NPs and CNSs. Requires an unrestricted APRN license, an accredited graduate NP or CNS program (with advanced pathophysiology, health assessment, and pharmacology plus a 500-hour practicum), and 500 advanced-practice hospice/palliative hours in 12 months or 1,000 in 24 months. This is the advanced-practice tier, distinct from the RN-level CHPN.

CHPLN (Certified Hospice and Palliative Licensed Nurse), HPCC

The LPN/LVN-level credential, for licensed practical/vocational nurses in the specialty. Included for completeness; RNs pursue the CHPN, not this one.

Preparing for a board exam? See the certification and board-exam prep guides, and keep your license current with the free CE catalog.

What it pays

$70,000–$100,000+

Hospice and palliative care nurses are RNs and have no distinct federal occupation code, so this range is anchored to the U.S. Bureau of Labor Statistics figure for Registered Nurses (29-1141): a median of $93,600/year (May 2024), with the middle range running roughly $66,030 to $135,320. Actual pay varies by setting (home hospice vs. inpatient vs. hospital palliative team), region, and on-call. Directional, not a guarantee; confirm against current postings.

Source: U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Registered Nurses (29-1141), May 2024. Actual pay varies by region, employer, setting, and experience.

Honest pros and cons

Frequently asked questions

What's the difference between hospice and palliative care nursing?

Palliative care is comfort-focused care for serious illness at any stage, given alongside curative or disease-directed treatment, in hospitals, clinics, or homes. Hospice is end-of-life care for patients certified as terminally ill (a Medicare prognosis of 6 months or less if the illness runs its normal course), where the focus shifts entirely to comfort and curative treatment stops. All hospice care is palliative, but not all palliative care is hospice.

Do I need the CHPN certification to become a hospice or palliative nurse?

No. The CHPN (Certified Hospice and Palliative Nurse), from the Hospice and Palliative Credentialing Center, is earned after you're in the role, not before. You need a current, unrestricted RN license plus 500 hospice/palliative practice hours in the most recent 12 months (or 1,000 in 24 months) before you can sit for it, so it formalizes expertise you build on the job. Most agencies hire and train nurses without it.

How much experience do I need to move into hospice or palliative nursing?

There's no fixed requirement, and many agencies hire nurses without prior hospice experience and train them. Acute-care backgrounds that transfer especially well include oncology, ICU/critical care, ED, med-surg, and home health, along with any end-of-life or comfort-care work you've done.

Is hospice and palliative nursing emotionally hard?

Yes, and it's the honest dealbreaker for some nurses. Repeated loss and end-of-life work are central to the job, and burnout and compassion fatigue are real risks. The nurses who last build deliberate self-care, use the team's bereavement support, and find the depth and meaning of the work outweighs the emotional cost, but it's worth being clear-eyed before you switch.

What does a hospice or palliative care nurse earn?

These nurses are RNs with no separate federal pay code, so the most honest anchor is the U.S. Bureau of Labor Statistics figure for Registered Nurses: a median of about $93,600 per year (May 2024), with the middle band running roughly $66,000 to $135,000. Actual pay varies by setting, region, and on-call. Treat ranges as directional and confirm against current postings.

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