Hospices Lean on Nonclinical Staff During COVID-19

Nurses and clinicians have been on the frontlines of hospice care during the coronavirus pandemic. However, the unsung heroes of hospice are those who are working behind the scenes in nonclinical roles to help keep the operational fires burning.

Health care organizations nationwide — and the communities they serve — are recognizing frontline staff for their efforts as they risk their own health to continue patient care during the COVID-19 outbreak.

“There are several categories of people who are heroes within our home care and hospice organization,” said Kellie Brockman, director of business development at North Carolina-based Duke HomeCare & Hospice. “Our clinicians are absolutely heroes, but it takes a team. There is a whole group of people on the operation side.”


Hospices are expanding the definition of “hero” in this time of crisis to include individuals performing a variety of nonclinical roles. Hospices are calling for more recognition of their nonclinical staff continuing to work through challenges brought on by the pandemic.

“Everybody who works in health care is impacted by this pandemic in one way or another,” said Vickie Leff, hospice and palliative care clinical social worker and previous board member for Social Work Hospice & Palliative Care Network (SWHPN). “Everybody is involved. It’s an incredible sacrifice to be on the frontlines, but the verbiage of ‘hero’ can be very visceral. I think it puts a great responsibility on the individual and can give the feeling that they’re being judged by how hard they fight. When we identify just a select group of heroes, we burden them terribly with the idea that they cannot act any other way. Assigning hero status can come with the cost of not allowing folks to ask for help if they need it. If you’re a hero, you’re not allowed to take a day off.”

Hospice executive leaders are among the nonclinical personnel that support clinicians as the outbreak continues putting pressure on organizations. Roles such as billing and accounting, human resources, administrative and office support, communications, IT and donor fundraising all play vital parts in a cohesive operation.


The pandemic has brought a barrage of new challenges to each clinical and nonclinical aspect of a hospice organization. New billing codes, guidelines for staff and patient safety, procedures and policies, and economic strains have been among the nuances providers have had to navigate. While it’s all hands on deck, the general public has focused their appreciation and encouragement on clinical staff who are f at the greatest risk of exposure to COVID-19.

“We all show up to work; we’ve got some restrictions, but we’re doing the very best we can,” said Leff. “Everyone is challenged in a different way. If you’re touching health care in any way shape or form, then it’s likely impacting you. In a really extraordinary way, the pandemic is unveiling how difficult health care in hospice can be for doctors, nurses, administrators, social workers — it’s intense. It’s all one big group; no one can do this by themselves. It doesn’t work that way.”

Many hospice staff teams have increasingly become more interconnected, moving into different or entirely new roles and settings altogether. As providers reorganize and redeploy staff to minimize risk of spread, employees are stepping into patient or non-patient serving areas or working in remote capacities with one another to continue care. Hospice staff teams are growing more connected through collaborative efforts.

“Everyone matters and everybody’s role plays a difference every single day, not just in a pandemic,” Brockman told Hospice News. “When this is something that’s in our rearview mirror, we’ll all hopefully always remember every person and remember what they bring to the table each day.”

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