When I was in nursing school, a classmate of mine shared she wanted to work for hospice after graduation.
“HOSPICE?! How depressing!” I practically shouted. I was only twenty then, and now I’m embarrassed at how rude and ignorant I was. Especially since, many years later, I am now a hospice nurse myself.
I never thought I would work for hospice. I became a nurse to save people, not let them die. Hospice wasn’t real nursing… or so I thought. Again, I reference to my age- maybe I just couldn’t grasp the concept.
The truth is hospice is one of the most sacred areas of health care that exists, and it certainly is sad when people die, but it’s not depressing. That sounds crazy, I know. I promise I’m not heartless. Let me explain.
When it comes down to the wire, the only thing in this life that is 100 percent is death. We hate to talk about it. Hell, we hate even to think about it. But the truth is its the only thing that is for sure on this planet. We were all born and someday, we will all die. Some of us will live to be near 100 and have long beautiful lives, while some of us will, unfortunately, pass on much sooner. No doubt about it, though, none of us are getting out of this place alive.
Some will die quickly in an automobile accident, from a heart attack or stroke, or some other ailment that offers no warning. The rest of us, and probably most of us, will either get a) really sick or b) really old, and then later we’ll die. We will have a middle period. Time in between health and death. Limbo on Earth.
Most of my patients over the years have been those who have been struggling with sickness for a very long time. They’ve suffered the unbearable discomfort caused by chemo and radiation treatments. They’ve been in and out of the hospital twelve times this year. Their medication lists are long, and their kitchens look like pharmacies. More than a few of these patients and their families have expressed to me that they feel as if they’re giving up. They have fought so hard for so long, and now they’re just going to…. stop? I always have the same answer for these sweet, scared souls:
“You are not giving up. Giving up is what you do when you can do something, but choose not to. You decide it is too hard, too painful. That is not what is happening here. You fought. You fought for years and with everything you had. Unfortunately, the options ran dry and now despite all the blood, sweat, and tears you gave, there is nothing left to do. This is sad and its supposed to be. This is hard, and it’s not intended to be easy. But I’ll tell you what: You are strong, and you are lucky.”
Here, they always look at me like they want to hit me. How could I think of them as lucky?
I gesture to their children (or the pictures of their children if they are not physically present), “You have them, and they have you. You grew a beautiful family. Look at them! They are here because of you, and now they will continue to be here for you. We all die one day, but you my friend, you see it coming. Spend time with your family. Laugh. Go out to eat and try something new. Drink expensive wine (yes, your nurse did just offer you wine) and enjoy your life. It won’t be easy, but what you have left, it will be beautiful if you decide it will be. You are not giving up on life; you are embracing it for all it has to offer, even in death. I will make sure you stay comfortable until the very end. I promise.”
What happens at that moment is one of the most beautiful things in the entire world. My patients face fades of pain and are replaced with peace. They can let go. They don’t have to fight anymore and can do so without feeling guilty for the cease-fire. Now, after years of treatments and suffering in hospitals, they can be home, and they can live again. They are no longer this weak, sick person who feels hopeless faced with death. They’re full of life and full of spirit like they haven’t been in recent memory. They have relief. They are strong. When the children see this serenity come over their mother or father, they lose it. In one glance they understand. Everyone embraces and soon our tears turn to laughter. We just talked about the worst inevitability life has to offer, and we’re laughing! Joy fills their homes and their hearts, and it’s with that continued blessing my patients eventually pass on.
When my patients die, they die comfortably. Nothing is done to them to hasten or slow down the process, and the few interventions done are just to make them comfortable throughout their bodies natural process. There’s no blood on the floor or CPR crushing their fragile ribs over the shouts of doctors. There’s no beeping of monitors in cold hospital rooms. My patients are surrounded by their families and (most of the time) in their own homes. Children get to say goodbye to their mothers and tell her just how lucky they were to call her mom. Fathers take their last breaths knowing their legacies have been passed on faithfully to the next generation.
As we have already established, we all have to die at some point, and there is no better way to do it than this. My patients pass away with comfort. My patients die with dignity. My patients die with no unfinished business, with nothing left unsaid. My patients pass away with their friends and family surrounding them with more love you than you can fathom. As sad and final as death may be, this is beautiful.
Now tell me, what part of that is depressing?