Friday, February 5, 2010


The word "hospice" comes from the Latin "hospitium" meaning guesthouse. It was originally described a place of shelter for weary and sick travelers returning from religious pilgrimages.

I wanted to write something about hospice, it's such an important part of what I do and what I care about and want to be a part of during my nursing career. Hospice is not only comfort care and providing dignity to the patient it's serving, but to the family as well. Its a support system, a shoulder to cry on, an ear to listen, and so much more. (not to mention its non for profit)

Recently, I was privileged to take care of a patient who was "healthy" for his standards. He had significant heart disease but was living at the highest quality he had. He came down with pneumonia and just succumbed the battle. After careful thought, the family decided to put him on hospice. I am always careful to show my enthusiasm for the choice of hospice, I know the benefits and all that hospice has to offer but for many families and patients even they only think "I'm dying, and soon.". The prerequisite for hospice care is less than 6 months to live after being diagnosed with an incurable disease. I have seen many people on hospice for more than 6 months though.

This gentleman lived for 4 days on hospice. He was comfortable, was provided quality care ( at least by me) and was given dignity, even after his last breath. At the time of his passing, his breathing changed from agonal to almost peaceful. His face, relaxed and content. His family was present and I truely believe that he knew they were all there. There is empirical evidence that states that hearing is the last sense to go before death. Often the patient will not acknowledge that they hear due to not having the ability but they hear the memories shared by the family, the "i love you's", the "i'm sorry's", the "its okay to go's". Sometimes that is all the patient needs to hear, permission to go.

The hardest part, that I wasn't expecting was calling the death. You auscultate for breath sounds, feel for a pulse in strategic locations and then note the time. You let the family grieve and they will, give them time to absorb what happened. As I left the room with tears in my eyes I realized what an amazing job I have. Its not the most glamorous part of the job, not my most favorite part of the job but it is amazing. Amazing in the sense that I am a part of someones last breath, last heart beat, last goodbye. Honored.

I know I will not remember each death, although I really do try to take in all the emotions and feelings that I have, to honor the death.

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