Nurse Anne Lanier shares the 3 responses she hears when someone learns she’s a hospice nurse—and what working in hospice has taught her
Hospice comes to people in different ways. It may be as part of their profession, it may be when they volunteer, or it may be when a loved one comes to them with the news of a terminal illness or when they themselves have such news. So hospice is a different experience for different people. As with other parts of our lives, we all bring different experiences to the experience of hospice.
At Angela Hospice where I work, our mission statement is “to provide compassionate Christ-like care to terminally ill patients and their families.” So all of us who work there have in common the goal to walk with our patients at the end of their lives and to treat them with respect and dignity. They have often come from months or years of cure focused treatment where they have had little choice in what happened to them. We give them back their choice. We treat them as human beings.
As one of my colleagues puts it, it is all about Jesus’ words: “For I was hungry and you fed me; I was thirsty and you gave me water; I was a stranger and you invited me into your homes; naked and you clothed me, sick and in prison and you visited me.”
Anne Lanier, RN
When people find out I am a hospice nurse, they usually have one of three responses—“I could never do what you do,” “I don’t know how you do what you do,” or they have a story to share of an experience they have had with hospice.
I long to speak to those three responses.
“I could never do what you do.”
The first one is “I could never do what you do,” but I believe anyone can do what I do. Everyone who comes to hospice work, whether as a profession, a volunteer, or a family or friend, brings a different gift to the work and everyone already knows how to do this work. You don’t have to be someone special. You just have to pay attention and have confidence in your kindness.
The trouble is, I think, that death has become a medical event and caring a professional role and it is really a matter of relationships to ourselves and to others. I have sat with hundreds of people as they were dying and they have taught me that in the end, all we have are our relationships. They have also taught me to never give up. That what we do this day is what is important. I have seen people healed when there has been forgiveness on the last day. I have also seen great suffering when forgiveness has been withheld. I have come to believe that in the end a meaningful life is one lived with kindness. I work on this every day. I mess up every day. It is not easy. But, if we pay attention and keep the reality of death close to us, we learn to take care with our lives and the lives of others and we appreciate how precious life is.
The activities of care-giving are easy, ordinary—we change sheets, we brush teeth, we give back rubs, we give medications, we listen to stories, we provide a calm presence. I don’t mean that caring for the dying is easy, it is difficult. It can challenge your very beliefs. It can push you beyond fatigue, it makes you doubt yourself, you question your abilities, you come face to face with your limits—your limits of compassion, of patience of kindness, your limits to give. You face loss. It can break your heart.
But you find a balance. You find what helps. Sometimes it is right to do something one way, the next time it may not work. You keep trying. There are some things about dying that are the same for each person, but each person’s death is different because each person is unique. There are no formulas. You learn that the only thing that stays the same is change.
I have studied different teachings over the years and through these teachings and through my own experience I have learned there are basically three ways to serve and care for the dying with compassion. The first way is with touch. We all need touch but the dying are especially vulnerable. They may be weak, lonely, confused, in pain, their bodies may not be functioning well. They may feel untouchable. We do a lot of hugging and holding in hospice but we do it with care. We go slowly. You don’t have to take a massage class to know how to touch. You can trust your own instincts—and you pay attention. Touch gives us opportunities to let people know that they are important just by placing a hand on someone’s arm, placing a cool rag on their forehead, or holding their hand. And touch is not just physical. We touch with our eyes by seeing softly, we touch with our ears by listening with care, we touch with our voices by speaking slowly and gently.
The second way to care for the dying with compassion is to attend to the heart and mind, to offer emotional support through listening. Again, you pay attention. You give your full attention to the other person. You have no agenda. You listen to their story. You don’t judge. You just let them talk.
The third way to care for the dying with compassion is to attend to the spirit by offering spiritual support through awareness. Spiritual support is often as important as medical care. Sometimes it is calling the priest, but spiritual support is also something we can all do. It is bearing witness—it means not turning away—being present with the person who is dying. It is not usually a matter of discussions but of just being there. It could be watching T.V. if that is what the person wants, or looking through photo albums, making scrap books, or just sitting together. Doing normal things and not treating the person differently because they are sick. Spiritual support is also about creating and maintaining calmness—lending the dying person the stability of our mind as we lend them the strength of our bodies when theirs become weak.
“I don’t know how you do what you do.”
The second response to my being a hospice nurse was “I don’t know how you do what you do.” I do this work because I love it and I have learned to surrender to it. About 18 years ago, I started meditating and that has helped me to do what I do. It has helped me learn to pay attention and when I remember to pay attention and remember to bring my best self to my work, there are three things I try to do. I bring my whole self to the bedside—my strengths and my weaknesses. You don’t always have to be strong, just willing to let whatever needs to happen, happen. I always ask my patients and their families to teach me how they want to do this part of their lives.
I have learned not to wait. Many times family or friends will ask when the moment of death might be. I encourage them not to wait for death. If you wait for the moment of death, you miss the moments of living. I tell families you can sit here and watch the clock or you can sit here holding hands. If you love someone, tell them, don’t wait. When my mom was dying, the doctor said nothing was imminent, that I didn’t need to go to be with her. I listened carefully to what he said about her condition. I listened carefully to what my mom said about what was happening to her and I did not wait. I went on Wednesday, she died on Sunday. When a loved one is dying and people ask me if they should go, I always say go, don’t wait.
I have learned to find a place of rest in the middle of things. We think we’ll rest when everything is done…when we go on vacation we’ll stop and rest. We need to find a place of rest no matter what is happening. You breathe, you pray, you meditate, you find a quiet place, if not physically, then in your mind.
“Can I share a story?”
The third response about being a hospice nurse was to share a story about an experience with hospice. My own story includes my brother choosing hospice. I believe that when he chose hospice care, he was choosing life. He had spent four years in a haze of surgeries and pain and drugs. He had been in and out of the hospital. He had lost his health, his job, his independence. He had lost his dignity and his hope. He was so tired of fighting.
In choosing hospice, he chose to stop all aggressive curative treatments. He chose to stop fighting. He chose to find a place to rest, to spend time with his family, to mend broken bridges, to feel like a human being again.
I believe that is what most people are choosing when they choose hospice. They don’t want to fight anymore and they want to live. In hospice people are treated with dignity and respect and compassion. They are treated as human beings. They know they have choices. They know they are not alone.
