Barbara Karnes, RN, author of "Gone From My Sight, The Dying Process, responds to a question about a hospice nurse who grieves deeply after each of her patients die.

Is Dying Defeat? A hospice perspective...

It is how we feel at the end of the day about ourselves and our life that comes first. Our personal well being takes priority over any amount of work that we do for others. If we don’t feel good about the work we are doing then no matter how...

Dear Barbara, I have a nurse that is having issues with death in our job. She feels that she is not emotionally strong enough to deal with death and is ready to quit. She is a phenomenal nurse and her patient's adore her. She just feels helpless knowing she isn't saving them. She has refused my offer of counseling to support her. How can I support her and show her that she is doing more for her patients than she realizes.

Your employee may be doing a lot for her patients and their families but it is at the expense of her well-being. By refusing counseling she is telling you how uncomfortable she is and that she really doesn’t want to make this job choice work.

Some people just aren't equipped to deal with their patients dying. A lot of us got into healthcare so we could “fix” people and fixing people is very rewarding.

Everyone has their specialness and it behooves us, for peace of mind, to find that area that makes our heart sing.

It sounds like hospice may not make your employee's heart sing. No matter how good she is with people or how much her patients and their families love and respect her, if she doesn’t feel good about her work none of the rest counts. It is how we feel at the end of the day about ourselves and our life that comes first. Our personal well being takes priority over any amount of work that we do for others. If we don’t feel good about the work we are doing then no matter how much support we have it isn't going to be enough.

I am glad your nurse is phenomenal with patients but it doesn’t sound like hospice is a good fit for her. My guess is if she continues to work in end of life she will burn out quickly.

When I am hiring someone for hospice work the first thing I talk with them about is their thoughts on dying and death. I can teach anyone how to care for the dying but I can’t make them believe dying is not a failure or the enemy of the medical profession. We all have our unique talents but it sounds like end of life work is not this employee’s speciality. For her life well being it would be best if she found another area of work.

Something more about... Is Dying Defeat? A hospice perspective...

The Final Act of Living: Reflections of a Long-time Hospice Nurse is my book on end of life that offers knowledge and clarity to ease the fear and misinformation about dying and death. It explores the topics of living with a life threatening illness, fear of death, understanding the signs of approaching death from disease, the dying process, stages of death, the normal grieving process, living wills and other end of life issues.

7 comments

Barbara

Hi Kris, I am so glad you have written your comment. If working for hospice teaches one thing it is life is short. It is over before we want it to be —— so while we are here and able to have some control over ourselves we need to be doing what makes us feel good. Your job is not making you feel good or is even good for your body and mind. It is time to get a different job. One that you are excited to get out of bed for. Everyone has their “specialness”. I couldn’t be a veterinarian but I am so glad there are those that find that work rewarding. I found my “specialness”. Kris, go find yours. Find what makes your heart sing each day. My blessings are with you. Barbara

Hi Kris, I am so glad you have written your comment. If working for hospice teaches one thing it is life is short. It is over before we want it to be —— so while we are here and able to have some control over ourselves we need to be doing what makes us feel good. Your job is not making you feel good or is even good for your body and mind. It is time to get a different job. One that you are excited to get out of bed for. Everyone has their “specialness”. I couldn’t be a veterinarian but I am so glad there are those that find that work rewarding. I found my “specialness”. Kris, go find yours. Find what makes your heart sing each day. My blessings are with you. Barbara

Julia Seibert

Nancy DeYoung,
“helping them pack their bags for the next destination with clarity and positive care” – I love this so much. I am an oncology nurse as well, working with brain tumor patients. I agree that the information provided in these posts are so valuable.

Julia

Nancy DeYoung,
“helping them pack their bags for the next destination with clarity and positive care” – I love this so much. I am an oncology nurse as well, working with brain tumor patients. I agree that the information provided in these posts are so valuable.

Julia

Kris

I have been doing hospice Nursing for 2 years and have slowly gotten more and more stressed to the point I have daily headaches. I don’t know how to grieve and heal from so many deaths. I have also seen so many coworkers leave and that is sometimes worse. I don’t know If I can continue and not spread the stress to the rest of my life I have gained 30 pounds because I have fed my sadness and stress with food. I’m thinking I might have to move on as much as I love my job. How do caregivers truely deal with so much death and dying

I have been doing hospice Nursing for 2 years and have slowly gotten more and more stressed to the point I have daily headaches. I don’t know how to grieve and heal from so many deaths. I have also seen so many coworkers leave and that is sometimes worse. I don’t know If I can continue and not spread the stress to the rest of my life I have gained 30 pounds because I have fed my sadness and stress with food. I’m thinking I might have to move on as much as I love my job. How do caregivers truely deal with so much death and dying

