Is Palliative or Hospice Nursing For You?

By Marijke Vroomen-Durning on Fri, May 23, 2014

hospice nursing"It must be so depressing,” is often the first comment. It’s followed by, “Oh, you must be special because it has to be really hard.” The first time I heard those comments, I was actually taken aback. But these are often the first things you hear when you tell someone that you work as a palliative or hospice nurse.

I don’t work in palliative care anymore. But I had the privilege of doing so, part-time, for almost five years. It wasn’t depressing and it wasn’t “really hard.” In fact, it was the most rewarding nursing job I’ve ever done.

Nursing School

In nursing school, we’re taught how to help people as they recover from their illnesses, injuries, or surgeries. Death is discussed, most often in terms of us trying to avoid it. However, there are some lessons on how to deal with dying patients and their family members.

More schools are introducing a palliative care and hospice component to their nursing programs. But it is only recently that palliative and hospice care is coming into its own as a specialty that nurses want to work in.


Often, the question asked is “why?” Why would someone want to work in palliative or hospice care? To me, it’s very simple. It’s a completely different type of nursing career than what we’re used to in the hospitals. We know that these people are dying and that they will die, sooner than later. Our goal isn’t to prolong their life, but to help them live their life as comfortably as is possible in their remaining time.

It used to be that people just waited to die. But with modern medicine and know-how, we can help make those final days comfortable enough for many for them to enjoy them. They can visit with family members and friends. They can tie up loose ends. They can laugh and cry. They can take the time to say good-bye to those they love.

Hiding Death

When I was a nursing student—and later working on the floors—I came across many situations where dying patients weren’t told they were dying. In fact, often the patients would ask outright; only to be told, “No, you’re not dying” by their family members. They had decided it was best for the patient not to know.

Even back when I was 20 and not all that experienced, I knew that was wrong. It was wrong to rob someone of the opportunity to end their life in a way that they could finish what they could finish.

I would often say, “How lonely must it be to be dying,” and know that the people around you are lying to you and won’t talk about it. I say that because in my heart, I truly believe that the vast majority of dying people know that they are dying, even if they are told that it isn’t so. I can’t imagine what it must be like to be denied that honesty right up to the end.

Palliative care and hospice nursing allow for that honesty. It allows us, as nurses, to help the patients do what it is they need to do. We provide to them the most intimate of care possible. What is more intimate than being there to listen to them, to talk to them, to care for them, in their final days?

The Reward

The reward from palliative care comes out throughout the time we have with our patients. When they can move from one stage to another, when they can ask for help and get it, when they can talk openly about what they want and what they can do.

In the end, we know we have our job when we know that the passing has been as pain-free as is possible, when the families have had a chance to say good-bye, and when we can turn around and give the same care to the next patient who needs us.

Have you ever considered working as a palliative or hospice nurse? What are your thoughts?


Connie smith 3 months ago
My choice out of nursing school was oncology. I worked there for 8 yrs. Loved it and loved my patients. Nursing staff worked together and we had our patients from diagnosis to death. We were fortunate enough to have support from our doctors and administration. We also had a psychologist who came to our floor weekly. This was for patients but more for staff. On any given day we could check obits and usually there was someone we knew. Some of our docs were not good at explaining DNR status. I explained hundreds of times to patients and families. Most people do not understand what goes on during a code. I explained. Or to encourage families to adhere to the requests made by their family member. And to think of the patient and not make selfish decisions. Palliative care should be in every hospital. Our floor was very upbeat and we did everything to make sure it was never a depressing place.
We are all going to die at some point. My job was to ease the patient and family into the inevitable. Keep the patient comfortable. Know that sometimes you are medicating the family. If family thought the patient was hurting because they groaned or grimaced, they asked for meds to be given. As a nurse, it's not up to u to judge whatever decision is made. Talk to the family and encourage them to keep talking to the patient. Let them know u are there and that u will be ok. Give them the peace they need to slip away

Carol Hardison 9 months ago
Hospice nursing means doing all the things you wanted to do when you were in nursing school. Comfort, care, touch, teach, laugh and cry with patients and their families. It is not depressing to me, but it is not for a nurse who gets seriously attached to every pt and can't accept death as part of life. I have met the most amazing patients who have chosen to take control of the life they have left. It is a privilege to walk the journey with these pts and their families. It is the most rewarding nursing I have ever done.

Kate Carpentier 9 months ago
I have had the honor of working in a faith based, not-for-profit Hospice for 10+ years and feel truly blessed to be able to do the work we do there. This is the reason I went to nursing school! Hospice and palliative care is to listen, touch, clean, teach, pray, share, and do all you can within your knowledge and skill to help this patient, family and friends walk this journey with peace, dignity and comfort. And yes, it is very rewarding- you get more than you give often time. You learn something with each patient. That helps you take even better care of the next one....

Anonymous 9 months ago
very well written. Death is something that is going to happen to all of us sooner or later and although I would think the job is not an easy one emotionally---palliative care nurses can help patients have a little less difficulty at the end.

Connie smith 3 months ago
We had times when we would sneak the patients pets inside. That was wonderful.
I worked Onc and palliative care as a travel nurse also. It truly is an amazing experience to provide peace and comfort to those who are in this situation

Trudy Armstrong 9 months ago
I have been a hospice nurse 7 years and can say this is the most rewarding and humbling experience of my life. We are allowed into a patients and their families lives in the most personal time of their lives. We care for the families, not just the patient. Itis continuous education for the families by the nurse walking them through their grief as well as the grief experienced by the patient. I have taken part in making finsl wishes come true.We have prepared a luau for one patient, a wedding for another, a baptism for another. Oh and the patient who wanted to see the sun rise once more. We bundled her in blankets, placed her in a gerichair and rolled up and down a snow filled driveway for the perfect view of the sunrise. Her expression was priceless. But then she requested watching the sun set. No problem, our routine was mastered by that point, and oh what a view it was that wjnter evening. So, you see, hospice nursing is so much more about symptom mgmt with medication. Its caring for the spiritual, emotionsl, and social sides of the patient and the family all while respecting final wishes and treating others ss you want to be treated ehe your time comes. 9 months ago
This article made me think. Well, nice article though.