This May is National Nurses Week. But although many of us know what nurses do, there is one small niche in nursing that often gets overlooked or misrepresented: the field of hospice. This month, get a taste of the duties and responsibilities of nurses in hospice, and why people say it “takes a special person to be a hospice nurse.”
Kara Smith of Belleville, Ill., can tell you about death coming in threes – 3, 6, 9, or none for a while. She can tell you about the power of music – and human touch – at deathbeds.
Kara is a hospice and palliative care nurse at Unity Hospice of Greater St. Louis. For Kara, seeing death has become so common that one night on-call might have her seeing two to three patients pass on – and yet, she still cries…every single time.
Kara can tell you about the transition process on the journey to death, or what “near-death awareness” is and how a patient may sometimes hold on to life if a family member isn’t “ready to let go.” She can tell you about organizing a group of volunteers and staff members for a patient who has no family, because they don’t want them to pass on alone, even if they aren’t conscious.
And ultimately, she can tell you how a hospice caregiver needs to attend wakes and funerals of patients not only for the family’s sake, but for their own sake: hospice caregivers need healthy closure so they can restore themselves in time for the next patient.
As a hospice nurse, she can tell you all this, and more. Kara was originally on track towards becoming a court reporter. But she hated shorthand, so she switched to healthcare; hence her current position as a visit nurse at Unity Hospice.
But what, exactly, does a hospice nurse do?
The goal of hospice is to provide a peaceful end-of-life. This includes managing the physical, emotional and spiritual care of every patient. The goal is to make patients as comfortable as possible—which involves everything from stocking the patient’s pantry with enough food to educating families on symptom management to dealing with any crises that arise. Hospice nurses also review and discuss a patient’s medication regimen on a regular basis, accurately adjusting them to improve comfort if necessary.
Kara’s colleague, Patrick Joyce, RN, has been a hospice nurse for nearly a decade. He says he always tries to get his patients’ families to understand that while “death is difficult, it doesn’t have to be scary.” Reflecting on the challenges that hospice nurses endure, he says that still doesn’t change the fact that the profession is as rewarding as they come. “I love when I hear stories about my patients’ pasts – it’s why I do what I do. Imagine a hospice patient in a wheelchair, and behind them is a shadow of a ballerina. Many times, people and even patients themselves see only the person in the wheelchair.” Patrick concludes, “but a hospice nurse sees the shadow of the dancing ballerina.”
India Ward, RN, wanted to be a nurse since she was a young girl — “since the time I was tying my shoes,” she smiles. When India finally made the switch to hospice, she was delighted to find what she was looking for. She currently works at Unity Hospice of Northwest Indiana. “You’re spending so much time with the patient that you become, in a way, part of the family.”
One of the first thoughts India had when she entered hospice nursing was “how incredible” it was that family members open up their lives so hospice can adequately provide care for their loved ones. “It takes a lot of courage to be vulnerable like that,” she adds.
Sometimes hospice nurses will organize “last wishes” – requests of patients who have only days, or hours, to live.
Dawn Forst, RN, CHPN, of Unity Hospice of Chicagoland did just this for one of her patients, a 21-year-old patient with terminal cancer. She was paralyzed from the waist down due to her illness. [Patient] lived with grandmother and thirteen-year-old sister, and she was dying. At that stage, the one thing that brought her joy was Precious Moments characters. Her “last wish” was to visit the Precious Moments Chapel in Carthage, Mo., with her family alongside her.
Thanks to the former Fairy Godmother Foundation of Chicago, Unity Hospice applied for and received a grant to sponsor the trip which paid for her travel, hotel stay and necessities throughout the trip. Proper accommodations were made through hospice to oversee her care during travel.
That same weekend, it also happened to be [patient’s] 22nd birthday. Dawn added, “we had a balloon bouquet sent to her hotel, and she called me right away. She said that she couldn’t thank us enough, and broke out into tears when she saw the bouquet. It was her concluding words that got me – she said ‘but these are happy tears; and I cant remember the last time I cried happy tears.’” While the patient has since passed, Dawn says she will never forget the impact of brightening her life just months before her death.
“And that’s what makes me so proud to be a hospice nurse,” Dawn says. “Knowing that I was one of the last people in her life to bring her that kind of joy.”
About Unity Hospice
Founded in 1992, Unity Hospice is a family owned and operated hospice and palliative care company committed to providing comprehensive care, support and education to people facing a life-limiting illness, those who care for them and the community. Unity Hospice offers care of the highest quality by licensed and competent staff in accordance with laws & regulations and accepted standards of practice. With the dedication to make their patients’ days comfortable, Unity Hospice provides an interdisciplinary approach to each individual and family, in which they go above and beyond every day to meet their needs.