With the 2015 Quality of Death index ranking the UK as the best for end-of-life care, I’ve been reflecting on what being a hospice nurse means and why it’s different to other types of nursing.
“So you’re a nurse! Which hospital do you work in?” “Oh, I don’t work in a hospital; I’m a hospice nurse.” And at this point, the most common response is a mixture of horror and pity: “Gosh, you work in a hospice? How do you do that job? It must be so difficult…” My stock answer tends to be: “it’s a lovely place to work and very satisfying,” but it’s usually an awkward conversation.
Sometimes I even have to explain that we’re not all nuns, or even religious, and I find the assumption that we must all be “angels” quite unsettling. Most of us have a great sense of fun, but we do care – deeply. Hopefully this is a given for all those who choose nursing as their profession. The fact that we’re able to accept that our brand of care is not about nursing people back to health, but about helping our patients to feel as good as they can and live as well as they can “all things considered” is at the heart of what we do.
We deliver compassionate care with integrity and openness. We often instigate conversations that others are too afraid to have, whether that’s asking if someone has made a will or suggesting that a patient have a discussion about their wishes for their funeral. We deal with life’s taboos. And that is so refreshing. Being able to allow a patient or their relative to open up and ask all the questions they’ve hidden away for fear of shocking their family is like breathing in fresh air. To make it OK to laugh about some of the darker aspects of a person’s frightening journey is a gift. Lending your shoulder for someone to cry on is always moving.
We recognise that people are more than their illness. Naturally, we also carry out all the tasks generally associated with nursing. We administer medications, including injections. We give blood transfusions, flush chemo lines, dress wounds, take temperatures and blood pressures. We help patients sip a drink or feed them, and none of us are “too posh to wash”, in fact for me that’s the task that I enjoy most of all. Maintaining a patient’s dignity and gaining their trust through the care that you gently give is extremely satisfying. It’s during such intimate moments of care that we often have our most important chats. We discover life stories, regrets, desires and fears and we sometimes provide the opening that a person needs to get a few issues off their chest. Our care acknowledges that emotional support is as important as the physical care we provide. At a time when so much has been taken away, we help people suffering from scary conditions to find a way to move forward.
Watching a loved one suffering is extremely stressful and we do our best to minimise the pain and anxiety felt by the patient and their family and friends. We’re there with our patients to hold their hands, comfort them if they wake in the night, to help take the fear out of dying and dispel the myths that surround the end of life. We can’t nurse their bodies back to health, but we can help to soothe their souls.