Midwifing, in death as in life
Dealing with end of life matters occurs in all areas of health care, but for me, the transition from ICU to hospice was like taking a deep breath and recognizing "I'm home." That was 27 years ago, and while I miss the constant presence of attending those who are dying while I was an inpatient hospice nurse, it has been refreshing to return to visiting those we care for in their homes. As a home hospice nurse, we visit wherever "home" is for that person, be it a private home, a variety of care facilities, a homeless shelter, a trailer, or even a car. We are guests, there to guide and support during a time of high emotion, stress, and fear. Even after all of these years, the common response from others upon learning of my profession is "Isn't that so depressing?" For me, the answer has been and remains "Not at all!"
In my past life as a home hospice nurse, I hadn't fully appreciated the intimacy of being present with a person dying in their home. While all inpatient hospice facilities are mandated to appear homelike, we were able to provide care with the precision, albeit incredibly compassionate, of other hospital units. As a member of a home hospice team, I usually am by myself as I assess and provide hands on care. As I finished cleaning my patient, knowing I may not see her again, I gave a silent thanks to the opportunities I have been given to care for people in this way. I whispered into her ear to find the best cloud she could to float away on.