Hospice Nursing Thoughts For Wednesdays Digressions

• Hospice nursing continues to surprise as one of those rare (I think) jobs in life on most days you would do for free but, get paid well to perform.
• Of all the patients I've seen on their way I've only said of two I wish I could have known them earlier in life. Nurses may say this often thinking it's what the family wants to hear but, if it's even benignly dishonest I will not say or do it in this field.
• Recently, a patient only something like 48 hours away from death said to me at about 2 in the morning,"I don't want to die." I cannot express adequately everything summed up in the tone of his voice when making that simple statement. It wasn't regret, fearfulness, anger, arrogance or a plea for more time necessarily but, just an honest statement.
• The most honest thing I've ever heard in my life.
• I've cared for people in 500,000 dollar homes overlooking a lake and shacks that when the wind blew the drapes would fly into the room with it and I wore a coat and was wrapped in a blanket throughout the night.
• You'd think the middle class people would be the most rewarding to deal with and maybe the rich the most difficult but, this is not my take on it and even I'm surprised at that.
• The poor people will love you like no other and while they may lean on you as much as anybody for support- they also trust you which keeps you on your toes (or should). You may represent the first group of professsionals in the patients decline who more or less say the same thing in response to a given scenario. Also, you are relieving the suffering of someone that it may seem like previously everything that was done for their loved one by medical personnel caused suffering. You also may be carrying a load for them they can't quite come to grips with because they simply don't understand.
• The middle class people may be pretty well educated or dropouts, superstitious or level headed, fairly well versed in the world at large or sadly ignorant people and all these off the cuff differentiations and more will be found in a large family under one roof. When you get down and dirty and lay things out- you still may not know how the wheels are turning in their brains, whether they've accepted your education or just telling you what you want to hear. Bring everyone together to try and lay out everything you want them to know and invariably you will get pulled aside by them one at a time later for clarification, disagreement over some minutiae or flat try to be drawn into some kind of family intrigue.
• Wealthy people are almost always well educated and accept provided education on the particular case well. They are always up to date with contemporary treatments and general knowledge. They honestly also across the board accept the inevitability of death better. They will be very grateful and as gracious as anyone but, you are usually telling them things they already know.
• Recently a lady who was a spiritual advisor to a family went on while we were talking privately saying things like,"I look at death as a beautiful new beginning- when we are born we are dying and when we die we start living." "Death should be a time of peace and joy. We shouldn't look at it as something to be afraid of- they are going to be in glory..."
• Well and good, I needed to hear some of that but, it can also be horrifying for witnesses when it's not a good death. It can be the start of lifelong heartbreak for those left behind. It can be absolutely terrifying for the person whose dying...