Most nurses come to hospice from other healthcare jobs, but all have an interest in helping patients and families through one of the biggest events in their lives.

Why enter this field?

"I had many older relatives and I was exposed to death at a young age," says Rachel Rollie, RN, who came to hospice from long-term care and is now a team leader at Plymouth-based Hospice of the Twin Cities. "I felt comfortable around death and decided what a wonderful way to be able to use my nursing talents to be able to care for people in their dying stages."

Hospice of the Twin Cities employs 41 nurses, plus social workers, chaplains, music and pet therapists, home health aides and homemakers, according to Lisa Abicht-Swensen, chief executive officer. "We serve people wherever they live: in private homes, in skilled nursing facilities, in assisted-living facilities," she says. "We've even cared for people in homeless shelters."

Major healthcare providers such as Park Nicollet Health Services offer hospital- and home-based care, according to Nancy Gelle, RN, manager of the hospice program. Both programs also accept volunteers.

What these nurses need

Regardless of the setting, hospice nursing is hands-on care, says Susan Smith, RN, a night nurse with Hospice of the Twin Cities. "You're dealing with specific symptoms and issues," Smith explains. "You have to know the disease progression of just about every end-stage terminal disease," plus pain and symptom management.

Hospice nurses also must be able to address patients' emotional and spiritual needs while not getting emotionally over-involved. Hospice programs recognize that need and offer several ways to help.

Support on several levels

Hospice nurses are part of a team who can support them daily as well as with weekly meetings and annual retreats. During on-the-job training, nurses stay in close contact with mentors to help them through difficult situations, Rollie says.

Park Nicollet also holds an annual memorial service, where families and staff reunite to remember patients. "I think that reconnection with families is very helpful to people," says Gelle.

Adds Smith: "Hospice is about enjoying every moment. When you focus on providing the best quality of life that you can rather than on death, it puts a different focus on it."

Nancy Crotti is a freelance writer who lives in St. Paul.