Hospice: Knowledge and Wisdom Worth Dying For

Leading up to May 2007, I had worked in a variety of nursing areas. I have worked in long-term care facilities, Peds, PICU, NICU, PASU, ICF/MR, SDC, OPS, and Endo. Wow, there are a lot of abbreviations in the world of medicine. I made the decision to step out of management and into the world of Hospice. Nurses Announcements Archive Article

Hospice: A New Direction

Now I wasn't just stepping back into a direct care role on "the floor" of Med/Surg. No, I took a role as a field nurse in an area considered taboo by even the best nurses.

Most nurses cringe when hearing that name with the usual remark, "I could never work there. It takes a special person to work in that area."

Yes, I accepted the job and began working the first week of May 2007 in none other than Hospice. I chose Hospice because it really was nothing like what I had worked in the past. I thought it would get me out of the hospital walls and the headache of management.

I had worked in community health nursing in the past an enjoyed the autonomy it allowed. The time for private thought and traveling farther than the bathroom or the cafeteria was oddly appealing to me. It even seemed weird to say but I thought after working in management I owed it back to the direct care nurse to put my hands to the grindstone, a philosophy I appreciated as a floor nurse and held myself to as the coordinator. I looked forward to giving of myself to my patients. What I have gotten from my patients, however, has left me often feeling like the receiver instead of the giver.

Hospice: A Never-Ending Experience

In a nutshell, the Hospice philosophy is to provide the patient with the best quality of life for as long as the patient is alive. That sentence doesn't give Hospice justice, but this article isn't about what we as nurses can do for the patient. This article is about what the nurse takes away from the experience.

Call me the eternal optimist, but in a world where gray clouds loom and joy gets robbed with every heartbeat, I believe God provides a silver lining. In the realm of a dying person, there are always treasures to uncover. I never imagined how a job taking care of others in their greatest time of need could give back so much. Sure, every day I see a patient and I am reminded that my problems are not life ending. Every moment helping them when they deal with pain or breathing difficulty I thank God my problems are life changing, not life-threatening. Every time a patient dies I know I am blessed to be alive.

Patients Share The Greatest Wisdom

I am amazed when out of the crackling voice of a dying patient comes words of clarity, truth, and strength. When we are not treating, comforting, and answering questions; when our mouths are shut and our ears are open, it is the patient who usually has the greatest wisdom to share.

In providing the best quality of life to a dying person, it is that person who has spoken so much into my life. I find myself driving away from the home speechless at the boldness and profound words that pour out of them. In eight months I am honored that my life has been blessed by my patients. I honor the wisdom, knowledge, and strength of a man, woman, or child who faces the greatest unknown and has made peace with their life. They get it. They understand it. If only we, the non-terminally ill nurse, social worker, therapist, and the doctor could learn to live with that passion and boldness. If only we could learn to live like we were dying. It is that knowledge and wisdom when we listen, that is worth dying for.

T.J. Bristle RN BSN CLNC

Specializes in midwifery, NICU.

Just a wee update., my "Best Boy", he died on Saturday, which was my day off. I called work for some trivial thing, and was told he had gone. My heart was so sore, but relieved for him at the same time. No more pain, no more suffering, for him and his wonderful parents. My colleague told me, she thought he waited to go when it was my one day off, as me and the wee guy shared smiles and mutual admiration! This was such a sweet thought, but tears still flowed. Nursing is not always about life at all costs, its about getting the best from life whilst possible, then if its going to be so, having an easy and peaceful death.

He had such a death, easy and peaceful, wrapped in the arms of his parents, outside on a warm and sunny June day, knowing that he was loved, but knowing it was ok to go to where he had to go. My best Boy, may the angels cuddle you tight, and wake you in the morning with sweet songs and gentle kisses, X

Specializes in ICU, SDU, OR, RR, Ortho, Hospice RN.

Danissa,

So sorry to read of this little darling and his death.

My prayers to his loving family and to you for all the tender loving care you gave this little man.

Let the tears flow you did your best.

Specializes in midwifery, NICU.

Thanks Sabby, for your heart felt words, and prayers for this wee souls family. Means a lot babe, thank you. I don't cover my tears, now, in private moments, they come, eases my hurting heart. In prescence of a greiving family, I cry, but dont weep, it's all about them, isn't it. Anything to do to help them, and it's done. On Sunday afternoon, we actually had just them and their surviving twin and the nursing staff in the unit, (no other babies parents), it worked out so well, was so relaxed. We looked up pics on the computer of the wee guy, laughed a bit, cried a bit, spoke of random stuff as well as funeral stuff to come. Felt like family, you know, that kinda closeness, before the world wants a piece of whats happening. Was so honoured to be there that afternoon, taking part in their lives, just all our wee gang..minus the wee guy. Helped them, and as nurses..well, it helps us..

