Answering the call of hospice nursing

Caring for communities

As a hospice nurse, it’s common for people to ask me if I believe hospice is a calling. My answer? Absolutely. 

My first experience with hospice was different compared to most. I was a teenager and my mother was receiving hospice care. After she passed, I vividly remember my younger brothers’ somber faces and trying my best to comfort them after our tremendous loss.

Seeing the pain on our faces, one of my mother’s hospice nurses sat with us and effortlessly provided the comfort we desperately needed. I was amazed at a how a nurse could console my brothers in a time when their own sister couldn’t.    

A few years later I found myself on the path to becoming a nurse myself. I started off in orthopedics but soon fell in love with the fast-paced, high adrenaline atmosphere of the ER, and even moved to Alaska to pursue my career there.  

Although I loved my time in the ER, I began to feel as though something was missing. I enjoyed the challenge of my job and the satisfaction it brought, but I still felt like I was longing for something more.

I ultimately decided that I needed a change of pace. For me, that meant going back to my roots and moving home to southeast Idaho. 

Once I moved home, I began working in home health. I had friends from nursing school who worked for Enhabit Home Health & Hospice who shared how happy they were. Enhabit had a long-standing reputation in the community for being an ethical and reliable organization, so I knew it was a good fit. While working with the home health team, I was approached by the Enhabit hospice branch director in Pocatello.

While working with the home health team, I was approached by the Encompass Health hospice branch director in Pocatello. She presented a unique opportunity for me to cross-train between our home health and hospice service lines. I immediately recognized this as my next great challenge and accepted her offer.

While working for both our home health and hospice branches, I quickly realized how the two service lines require clinicians to think in completely different ways.

In home health, clinicians view positive outcomes as their measure of success. Home health nurses focus on education and their main goal is getting patients better. If a patient starts to decline or has unstable vital signs, it is often considered an emergency. 

As a hospice nurse, you know what the expected outcome is for your patients and your goal is to make them as comfortable as possible during the end of life. Compared to home health, unstable vital signs are often common in hospice. Instead, nurses view uncontrolled pain or symptoms, or even caregiver burnout, as emergencies.

Another significant difference in hospice is the focus on family. Not only are you treating and caring for patients, but you’re also providing emotional and spiritual support for the patient’s most important people. As a nurse in the field, my favorite part of hospice care was helping patient families and being there for them when they needed me most.

I loved the challenge of switching between these two mindsets every day and how it allowed me to be with patients throughout the different stages of their care journeys.

Not every nurse who works in home health can work in hospice, and not every hospice nurse can work in home health. Home health nurses are amazing in the way they are able to see the big picture and help patients achieve superior outcomes.  

However, it does take a special person to work in hospice. Hospice nurses have a way of doing things that others cannot. You have to be a strong person with firm values and beliefs to be able to do what we do each day. You have to have the ability to dig deep and push past the difficult moments of the job to truly understand the beauty of it all.

Inside every nurse is a need to be fulfilled. When we have a patient who is in their most critical moment in life, hospice nurses are able to be that person for them or their family, and I find that extremely fulfilling for me.

Looking back at my first hospice experience, I realize that I was called to be a hospice nurse. I now serve as the hospice branch director in Pocatello and can finally say I have answered that call.

I never thought I would end up being that nurse who was there for me so many years ago. I’m honored to now provide that same compassionate care that was shown to me to others during their greatest time of need. 

Heidi Hale, BSN, RN, is a branch director in Pocatello, Idaho.

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