Safety, Infection Prevention, and Emergency Response
Infection prevention
Use standard precautions with every patient: hand hygiene before and after care, gloves when contact with body fluids is likely, and safe handling of sharps and soiled linens. Hand hygiene is the single most important measure. Follow transmission-based precautions when indicated. Keep the environment clean and dispose of waste per policy.
Safety
Prevent falls (clear paths, call light in reach, non-skid footwear), prevent burns (check water temperature), and prevent injury during transfers. Know the patient's code status and advance directives - in hospice, the plan may be comfort-focused rather than resuscitation.
Emergency response
Recognize changes (sudden shortness of breath, severe pain, bleeding, unresponsiveness) and call for help and report promptly. Follow the patient's documented wishes. Do not initiate interventions outside your scope or contrary to the plan of care.
Traps to watch
- Skipping hand hygiene because "the patient is dying anyway."
- Assuming every emergency calls for resuscitation - check the code status.
- Ignoring a fall or near-miss without reporting.
- Using gloves as a substitute for hand hygiene.
Rule of thumb
Clean hands, clear paths, and know the code status.
Worked example: A patient becomes suddenly short of breath and anxious. The assistant stays with the patient, calls for the nurse, raises the head of the bed, keeps the patient calm, and knows from the chart that the goal is comfort - not emergency resuscitation.
Documentation, Ethical and Legal Issues, and Self-Care
Documentation
Document objectively, promptly, and accurately: what you did, what you observed, and what you reported. Use quotes when relevant. Avoid opinions, blame, or speculation. Record refusals and who was notified. Late or altered documentation undermines credibility.
Ethical and legal principles
- Autonomy: the patient's wishes guide care.
- Beneficence/nonmaleficence: do good and avoid harm.
- Confidentiality: protect patient information (HIPAA).
- Scope of practice: stay within your role.
- Advance directives: know and honor them.
Report suspected abuse, neglect, or exploitation per law and policy. Never accept gifts that could compromise care or discuss patients outside the team.
Self-care
Hospice work carries cumulative grief. Recognize signs of burnout and compassion fatigue, use debriefing and support resources, maintain boundaries, and practice rest and reflection. Caring for yourself protects the care you give.
Traps to watch
- Charting opinions or conclusions rather than facts.
- Sharing patient information inappropriately.
- Performing tasks outside your scope.
- Ignoring your own grief and fatigue.
Rule of thumb
If it is not documented, it did not happen; if it is outside your scope, report it instead.
Worked example: After a patient dies, the assistant feels tearful and distracted. The assistant uses the team's debriefing and employee assistance resources, talks with a supervisor, and takes time to grieve - modeling healthy self-care rather than pushing through alone.