Current Events > I am a hospice nurse AMA

(+) Yeah! (+)

Hospice is end of life care , or "potentially" end of life care. We don't cause death to happen slower or quicker, we just make people more comfortable when they get a terminal diagnosis (less than 6 months to live), be it through strong ass drugs or getting them equipment to make their lives easier to move around and not suffer. Sometimes people are on it for over a year and come off, their cancer goes into remission or they are in less pain for whatever condition and don't need our services.

No question.
But bless your heart

How many people die alone (best guess %)

have you ever had someone come into your care, and for whatever reasons, end up living a much longer life than everyone was expecting?

like, you might hear about them/from them after they've left, and were doing better years later?

First thank you for what you do, you are needed.

How in the heck can you do that job ( in good way). I was thinking about getting a job at a hospice and just thinking about my grandmother in one of those things I just couldn't do it. Just going for the interview every door I passed , I knew it person with a family and their family member was not going to leave. Even typing this is messing me up. So once more thank you.

Can only wonder how that goes, whether or not you every really get used to things.

I remember the hospice nurse for my dad. I guess she had to go through the formality of asking him if he wanted morphine with his water. He turned it down, but when she was getting the water and cup near me, she told me she had to do so anyway because of how much coughing was escalating with his lactic acidosis.

Just crazy that things like this, is supposed to be a day in and out job.

My grandma is on hospice and isn't at the end of her life and doesn't have less that 6 months or a year

[LFAQs-redacted-quote]

I'm in a similar position and I'm still able to truck along most of the time and live normally. But when shit goes down and I lose someone or someone gets worse, it can get bad for me for a while

Tyranthraxus posted...

How many people die alone (best guess %)

I wonder this too...

g0ldie posted...

have you ever had someone come into your care, and for whatever reasons, end up living a much longer life than everyone was expecting?

like, you might hear about them/from them after they've left, and were doing better years later?

That's like a quarter of our patients, Maybe a little less. They come in with a diagnosis of COPD or heart arrhythmia, something that isn't metastatic cancer and they're pretty rough when we get them, but after a few months they make some improvements, then it's a year and they don't need our services anymore. They can go on to live many more years. It's not the norm but it happens frequently.

cjsdowg posted...

First thank you for what you do, you are needed.

How in the heck can you do that job ( in good way). I was thinking about getting a job at a hospice and just thinking about my grandmother in one of those things I just couldn't do it. Just going for the interview every door I passed , I knew it person with a family and their family member was not going to leave. Even typing this is messing me up. So once more thank you.

Its really not all doom and gloom. Only a handful of patients are actually actively on their deathbed and will die in a few days at any given time, the rest of them can maybe move around fairly well, have their wits to them and are happy to see us because we actually treat their discomfort and pain not just try and edge around giving any "strong" meds. Death is inevitable, we try to help them go through the process in a comfortable place like their own home so they aren't just suffering at the end of their life. You don't see hospice patients suffering, that's a big change compared to the hospital

How many times have old people confessed to you of the ancient crimes they got away with? How often did it involve killing a human?

Uglybass69 posted...

That's like a quarter of our patients, Maybe a little less. They come in with a diagnosis of COPD or heart arrhythmia, something that isn't metastatic cancer and they're pretty rough when we get them, but after a few months they make some improvements, then it's a year and they don't need our services anymore. They can go on to live many more years. It's not the norm but it happens frequently.

that's good to hear, that in some cases, people still have a good chance at life.

Smackems posted...

My grandma is on hospice and isn't at the end of her life and doesn't have less that 6 months or a year

Its not the only qualification, but its a major one. You can be put on hospice if you don't want to pursue more aggressive treatments for a disease that could take longer than six months or if they are in mid-late stages of dementia. We have had some people on for 2 years.

KaZooo posted...

Can only wonder how that goes, whether or not you every really get used to things.

I remember the hospice nurse for my dad. I guess she had to go through the formality of asking him if he wanted morphine with his water. He turned it down, but when she was getting the water and cup near me, she told me she had to do so anyway because of how much coughing was escalating with his lactic acidosis.

Just crazy that things like this, is supposed to be a day in and out job.

I saw much worse things in the hospital in the ICU than I see in hospice. People that are brain dead being kept alive by machines when they will die immediately if taken off of them, but family drag their feet any they stay on them for months and months and there's no dignity in it. I am OK with someone passing peacefully, but after the 50th or so non-peaceful passing I saw in the ICU I couldn't do it anymore.

People like to be stoic and play down their pain until it gets really high and difficult to bring it down, that's why we want to try to keep them on a baseline dose so it doesn't get extreme.

