What I’ve learnt from working in a hospice

Categories: Care, Featured, Must Read, and People & Places.

Andrew Knight is a Staff Nurse at St Catherine’s Hospice in Crawley. Here he reflects on the lessons he’s learnt from 26 years working in hospices caring for people at the end of their life.

I’ve worked in hospice care for 26 years, over half of my career. Looking back I think that I was rather naive when I first went into working in the special place that is a hospice. But I’ve learnt many things since then. Here, I wanted to share the overarching lessons I’ve learnt.

Hospice care is vitally important

I often think of a notice that was displayed in a neonatal unit in New York. It said, ‘The first 48 hours are the scariest’, underneath which someone had scrawled ‘And the last 48 aren’t so clever either’! They aren’t, but hospice care can make them so much better.

It’s important to talk about death and dying

Just like we discuss birth plans, we shouldn’t be afraid to discuss our wishes or plans for our death. And to acknowledge that people’s deaths need to be managed.

We’re better at talking about it than we once were. Today there are websites, blogs, death cafes and people publically sharing experiences of receiving diagnoses, treatments, and experiences of palliative care. But it was not always so.

I believe hospices have helped open up conversations around death and dying, and although we’re talking, there is still more we can do. We can all play a role in making sure we normalise conversations about death and dying in our professional and personal lives.

End of life care relies on lots of experts

This might seem a strange thing to say as a nurse who proudly recalls that end of life care was once a nurse-led speciality, but thank goodness that we now have the professionalism, skill and science of our multi-disciplinary colleagues. As a nurse, I have benefited immeasurably from the input of my medical colleagues, who in turn, I hope have benefited from hearing from my colleagues and I.

There’s no such thing as an ‘ordinary’ family or patient

I recall a nurse once asking ‘Are there no ordinary, functional families anymore?’ I laughed in recognition as it can often seem that we only deal with dysfunctional families during someone’s end of life. In reality, we help families, like any other, who are trying to cope in extraordinarily difficult circumstances.

I used to remind colleagues that ‘you only lose your mother, father, brother, sister, son, daughter, whoever once’ so it’s up to us to make that experience as good as it can be, while acknowledging that the situation is awful.

We see families trying to adjust their behaviour when someone they love is dying. You’ve probably seen it too. And it doesn’t surprise me that my colleagues and I are often asked, ‘How long has she or he got?’ by families. Really, they mean ‘How long is this hell going to last?’ It’s never a surprise to me that many families can’t bring themselves to come back to a hospice after their loved one has died. But equally, it’s always important to acknowledge for those who do, how hard they may have found it.

We do everything with love

We have a love of our jobs, a willingness to stick with problems, and a love that says that we will help you and we will do our best. For to nurse is to love.

Suzanne Moore wrote in the New Statesman magazine about the time she was with her daughter who was in a coma. Her daughter had sustained a fractured skull after coming off her bike very fast. It was her twelfth night in hospital. ‘The nurses were incredible, washing the dried blood out of her hair. Sitting with us, 24 hours a day. They put lip balm on her, which reminded me of the hospice in which my mother died. I know too much about intensive care. But I also know love when it is in front of me.” ‘Yes,’ I cried, ‘that’s it!’ She was so right. I see this kind of love everyday at St Catherine’s. In reception, housekeeping, and our onsite coffee shop. Love is here. It’s part of our fabric.

Hospice care is not everyone’s choice of job.   But it is mine. It’s one that I’m glad I stepped into and that I’ve been fascinated to see grow over the years. Hospices serve an essential human need: caring for the dying and those that love them. And 26 years on, for me, there remains something special about doing that.”

For more information visit St Catherine’s Hospice