So, Papa has just been admitted to hospice, and now you have this collection of confusing and scary medications in your home. The nurse has long gone, and while you have the hospice number to call anytime, with racing thoughts, anxiety, and Papa's pain, the last thing you're probably thinking about is finding a number you may have already lost. No judgment here—I've seen this scenario many times.

Step 1: Input your hospice agency’s number, address, and your case manager’s name into your phone.

Step 2: Ask for a printout of Papa’s medication list, or create one that is clear, understandable, and accurate.

Step 3: Learn how to assess non-verbal signs and symptoms of pain.

Non-Verbal Signs and Symptoms of Pain:

1. Facial grimacing or frowning

2. Rapid blinking or dilated pupils

3. Restlessness or agitation

4. Moaning or calling out

5. Guarded or tense body posture

6. Fidgeting, rocking, or pacing

7. Writhing or constant shifting in bed

8. Behavioral changes

9. Changes in sleep or eating patterns

10. Crying

11. Increased heart rate, blood pressure, or breathing rate

12. Sweating

Typically, the infamous comfort pack includes fast-acting pain medication for severe pain or shortness of breath, an anxiolytic for anxiety or shortness of breath, bowel medications for constipation, nausea, or diarrhea, and an antipyretic for fever or mild pain/discomfort. Some comfort packs may also contain antipsychotics if severe agitation or delirium is anticipated by the interdisciplinary team.

When you receive this little collection of medications, it’s wise to store them in a safe place. If you think there’s any risk of these medications being accessed—whether by mistake or on purpose—tell your interdisciplinary team to provide a lock box, or consider purchasing one yourself. Although rare, small children, those with substance use issues, and even animals can accidentally get hold of these medications and harm themselves, so please be cautious.

I often complain about my job due to the dysfunction and the inability to meet every request. These factors make my work unbearable at times and contribute to high burnout rates for many. Early on, I learned that some things simply can’t be completely healed, resolved, or closed. Not everyone will be satisfied, content, or happy with the solutions I offer or with the organization I work for. I often walk away feeling like I didn’t do enough, say enough, stay long enough, or make myself clear enough. But those are my inner struggles. To ensure clarity, I always ask the client if they have any questions or additional needs before concluding my appointment. Only then do I feel it's safe and appropriate to wrap up.

For the last 15 years, I have been nursing people from all walks of life, and I’ve learned so much along the way. I am no longer the naive nurse who started out in a Skilled Nursing Facility, stumbling and making mistakes. New nurses need to understand a few key secrets to succeed in this field. These secrets are often specific to the individual nurse. What drives and supports a nurse to thrive lies within their personal universe first and foremost. You must be highly perceptive, humble, and intelligent—all at the same time. You must always be "on." 

There will be patients who see you as an idiot. Know this: you are not an idiot. You might be nervous, naive, sweet, or co-dependent, but you are not an idiot. Idiots don’t get to where we are. It just doesn’t happen. The patients you encounter, the interdisciplinary team you work with, family members, and unfortunately, other nurses, may make you question yourself. They may make you want to become a secretary or a tour guide in Bali. They may make you reconsider your noble intentions for becoming a professional caregiver altogether. 

Then, one day, when you least expect it, a little girl will assume you’re thirsty and, with her sweet chubby hands, offer you a cool drink of water, thanking you for the care you provided her grandpa. A grieving daughter will insist you stay for a full-course meal at her father’s dinner table as a thank you for bringing comfort, clarity, and laughter into a bleak situation. A grieving wife will take time to handwrite a letter expressing love and gratitude for the care you gave her husband.

This work is not about money. Don’t let social media fool you. The money will eventually lose its allure. At its core, this profession is about healing—mind, body, and soul—for both you and the people you serve. You will make mistakes, but they don’t define you. Take your time to learn the science of nursing, but remember that nursing is also an art. Nursing is love. Nursing is an expression of love.

Experience a nurturing embrance for you and loved ones in your most delicate moments. I’ll provide thoughtful guidance, support, and create a space for making the best decisions during this precious and transformative period in your lives. In hospice, dying is a family affair, not an emergency.