[LFAQs-redacted-quote]


Depends on the company really. Everyone is happy with their job where I'm at. We all usually put in about 4 hours a day and that's full-time salary. Only have to go into tye office for supplies or pick up paperwork otherwise the bosses do not bother you at all. We have a good system set up so most patient deaths happen pretty peacefully and thats a good death, as grim as that sounds.

Tyranthraxus posted...

How many people die alone (best guess %)

Maybe 10-15% they could be in a nursing home or assisted living and pass away overnight. If theyre at home family will usually be there, or might wake up find they passed in their sleep. Usually if they're in nursing homes you can get family there before the final moments but but always. We will be there if we get there in time, sometimes it's fast sometimes it takes a few days of shallow breathing and slowly fading.

Evening_Dragon posted...

How many times have old people confessed to you of the ancient crimes they got away with? How often did it involve killing a human?

One guy is a former hit man in the Minnesota Mafia and he went to prison for killing his ex-wifes lover. He got out after a few years and he will tell me some wild mafia stories. Bound to a wheelchair but keeps his nails pristine and is actually a pretty nice guy, but he has killed countless people lol.

My mom was a nurse for 25+ years. Her last nursing job was a hospice nurse. She absolutely hated it and gave her mental issues and had to retire.

In your experience do people generally die peacefully? I kind of hope I just go in my sleep tbh

Uglybass69 posted...

One guy is a former hit man in the Minnesota Mafia and he went to prison for killing his ex-wifes lover. He got out after a few years and he will tell me some wild mafia stories. Bound to a wheelchair but keeps his nails pristine and is actually a pretty nice guy, but he has killed countless people lol.

Was his name Yoshikage Kira

The exact same thing Im doing with my father, what are the chances that I would see a topic about it?

I like your sig

VampireCoyote posted...

In your experience do people generally die peacefully? I kind of hope I just go in my sleep tbh

Yes, they have usually accepted their fate and pass without much distress. They are usually not very sound of mind at the time of passing and it's a progression from semi-coherent lucidity to axonal breathing, to death. Families are sad but usually accepting and thankful it could happen in their home and not in a hospital bed alone.

Are you more used to death now that you did the job longer or is it still tough on you? >_>

DirkDiggles posted...

My mom was a nurse for 25+ years. Her last nursing job was a hospice nurse. She absolutely hated it and gave her mental issues and had to retire.

I'm sorry to hear that. After working ICU during peak COVID I really like the change of pace and I feel like I'm actually helping people now. I guess if you're someone who gets really attached to people it can be hard to see them pass over and over. I don't mean to sound like a psycho and I don't care, I guess I just see it differently and I would rather help people pass peacefully or keep them comfortable when theyre terminal than constantly doing mostly futile care
with insane interventions in the hospital

How do you wash the smell of death off? Not like, what you wash with. But rather, how can you go home knowing what you've seen and knowing you'll be right back at it over and over. How do you keep that from lingering on you?

gunplagirl posted...

How do you wash the smell of death off? Not like, what you wash with. But rather, how can you go home knowing what you've seen and knowing you'll be right back at it over and over. How do you keep that from lingering on you?

Death happens to all of us whether we like it or not. Most people only really experience death up close when their family or loved ones pass away, either naturally or by accident, so it can be pretty traumatic and jarring. When you work in the ER/ICU/Ambulance etc... you see it all; traumatic deaths, peaceful ones, sudden, abrupt and sad ones. It's all part of the circle of life and death is as much a part of medicine as any other aspect.

I feel like I am actually helping this group of patients more than I did in any other part of medicine I've been in. I am making their final days on earth comfortable and they aren't dying in in pain or agony, and usually with their loved ones around them. Of course it's sad to see someone pass away that you've been following for months and got to know them well, but I know that I helped them be comfortable and I can sleep well at night with that. I couldn't sleep well when I had to tell the families of a 45 year old father that COVID has ravaged his body and he wouldn't survive off the ventilator and there's nothing more we could do. He didn't die comfortably or with dignity, he was unconscious from sedation and couldn't say his final goodbyes.

Uglybass69 posted...

It's all part of the circle of life and death is as much a part of medicine as any other aspect.

That's exactly how I feel about it

DKBananaSlamma posted...

Are you more used to death now that you did the job longer or is it still tough on you? >_>

Its still sad when someone you got to know well dies, but it doesn't weigh heavy on my soul or make me depressed constantly. Yes, I'm used to death but there's solace in knowing they aren't suffering anymore. Death in the hospital was usually a lot harder because it wasn't the "goal".