Research

Becoming comfortable with that nervous call from the hospice nurse


Hospice chaplains and social workers are surrounded by emotionally vulnerable people, and this includes our colleagues.

It may not be part of your job description to provide emotional support to your team’s nurses, but when they express willingness to receive your support, it is good to provide it. And regardless of whether they open up to you about their struggles, you can be a supportive colleague by maintaining a validating attitude as you interact with them.

When urgency strikes

Nurses come in all temperaments, but I’ve usually had more than one on my team who frequently called me to express a great deal of urgency about situations where the urgency seemed more an expression of the nurse’s struggle than with the situation itself. Some the things they’ll call you frantically about include:

  • patients are not being adequately cared for by their live-in relatives
  • patients suggest life isn’t worth living
  • family members are expressing denial
  • patients or families have unreasonable requests
  • someone doesn’t seem to be fully on board with what hospice is

My internal response to these issues is a combination of the desire to help and an attitude of “of course.” Of course, patients or family members will be in denial or not fully on board. Shock, denial, anger and depression are normal responses to the idea that you or someone you love will die, right Liz?
But I don’t say “of course” to the nurse that calls me. If someone sounds distressed, then they are distressed. I won’t invalidate a nurse’s distress any more than I’ll invalidate the emotional difficulties of a patient or grieving family member.

Nurse have different jobs and different perspectives

It’s good to remember that though we see a lot of the same emotion that nurses see, our jobs and perspectives are necessarily different. In most cases I’ve seen, hospice nurses have much bigger workloads than hospice chaplains and social workers, making it harder for them to emotionally refresh and easier for their overwhelm to exacerbate their responses to emotional situations.

Chaplains and Social workers’ backgrounds also better prepare us for the emotional element of hospice. Though nurses get some education in ethics and boundaries, our training encourages self-reflection with the goal of empowering us from the inside with a sense of boundaries. I wouldn’t say that all chaplains and social workers are more self-aware than all nurses, but I’d say we have more responsibility to be mindful of transference issues.

The only thing worse than getting constant calls from colleagues

When nurses call with urgency, I listen. I listen to assess how urgent the situation really is and for what’s really going on. I contemplate a solution. Doing my best to maintain my calm center, I empathize with my colleague. When they’ve said what they need to say, I present a tentative course of action:

“I think my course of action should be to ____ and then to ____. What are your thoughts?”

And once we’re on the same page, I thank my colleague for bringing this to my attention. I get to work and send an email to update once I’ve made progress.

Many of the guidelines for communicating with patients also apply to communicating with colleagues. Sometimes, the communication can feel like too much, but too much is better than too little. It is certainly better than none, which is what we risk if we fail to validate communication. The next time a colleague seems emotionally embroiled in a situation and won’t let you off the phone, remember this:

You want your colleagues calling you for help.

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