RELEASE DATE: May 4, 2009

Delaware Hospice recognizes and honors their dedicated nurses on the occasion of National Nurses Week, from May 6-12. Delaware Hospice’s nurse and team leader, Claire Walsh, talks about the specialty of hospice nursing in this article. Anyone interested in learning more about this worthwhile and fulfilling career may call a Delaware Hospice Human Resources representative at: 1-800-838-9800.

Delaware Hospice Nurse, Claire Walsh, RN, CHPN

“I realized I was being more helpful to my patients and their families as a hospice nurse than I had been in any other nursing role,” said Claire Walsh, RN, CHPN, of Dewey Beach. “As a nurse for Delaware Hospice, you’re allowed to do what you always thought you would do as a nurse.”

Born and raised in Sussex County, Claire Walsh chose nursing as a career because she knew she’d be able to find a job. Upon graduation from Delaware Technical & Community College in Georgetown in 1980, Claire gained experience working in several hospitals. During a stay in Florida, she ran an Alzheimer’s unit at a Jewish nursing home in Palm Beach.

“This was the first time I’d ever met people with concentration camp numbers on them,” she recalled. “It was a tremendous experience for a sheltered Catholic girl from a small town. The hardest part was to hear them re-living what they had been through. One day I found myself crouched outside, crying, listening to a woman lose her family over and over again. I learned almost firsthand what they suffered in the camps.”

After a few years, Claire returned to Delaware and moved in and out of a variety of nursing positions. She served as a private duty nurse and in hospitals and long-term care facilities. “I enjoyed the people I worked with and providing care to people who need it. I gained excellent experience in technology, professional skills, and public relations. However, I found it frustrating and discouraging to never have the staff, time or resources to do what I felt should be done. I witnessed needs going unmet, patients in pain, and chronic understaffing.”

Claire “burned out,” left nursing, and said that she wouldn’t go back. Three months later, she ran into a friend at a restaurant who said, “You should consider working for Delaware Hospice. They’re hiring and you’d be good for hospice care.”

Claire had never heard of hospice until then. “My father died at home in 1994 of debility, and none of his five physicians ever told us to call hospice. My grandmother had COPD—one of hospice’s more common non-cancer diagnoses today—and died in the hospital in 1995. We had to fight to get her off life-sustaining treatment and, again, no one ever said, ‘Call hospice.’

Claire followed her friend’s advice and interviewed for a position at Delaware Hospice. “They hired me as a PRN or “nurse as needed.” Before long, I became an on-call nurse, then part-time, full-time, Admissions Nurse, and now I’m a Team Leader.

She soon realized that there’s quite a difference between what hospice nurses do and other nurses. Hospice nursing provides personal growth through sharing incredible experiences with patients and families. In fact, research now documents the fact that hospice nursing has a profound impact on nurses.

“As a hospice nurse, you drive up, knock on the door, and walk into a new adventure—to such a variety of situations, homes and lives. You walk into families who are at a critical time in their lives. They might be anywhere on the journey, and family members can be all over the map.

“I’ve met the most gracious people and I’ve received so much more from families than I ever hoped to give. I’ve left homes feeling better about life and myself than I did when I walked in.”

Claire feels that to be helpful as a nurse makes you feel worthwhile. “It’s actually the reason that most of us went into nursing--besides to get a job. Too often, patients admitted to hospice are in pain, and I often wonder why they’re in pain when it takes only 24 hours to control that pain. In hospice, we ask, ‘What do the patient and family want, or what do they need to get through this journey?’”

Hospice nurses spend considerable time educating patients and families about medication and clearing up misconceptions, such as “I can’t take this med now because it won’t be effective when I need it,” or “I’ll become addicted to it,” or “They’ll die with morphine.”

Claire vividly remembers an early experience with a couple who were both prisoners of war during WWII. They had walked across Europe to find each other and were both very strong people. Food and water meant life to them. Claire said, “Upon admission, he could no longer eat or drink and this was horrible for her. I had to explain that it was time to call her family. She couldn’t accept that and insisted he needed food and water, even though he was non-responsive. I received a call that night that he had passed away. As I walked in the door, she shook her finger at me and said, ‘You gave him morphine and killed him!’”

“So I spent hours with her, leading her through the process to understand what had happened and convincing her that he was going anyway and had been able to go in comfort. Delaware Hospice’s Bereavement Department counseled her, and I understand that three years later she continues to bring us cookies and cake!”

Many nurses would never consider a career in hospice simply because they lack understanding about what a hospice nurse does and the many benefits of this role. They think it’s about dying and death, when, in fact, 99% of the time it’s about living and quality of life.

Claire discussed the role of a hospice nurse in detail: “At Delaware Hospice, nurses enjoy autonomy—you’re not bogged down by tremendous oversight. You are free to use your professional skills to make professional judgments. You must be comfortable with your assessment and clinical skills, and you are faced with ethical decisions. You schedule your day based on patient needs. You must have good time management skills as you are primarily in charge of your own day.”

“Of course, one doesn’t face the end-of-life journey without spiritual and psychosocial components, and it’s comforting to know that you are part of a team that includes social workers, certified nursing assistants, chaplains, bereavement counselors, volunteers and office support staff. In no other type of nursing do we work as closely together as a team as we do in hospice, and Delaware Hospice provides all the support you might need.”

Hospice nurses use their nursing skills daily, although some days may be lighter than others. Claire said, “On a typical visit, a nurse will assess respiratory and lung sounds, cardiac sounds, conduct head to toe physicals, or examine skin and diet. We might change meds frequently to get symptoms under control as quickly as possible. We consult with pharmacists to find what works for that particular person and which can be administered in the least painful way possible.”

“You rely on your technical skills with a variety of equipment for patients on oxygen, suction, morphine pumps, or feeding tubes. However, I’ve never run into equipment that was so heavy that you lost sight of the patient as I’ve seen in hospital settings.”

Claire said, “Probably one of the most frequent worries you face is ‘Mom won’t eat or drink anything.’ Sometimes you can help mom eat or drink, and sometimes you need to help them to understand that that’s no longer the best thing for Mom to eat or drink. Helping them get to that point requires a lot of education and explaining over and over again. Fortunately, Delaware Hospice gives you the time to do it and reinforcement from your team members. You might also find yourself drawing on what you learned in classes you never wanted to take, such as Psychology 101.”

Claire feels that hospice nurses, as well as all staff and volunteers, should never underestimate the value of the ministry of their presence. “You may not have the answer or be able to change a situation, but just by being there you are meeting a critical need.”

“Above all,” Claire reflected, “you truly get to make a difference in patients and families’ lives. And they remember you for a long time. I’ll be in the grocery store, in the mall or Church, and someone will come up to me to say, ‘You took care of my father five years ago, and we can never thank you enough.’ You acquire a permanent place in peoples’ lives. You receive so many thank you cards. It is difficult when you establish relationships and suffer loss, but you grow with an appreciation of the big picture—that it’s about the journey and gathering positive experiences.”

By Beverly Crowl, Public Relations Specialist, Delaware Hospice, 302-547-1816, This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

About Delaware Hospice
Since 1982, Delaware Hospice has provided exceptional care and support to 30,000 patients and their families. Its mission is to help each patient, each day, live the fullest, most comfortable life possible. Delaware Hospice is the largest and only licensed, nonprofit, community-based hospice serving New Castle, Kent and Sussex counties in Delaware and southern Chester and Delaware counties in Pennsylvania. For more information about Delaware Hospice’s programs and services, upcoming events, or employment opportunities, call 800-838-9800 or visit our website, www.delawarehospice.org.