QUESTION: I am a Hospice Nurse for 3+ years but have been a nurse for over 35 years with varying experiences with death and dying prior to my present Hospice experience. I am a Christian and have some difficulty working with people from other faiths. I have asked many people of how I can help my patients and their loved ones when they are not Christian. I pray for these folks and I truthfully believe that before that last breath our Lord visits the patient and offers them eternity. The Christian leaders I work with are not really happy with my interpretation, but my own Mother I know saw either my Dad, Jesus or both at a day before her passing. She was a believer and I believe that our Lord wants all to come to him. Do you have any words of wisdom I could use with families or patients themselves at end of life?

I am so glad you asked me this question. End of life brings to everyone’s mind a spiritual aspect and with spirituality most people think of religion.
I would like to submit the idea that spirituality and religion are different. In Dictionary.com “spirituality” is defined as being “of or relating to the spirit or soul, as distinguished from the physical nature . . . of or relating to sacred things or matters...” where “religion” is defined as “a specific fundamental set of beliefs and practices generally agreed upon by a number of persons or sects”. I believe everyone has an essence of spirituality about them (belief in the essence and beauty of life is not reserved solely for those who believe in God). While most people’s religion includes spirituality, some people’s spirituality does not involve religion.

Different people have different beliefs that get them through the life experience. As professional health care workers our responsibly and our expertise is in medical assistance. That said, we each bring our own individuality and personality to the connection and interactions with our patients. Our expertise is not in spiritual and religious matters.

Patients approaching end of life present another perspective to care. End of life brings with it thoughts of God or no God, meaning of life, personal beliefs and expectations. This sometimes blurs the line of the care giver’s role which brings me to your question: Do you have any words of wisdom I can use with families and patients at end of life?

I don’t know about the wisdom but I do have some thoughts. As health care workers, even hospice, it is not our place to express our personal beliefs to patients and families --unless we are asked. We don’t say we are praying for them, we don’t talk about the Lord, we don’t share our beliefs. It is not our place or our purpose for being in the person’s life.

In sharing our beliefs, unasked for, we are getting into their personal space uninvited and can actually be more hurtful than beneficial. (Our intent is to be helpful but in most cases sharing one’s personal religious ideas is not helpful and can border on being offensive). Listen to your Christian leaders who are not agreeing with your approach. A solution to your discomfort with caring for non christians is to only take care of christians BUT even then you do not initiate a conversation about God and religion. That is private.

Now to address your mother seeing your Dad, Jesus or both as she was dying. I know what I am going to say is controversial but I have been with many, many people in the days to hours before their deaths and bore witness. Countless saw and talked with people who were no longer living, and that includes Jesus and angels. From those personal experiences I believe we do not die alone, that those who have gone before us come to help us make the change from this world to the next. The key here seems to be we see that which is in our personal belief system. If we believe in Jesus we may (operative word “may”) see Jesus. If we believe in angels we may see angels. Someone who does not believe in Jesus will not see Jesus.

I recognize your desire to be of service, to support and guide people during their end of life experience. I appreciate your strong belief in your religion to guide you in living a fruitful life. Pray Jesus helps you be the best nurse you can be and recognize that each person you care for has developed their own beliefs and coping skills to get them through life's challenges. Each of us will bring those skills with us to the bedside as we lay dying. There are very few death bed conversions. End of life is not when we are open to new belief systems. We tend to rely on the ones we have developed over our span of living. The place of hospice nurse/caregiver is to provide teaching, physical care, and guidance through the process of approaching death. May our spiritual/religious convictions strengthen and enable us to support patients and families at the end of life regardless of their belief systems.

Something more...

There are times when our desire to help, to make a difference can trip us up. As much as we might want to "help", it is not our place t do so. In The Eleventh Hour this very subject is discussed. Could this book help you or a family you are working with?