Suspect had a very valid notation about the prevalence of God as part

of comfort given. I can't imagine a person not rationalizing for himself

reasons for whatever his conditon is. accounting for predictable causes of death or disease has to be part of thier "raison d'etre"' .+

Embrassing science would help some I guess.

Safta24

i learn a lot from it

thanks!!

It is always uplifting to me to see someone else "gets it". I have been a Hospice nurse for 15 years and I wouldn't change that for anything.A Hospice nurse's life isn't all sad, because we are included into so many lives. It is a honor to be welcomed into the homes of these dear people.I have learned so much from them and have used those experiences to become a better nurse, a better person. It has helped me through the deaths of my parents and my own illness with breast cancer. The nurses, aides, chaplains, and social workers that I work with daily understand just what a privilidge it is to know these patients and their families.I'm not saying that I don't ever cry because I do, it is sad when we lose a patient,but I'm also grateful that this patient came into my life because of what I learned from them. Hopefully I will be a Hospice nurse for the rest of my career, I can't imagine doing anything else! It just is so nice to read about someone who knows it, loves it, and understands it as much as I do.

Thank you so much for the article. G-mo:nurse:

would like some feelings from hospice people re: my prior blog from suespets,6/9/08. Can't imagine why no one has answered sue

It is a continuous pleasure & satisfaction to read what G-mo

wrote. Wish all nurses felt the same way in which ever departement

they work in. I know I did & the feeling sustained me these many years. I repeat it is so great to be a nurse.

safta24

Does a hospice nurse need to be an R.N?

momatino

If I were a hospice patient (near future) I would first of all want

a nurse who can assess my situation & anticipate my needs mainly

discomfort/pain needs & for those qualifications I believe an RN

would be better than anyone else

If I had reached a plateau & my Vitals etc were predictable I do believe a non RN would have the necessary compassion to be very helpful. MHO. What do the rest of the nurses think?

safta24

Specializes in Nursing, Midwifery, Public Health.

Beautifully worded! It has enlightened me on whats involved in hospice care. Thanks for this article. I wish u the best!

Specializes in L&D, Med/Surg, Pretest, Int.Rad.PICC/Mi.

I have been an RN since 1987, starrted out in L & D for 8.5 yrs., moved to Med/Surg for 2 yrs all on the night shift then had a day job I applied to for outpatient pretesting for surgery. I had also applied to Hospice at that time but the position was filled by a nurse already on staff. After 10 yrs in the pretest department at the hospital, I moved to Radiology Nursing/PICC Lines, been there just over a year now, and am seriously thinking about going for Hospice again. Since I have been in this hospital for 17+ yrs, I am hesitant to move still. Could someone please push me........................I keep telling my husband who is unemployed that I am not sure if the money would be the same, but I feel my peace of mind should come as a higher priority.....I have 5 references, 3 who work for Hospice and an RN I work with who recently lost her husband and had Hospice......she tells me I was his 2nd favorite nurse. In Radiology we do biopsies, and para/thoracentesis, drainage tubes, nephrostomy tubes, etc. some of the patients have been 85+ with mets and I am always asking myself why are they doing this, a 94 yr old last week who has Hospice came to us for her 5th Nephrostomy tube placement, she's lost at least 60 pds since we first saw her and has dementia, this is when I feel it's about the money and I get so frustrated......the time we put bilateral tubes in she was on her stomach and somewhat overweight......we had to end up strapping her to the CT table and the Interventional Rad was yelling at me, that it was my job to make her not move.......I was so upset......and felt so bad for the poor woman. If that had been my mother............it never would have happened.....and I hope it doesn't happen to me someday. I sometimes feel like I should just apply and see what they have to offer.........At least in Hospice I would know what I am dealing with, and not be stressed on a day to day basis with ppl yelling, if you know what I am talking about. We also do conscious sedation, alot of responsibility. Need encouragement from others out there to move on........my self esteem has been crushed many times this past yr..............I actually had to do a presentation during my team nursing in school (back in the days) and it was done on "Death and Dying" I think my teacher was surprised as were some of the floor nurses. I did one time during my Med/Surg., take care of a 44 yr old woman with cirrhosis who was dying, I took care of her every night that I worked and I knew for some reason she was going to die soon, I called the evening floor nurse and requested that the other bed in the room be left empty if possible so her husband could spend the night, to my surprise when I came in they had not filled the bed and her husband was there.........she did die that night, and he was allowed to stay, and I had time to help him through it too........it's been one of my best experiences in my nursing career...........please feel free to help me out here.........:smackingf