Nurse Shares Transformative Lessons Learned from Working with Dying Patients in Hospice Care Across the United States

Nurse Shares Transformative Lessons Learned from Working with Dying Patients in Hospice Care Across the United States

As an oncology nurse, I never imagined how profound an impact my work would have on my own view of life and death.

One patient, in particular, Madeline, left an indelible mark on my perspective.

Madeline, a 44-year-old woman with gallbladder cancer, went through an unexpected journey in her final days that reshaped how I see the process of dying.

Madeline’s Unexpected Clarity and the Concept of a ‘Good Death’

Madeline’s final moments were not filled with fear or anxiety but with clarity and excitement.

After suffering a fall that led to a hip injury, she was rushed to the hospital where her health rapidly declined.

A blood clot from her hip soon traveled to her lungs, and it was clear that her time was running out.

One evening, as she woke from a nap, she told her sister, “Get my sister! I’m transitioning!” She said this with such enthusiasm, almost like she was embarking on an exciting new adventure.

Her calm acceptance and positivity around her death were truly remarkable.

To see someone approach death not with dread but with the energy of a traveler heading toward something new was awe-inspiring.

This experience helped me see death differently—it could be peaceful, transformative, and even welcomed.

I began to think of it as what I now call a “good death.”

What Dying People Often Say: Four Common Insights

From my time in hospice nursing, I’ve heard similar thoughts from countless patients nearing the end of their lives.

Despite their different backgrounds and beliefs, these four sentiments are strikingly common:

1. There is no death. I’m going home.

Many dying people express a deep sense of returning to something familiar, something beyond the physical body.

Whether they speak to loved ones who have already passed or have always held a belief in an afterlife, they seem to feel they’re heading home, transitioning into a new phase of existence.

2. Everything happens for a reason.

As patients approach death, many experience a profound “life review.”

They gain clarity on why they faced certain struggles or painful experiences, seeing them not as random or punitive, but as necessary lessons that helped them grow.

This newfound understanding often brings them peace and comfort, easing any regrets they may have had.

3. There is no judgment.

One of the most beautiful things I’ve witnessed is dying people forgiving themselves and others.

They realize their mistakes and missteps were simply part of being human.

They come to understand that there is no punishment or judgment after death—only love and the lessons learned throughout life.

4. We are all connected to one unconditionally loving energy.

Even those who once harbored prejudices or grudges often experience a shift.

As they near death, they recognize that all beings—humans, animals, even nature—are interconnected through a deep, unconditional love.

This realization often comes as a surprise, but it profoundly eases the transition from life to death.

The Phenomena That Accompany the Dying Process

Beyond the things people say at the end of their lives, there are also physical and spiritual phenomena that frequently occur:

1. The ‘End-of-Life Rally’: A Burst of Energy

It’s common for people nearing death to experience a sudden surge of energy.

Even if they’ve been bedridden and non-responsive for days or weeks, they may suddenly wake up, energized, and mentally clear.

This “rally” often allows them to say goodbye to loved ones before passing away shortly after.

2. Timing Their Own Death

Many dying people wait for a specific moment to pass away.

Whether it’s a significant date, like a birthday or anniversary, or the arrival of a family member, they seem to hold on until a certain moment feels right.

In one case, I knew a woman who waited until just four hours after midnight on her 100th birthday before she passed away.

3. Waiting for Permission

Some people hold on because they don’t want to leave their loved ones behind.

In these cases, hearing gentle reassurances like, “It’s okay to go, we’ll be fine,” can help them release their grip on life and peacefully transition.

4. The Final Act of Love

There are moments when a dying person will wait for their loved ones to leave the room before passing.

This can be heart-wrenching for those left behind, but it’s often seen as the final act of love—the person wants to spare their loved ones the pain of witnessing their last breath.

5. Visions of the Departed

It’s not unusual for dying patients to report seeing or communicating with loved ones who have already passed.

Many speak of these experiences not as hallucinations, but as real interactions with those they’ve lost.

These moments bring comfort to the patient and their family, offering a sense of peace and a reminder that death is just another form of transition.

How My Own Life Has Changed After Witnessing Death

Witnessing these incredible experiences over the years has completely changed my approach to life.

I’ve come to live each day as though it could be my last, focusing on being fully present and appreciating the small moments that make life beautiful.

It has taught me the importance of service to others, even in the simplest ways, like offering a smile or holding the door for someone.

Just as I followed my heart in choosing hospice care over traditional nursing, I now strive to listen to my inner guidance every day.

This led me to start the Doulagivers Institute, where I can train both professionals and family caregivers in how to handle end-of-life care with compassion and understanding.

I focus on gratitude and connection, seeing life as a journey of growth and learning, just as the dying often reflect upon their own experiences.

And above all, I have learned that there is beauty in death—it’s a sacred, inevitable part of the human experience.

The Beauty of Dying: Lessons From the End of Life

Through my work in hospice care, I’ve learned that death isn’t something to fear.

Instead, it’s a natural and beautiful part of the cycle of life.

I’ve witnessed countless patients who, in their final days, taught me that life and death are seamlessly connected.

It’s something we all share, and in their passing, I’ve found profound peace and beauty.

In my book The Good Death: A Guide for Supporting Your Loved One Through the End of Life, I share these lessons and insights to help others approach death with understanding and compassion.

The book will be published on March 18 by Little, Brown Spark, and I hope it will inspire more people to view the end of life as a sacred, transformative journey.