Gary Purdy

Two days a week I volunteer at a hospital cancer unit and one day a week I volunteer at a palliative and hospice care facility. There is a nurse on the cancer center who left her position with the palliative and hospice care facility. Her reason being she realized she wanted to treat people to get well and not to be with patients at the end of life. Every nurse at the palliative and hospice care facility are there by choice; this is the only type of care they want to girls. Just a sidenote, I am visiting only patients that are taking chemo At the hospital and I am visiting patients and staff at the standalone palliative and hospice care unit. 21 years ago my wife died after her last chemo and was on hospice less than 12 hours. Today I am The happiest I have been in my life as I visit weekly
Two days a week I volunteer at a hospital cancer unit and one day a week I volunteer at a palliative and hospice care facility. There is a nurse on the cancer center who left her position with the palliative and hospice care facility. Her reason being she realized she wanted to treat people to get well and not to be with patients at the end of life. Every nurse at the palliative and hospice care facility are there by choice; this is the only type of care they want to girls. Just a sidenote, I am visiting only patients that are taking chemo At the hospital and I am visiting patients and staff at the standalone palliative and hospice care unit. 21 years ago my wife died after her last chemo and was on hospice less than 12 hours. Today I am The happiest I have been in my life as I visit weekly

Barb Sanders

I’ve been a hospice nurse for 30 years. If a patient can tell me. at the end of life, what they want- they will say “I just want to be comfortable and I want my family supported”. I share this with all of the new nurses who feel that they “need to do more”. If my patient dies comfortable… and the family is supported… I give myself an “atta boy”. This is the job they hired me to do. Like a midwife to the dying. You know what the end result will be… the only question is what the path will be between here and there. They hire us to shepherd them through the scariest part of their lives. I am guessing this nurse has done this. She just needs to acknowledge her job isn’t to “save them”. By the time hospice meets a patient/family they know their diagnosis. They know their prognosis. Now it is up to us to help them- and their loved ones… be as okay as possible. My best phone call is …" he’s gone .. but I’m okay". That tells me – not only me but also the entire team has done their job. One of the biggest challenges for new nurses is understanding and using the TEAM. Just because you can … doesn’t mean you should. Not using your team is a predictor of burnout. Just sayin’

I’ve been a hospice nurse for 30 years. If a patient can tell me. at the end of life, what they want- they will say “I just want to be comfortable and I want my family supported”. I share this with all of the new nurses who feel that they “need to do more”. If my patient dies comfortable… and the family is supported… I give myself an “atta boy”. This is the job they hired me to do. Like a midwife to the dying. You know what the end result will be… the only question is what the path will be between here and there. They hire us to shepherd them through the scariest part of their lives. I am guessing this nurse has done this. She just needs to acknowledge her job isn’t to “save them”. By the time hospice meets a patient/family they know their diagnosis. They know their prognosis. Now it is up to us to help them- and their loved ones… be as okay as possible. My best phone call is …" he’s gone .. but I’m okay". That tells me – not only me but also the entire team has done their job. One of the biggest challenges for new nurses is understanding and using the TEAM. Just because you can … doesn’t mean you should. Not using your team is a predictor of burnout. Just sayin’

Julia Seibert

Very well said. I appreciate this perspective.

Very well said. I appreciate this perspective.

Nancy DeYoung

Hi Barb,
I left working with terminal patients when young for same reason this woman feels. Imagine my surprise when I ended up 30 years later finding myself back with cancer patients! Your blue book should be in every hospital and Hospice and Nursing School. It is all about perspective and maybe life experience.
Once quality of life is no longer possible my feeling became my job was then to give quality and comfort to life that was left. To see it as helping them pack their bags for the next destination with clarity and positive care. Living each day is all any of us really has so it should be lived without pain, getting touch daily, experiencing cheer and loved ones. Gone from My Sight can dramatically change perspective of the departing as well as those being left. It MUST be all about the patient not the caregiver. I have seen some families make it a misery and some a loving experience. The Blue book can be the key.
This nurse may just not have the life experience and should go to happier specialty for a time. Refusing counseling tells me there upis an issue untold here.
Hope all is well with you, I see all your posts. Great service and teaching.

Hi Barb,
I left working with terminal patients when young for same reason this woman feels. Imagine my surprise when I ended up 30 years later finding myself back with cancer patients! Your blue book should be in every hospital and Hospice and Nursing School. It is all about perspective and maybe life experience.
Once quality of life is no longer possible my feeling became my job was then to give quality and comfort to life that was left. To see it as helping them pack their bags for the next destination with clarity and positive care. Living each day is all any of us really has so it should be lived without pain, getting touch daily, experiencing cheer and loved ones. Gone from My Sight can dramatically change perspective of the departing as well as those being left. It MUST be all about the patient not the caregiver. I have seen some families make it a misery and some a loving experience. The Blue book can be the key.
This nurse may just not have the life experience and should go to happier specialty for a time. Refusing counseling tells me there upis an issue untold here.
Hope all is well with you, I see all your posts. Great service and teaching.

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