How to Stay Positive When You Work in Hospice
By Keith Carlson, BSN, RN, NC-BC
When you meet a hospice nurse, you might look at her and say, “I could never do that kind of nursing; it’s so depressing.” If you already work in hospice, nurses and non-nurses alike might say similar things to you. But is it really that depressing? And is it possible to maintain your positivity when you work with people who are staring death in the face?
Hospice nurses work in patients’ homes and inpatient units. Each environment has its own pluses and minuses, but their goals -- symptom management and dignified death -- remain the same.
>>Ask Nurse Alice Podcast: This is What It's Like To Work as a Hospice Nurse (with Beth Cavenaugh, RN, BSN, CHPN)
Nurses Know Death
Let’s face it: nurses know death pretty intimately. Maybe you experienced the death of a patient during nursing school, or you were recently involved in your first code.
While some nurses work in environments where death isn’t common (eg: school nursing, education, research, primary care), many of us work where patients routinely die.
We all grow old and die, and some of us die before making it that far. Hospice nurses know this process a little more intimately than many of their nurse colleagues. How about you?
Hospice, Death, and Nurses
The purpose of hospice is to support patients facing a terminal diagnosis and the potential for death. Some hospice patients actually get better and “graduate” from care, but most don’t have that option and remain in hospice until the end.
If a hospice patient has a painful condition like bone cancer, symptom management is crucial. As a patient nears death, they can experience confusion, delirium, agitation, and other symptoms that are difficult for family to witness.
Even if the nurse’s own emotions arise, the nurse has to remain thoroughly logical, while simultaneously communicating compassion and understanding towards the patient and their loved ones.
Watching a patient die is an honor, but it can also be scary. If you’ve never been present at a death, it’s an intense experience, to say the least. Hospice nurses learn to take this process in stride while providing awesome care for patients and families.
Staying Positive in the Face of Suffering
Whether your patients routinely die or not, you probably witness suffering as a nurse. Just realize that the suffering you see in hospice may actually be a lot less dramatic than what you see in the ER, ICU, or trauma. Most hospice deaths are actually very peaceful.
When you witness suffering as a hospice nurse, your job is to alleviate that suffering as best you can. When witnessing the dying process, your job is to make sure it’s as painless and peaceful as possible.
One of the challenges is alleviating others’ spiritual and emotional pain while dealing with your own feelings. Staying positive for your patients and their families is important in hospice, but you also have to stay positive for yourself.
10 Steps to Maintaining Positivity
Even if you work in hospice and are faced with death and suffering almost every day, here are 10 ways to stay positive as you provide amazing nursing care:
- Go to therapy or counseling to cultivate your own emotional health.
- Attend religious services or meet regularly with your favorite faith leader.
- Make time for friends.
- Take care of your physical health; you’ll be more positive more often when your body feels good.
- Talk with your hospice colleagues about how they stay positive and emotionally healthy.
- Volunteer with children, animals, or others that bring you joy.
- Surround yourself with positive, happy people.
- Use movies, books, movies, podcasts, and videos to fill your head with positive messages and uplifting stories. There’s nothing like a funny kitten or baby video to make you see the world through happy eyes.
- Focus on what’s good in your life through a gratitude practice; give thanks regularly for your blessings.
- Remind yourself that the excellent care you give to your patients and their families brings them great peace of mind. This is a reward of your work that can help you feel very good about yourself.
Staying positive in the face of death and suffering isn’t easy, but we nurses see suffering in so many places, don’t we?
Whether you work in hospice or not, stay positive by caring for yourself and feeding yourself messages that lift your spirits and remind you of the goodness in your life, as well as the goodness that you regularly bring to others.
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