You are reading part 3 of my series, “Avoiding Hospice Burnout.” If this is your first time reading this series, please visit my first post by clicking HERE. This will help you get a quick overview and the foundation for this series.

Since the title of this blog is “Confessions of a Hospice Nurse,” I thought I would start this week’s post by making a confession.

I have a hero complex. I really do. I want to save everyone. Not from a medical or spiritual standpoint. I just want to be everyone’s hero. Hospice can really feed this desire. I get to show up to someone’s house and be the hero. I’m the center of attention when I walk into the room. I sit down. Everyone gets quiet, and they wait to hear what I have to say. A lot of the time, I have undivided attention. Everyone hangs on everything I say. They want to know how long their loved one has to live. They want to know what medications fix their issues. For a few short minutes I have all the answers to all the problems. I can even predict when someone is going to die.

I am powerful.

Replace Yourself

Nurses are natural caregivers. Hospice nurses are a whole new level of caregivers. We walk in to some of the most demanding and challenging situations. We feel it is our duty to help bridge any and all challenges we encounter. We trained for this. This is what we do. We look for the problems, and our brains start running at break-neck speed to find the solutions.

The desire to have all the answers and solve all the problems is a major contributor to hospice burnout among nurses. It causes us to attempt to fix too many problems and stay longer than we should. We become the center point. We become the one with all the answers. The home becomes dependent. They want our number. They want to call and text us after hours. They need us.

My first six months as a case manager in hospice were overwhelming. I felt responsible for everything that happened in the home when I was there and when I was not there. I felt responsible to be available around the clock as a resource to my families and patients. After all, I’m the hospice nurse. I know stuff!

Eventually I realized something. I am not the hero in everyone else’s story. That is not what hospice nursing is all about. Hospice is supplemental care. It is our job to empower our caregivers to be the hero in their own story. They are caring for someone who, at one point, probably cared for them. I have sat with more than one daughter, wife, husband and son, looked them in the eyes, and said, “You can do this. I believe in you.”

How do we achieve this in practice? Let me provide you with some solutions.

1. Never be critical of your caregiver. Nurses are critical thinkers by nature. Many caregivers are emotionally fragile. It’s a natural condition when caring for someone who is dying. We do this work all day long. This is usually their first time. If they have cared for someone at end of life before, it was probably a lot different, because no two deaths are alike. Even if your caregiver did make a big mistake, don’t focus on the mistake or be dramatic about it. Watch your facial expressions and your posture. It can send the wrong message.
2. Reinforce good behavior. Be sure to focus on all the great things your caregivers are doing. Even if they are struggling in many areas, point out how well they are doing in other areas. It’s okay to lie a little. They are doing the best they can given the situation. Remember, we are there for a few minutes a couple times a week. Our caregivers live this every day. They are tired and stressed. They need to know that they are awesome!
3. Turn off your work phone after hours. This is absolutely huge! We do not want our caregivers to become dependent on us. They should see us as part of a larger entity. They should believe that any nurse within our organization is capable of meeting their needs. They should expect and know to call “the main number” any time they have needs outside of regular business hours. Even if you use your own phone, do not reply after hours. I know it’s hard, but this is a must.

A few years ago I met the most amazing caregiver. He was adopted, and he never knew his birth father. One day he decided to try and find his dad. This amazing man learned his dad was living several states away, and he was homeless. He was able to get in touch with him, and he discovered his dad had terminal cancer. He had his dad transported back here to Kansas City to be his caregiver while on hospice. I cried at every visit because it was so beautiful. He cared for his father until he died.

Now that is a hero.

Visit The Hospice Nursing Community for more assistance in avoiding hospice burnout.

James

James worked on-and-off as an LPN for over 20 years. In 2014 he completed a bridge program and became an RN. James became a hospice nurse in January 2015. He lives in the Kansas City area with his wife of over 30 years, 4 daughters and 2 sons in law.