Caring for Patients as a Hospice Nurse (Podcast)

Ashley Clifford, RN, began her nursing career at Cleveland Clinic on a surgical intensive care unit. After realizing it wasn’t the right fit, however, she quickly pivoted to hospice care.

While some nurses might find the thought of hospice nursing daunting, Clifford is passionate about the specialty.

“I think that all of us nurses are in the mindset that we have to save everyone, we have to fix everyone,” says Clifford, a nurse case manager with Cleveland Clinic Hospice Care. “Whereas with hospice, you can kind of step back and say, ‘You know what? I don’t have to save you, but I can help you.’”

In the latest episode of Cleveland Clinic’s Nurse Essentials podcast, she provides an inside look at hospice care. Clifford discusses:

• The transition from hospital-based care to home care
• The role of hospice nurses in the hospital setting, hospice facilities and patient homes
• Levels of care provided by hospice nurses
• Learning to have difficult conversations about end of life with patients and their families
• The difference between hospice and palliative care
• Sorting through the emotions of losing patients

Click the podcast player above to listen to the episode now, or read on for a short, edited excerpt. Check out more Nurse Essentials episodes at my.clevelandclinic.org/podcasts/nurse-essentials or wherever you get your podcasts.

Podcast excerpt

Podcast host Carol Pehotsky, DNP, RN, NEA-BC: Sometimes in the media and the literature you hear the phrase, "having a good death." What does that mean to you as a hospice nurse?

Clifford: I think that as hospice nurses, that's our whole goal – for [patients] to have a good death. And so, to me, when I think about a good death, I think about a death that is comfortable. So, you are not in pain. You're not gasping for air. You're not surrounded by a family that is overly sad. I feel like they are prepared – allowed to be sad, but they are prepared for it because we have done our job to prepare them.

I think to me that is a good death Just knowing that you're comfortable, you're medicated, your family has helped you get there. And your family has given you the permission and told you that they're going to be OK.

Pehotsky: So, I'm thinking also of death and dying as part of nursing in other settings. What advice would you have for the nurse not working hospice to help families deal with those situations and feel more prepared, like you just mentioned?

Clifford: I think that educating ourselves on death and dying is key. Before I was a hospice nurse, I didn't know much about death and dying. I had no idea. I think … reading some evidence on it and some literature, and then getting out there and actually speaking to patients and letting them know about the evidence – carrying on the information that you have obtained and just being there.

Some people don't want you to say anything. Some people just want you to stand there and just be present with them.