On hearing that I’m a nurse, the usual response is “Oh! Which hospital do you work in?
“I don’t work in a hospital; I’m a hospice nurse”, I explain. 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 answer tends to be: “It’s a lovely place to work and very satisfying”. But it’s usually an awkward conversation.
As hospice nurses, we nurse our neighbours, the assistant in the corner shop, the refuse collectors who pick up our household waste, the schoolteacher who educates our children and the bank manager who declines or approves our mortgage. We’re ordinary people, but we work in extraordinary situations.
I’ve been reflecting on why hospice nursing is different to other types of nursing. The fact that we’re able to accept our brand of care isn’t about nursing people back to health, but about helping patients to feel as good as they can “all things considered”. That is at the heart of what we do.
We deliver compassionate care with integrity and openness. We often instigate conversations others are too afraid to have. We deal with life’s taboos. And that’s so refreshing. Allowing a patient or relative to open up and ask the questions they’ve hidden away is like breathing in fresh air. To make it okay to laugh about the darker aspects of a person’s journey is a gift. Lending your shoulder for someone to cry on is always moving.
Naturally, we also carry out nursing tasks. We administer medications including injections. We give blood transfusions, flush chemotherapy lines, dress wounds, and take temperatures and blood pressure. We help patients sip a drink or we help to feed them and none of us are “too posh to wash” – in fact, that’s the “task” that I enjoy most. Maintaining a patient’s dignity and gaining their trust through the care you give is extremely satisfying. It’s during such intimate moments that we often have our most important chats – we discover life stories, regrets, desires and fears, and help people suffering from scary conditions to find a way to move forward.
We’re there with our patients to hold their hands, to help take the fear out of dying and to dispel myths around the end of life. We can’t nurse their bodies back to health but we can help soothe their souls.
Perhaps the biggest difference between a hospice and other medical facilities is that we don’t have restricted visiting times. We understand that a person staying here is the centre of someone’s world and try very hard to involve significant people in our patients’ lives.
If those key relationships are taken into consideration, we reach a deeper understanding of what makes the patient who they are. Sometimes this is challenging. Our patients and families come from all walks of life and view things from their own perspectives. Some people don’t want to “make a fuss”, even though we wish they would, while others are used to speaking out. Whatever their nature, we work hard to find common ground and do our best to minimise physical and emotional pain.
Working as a hospice nurse isn’t easy, but it’s never boring; I’m aware of how lucky I am to have such an interesting and satisfying position. A single shift can evoke a vast array of emotions: we can go from uproarious laughter to deep sorrow in seconds, but we’re a great team and we support each other. We also develop an appreciation for our own families and friends just that little bit more.
Caroline Collins is nurse, St Catherine’s Hospice, Crawley