With hospice being all about death and dying you’d think that it be all panic all the time. After all if everyone is dying then everyone is in crisis.

The truth is that “dying” is much more of a continuum in hospice care. Everyone is dying to some degree, but not everyone is on the brink of death. Hence the Monty Python and the Holy Grail bit.

Dying can take place over months, with gradual withdrawal and decline followed by more acute symptoms within the last few days. Of course it can also happen very suddenly, with almost no warning at all. I still remember seeing a new patient at the hospital who had just come on. She was complaining bitterly about pain in her back. The nurse had already given her some medication, so we thought re-positioning her would help the pain. We rolled her on her side and put a pillow under her shoulders. As she was no longer upset we thought we had helped. It turned out that she had just died.

Most of my visits are relatively routine, with side tracks for new admissions and schedule changes here and there. There are occasional emergencies of course. But even these emergencies are unique each time. A person dying isn’t necessarily an emergency on its own for example. If the family is struggling or the patient is having problems those are emergencies. But a patient dying comfortably under the care of trained staff isn’t an emergency. I get some strange looks whenever I tell a family that a patient is “doing pretty well” as they’re dying. “Pretty well” in this case refers to their dying in comfort without distress rather than being healthy. Sharing that often helps families with their own acceptance and that dying itself can be “ok”.

just like those miserable psalms, they’re so depressing!

Last time I wrote about how people chaplaincy isn’t always as fulfilling as it’s perceived to be. Well it’s not so glum either. Chaplaincy, on its good days, is incredibly rewarding.

My sister was a nurse in a transplant ward for several years, and a friend of hers worked in a burn unit at a different hospital. When they talked about their jobs, they often said that they could do the job the other was doing. However they found their own jobs relatively easy to do. Part of this comes with familiarity. When you’re new to something, it’s stressful. However with time those things become mundane – even things that others would find shocking.

The same often happens with hospice. Often I hear family members say that this job must be terribly depressing, given that we deal with death every day. However the truth is that we do not deal with death every day. True we have our share of deaths and emergencies every week, but not necessarily every day. I find that the good days with my patients come more often than the bad ones. Being able to take a patient outside, share a funny story, hear memories from veterans, or be ogled and fawned over by old ladies (which happens in my case) can brighten my own day as much as my patient’s. I find their lives touch my own in so many ways and that I grow so much from them, that I find it hard to be depressed most days.