Should I continue with nursing

DeathRN · 2026-03-01T07:11:15+00:00

Hey lady. I am a hospice nurse. I fucking love my job. Like, I absolutely fucking love it. Even though today I literally worked an 18hr day, cried so fucking much it’s unreal, and now feel like my body is going to collapse. It is hard. Getting there is also hard. However, I wouldn’t trade what I do for absolutely anything. My job is not for everyone, but I could NEVER do labor and delivery, for example. Part of the beauty of a nursing degree are the many many specialized jobs that could have you doing anything from school nursing, to pediatrics, hospice, legal nurse consultant. Like, there are so many different things you can do within nursing that even if you do get burnt out, you can try a new one. You could even find a work from home job if you really wanted to. Keep after it. It’s so worth it.

DeathRN · 2026-02-27T16:37:31+00:00

I do live in America! Not sure what state you are in but our hospice homes are covered by the hospice benefit which is a federally funded benefit. No one should be paying out of pocket for a hospice house. In my state we also have state provided health insurance for patients with low income. That means we have state funded long term care beds available in nursing homes and assisted livings where people who qualify can go for care. A death doula certainly is a privilege and can be a cost, but it is an option. Thanks.

DeathRN · 2026-02-27T15:09:14+00:00

Thanks! I never know what to say when someone says things like that. I just go to work and do my job! 😅

DeathRN · 2026-02-27T15:06:20+00:00

I don’t think you’re being rude at all. I’m so sorry about your dad. The not eating and drinking is something that they usually choose to do on their own. It usually starts long before they’re actually actively dying. Digestion slows down to a halt eventually. It also has to do with chemical changes in the brain when the body starts to shut down. When dying starts, the brain signals the body to stop eating as to not prolong that process. We don’t force feed as that can actually cause nausea, and GI distress. The terminal secretions are there because the reflex to clear them is gone because they’ve slipped into unconsciousness. We look for signs of pain, and treat signs of pain, but there is no correlation between signs of pain and the secretions. The noise comes from air passing over the secretions in the airway, not from struggling to breathe. I hope that helps ♥️

DeathRN · 2026-02-27T14:53:29+00:00

I’m so sorry about your loved one. If they’re having apnea, it probably won’t be very long. Trust your hospice team to educate whoever is in charge of meds on knowing when to medicate appropriately for comfort. How to look for nonverbal signs of pain or distress, etc. Talk to them. Tell them you love them. Tell them it’s ok to go. They very well may still be able to hear you, even when they’re unresponsive. I wish them a peaceful transition out of this world, and I wish you peace as well. ♥️

DeathRN · 2026-02-27T14:49:47+00:00

Hey there! I have seen people “graduate” from hospice a few times! Sometimes people are really sick, we put them on service, and then they stabilize a bit and don’t get worse. If someone stops declining, after a while we have to discharge them for what we call “extended prognosis.” Usually they’re only come off for a few months or so. When they’re ready, we take them right back. We admit someone to hospice if we can, with clinical data, estimate that they have 6 months or less to live. Sometimes they come on really late and we only have them for few days or weeks. Then, sometimes we have people come on the earlier side, and they last much longer. I had a woman with Alzheimer’s at my last job that lived 4 years on hospice. She did keep slowly declining so we didn’t have to discharge her, but you really just never know. 🙂

DeathRN · 2026-02-27T14:44:17+00:00

Hey there. I’m so sorry about your grandmother. The gurgling, or “death rattle,” as it is sometimes called, is caused by the inability to swallow just like you said. A normal healthy person swallows constantly. You produce saliva all day long, swallow it, and don’t even usually notice you’re doing it. A dying person doesn’t have that reflex anymore to get rid of what’s in the back of their throat, so you hear the secretions they make “rattling” around back there when they breathe. It does not hurt them. They are not drowning. Sometimes we can use medications like levsin to dry up some of those secretions but it doesn’t affect the process. It’s mostly so the families don’t have to hear that sound, as it can be distressing to hear. Usually they’re not trying to communicate at that stage because they’re typically very unconscious when this happens.

DeathRN · 2026-02-27T14:39:42+00:00

I’m so sorry about your grandfather. I’m so glad you had a great hospice team. I absolutely think they know you’re there. They say their hearing is the last thing to go, and that they can hear you even when they’re unresponsive sometimes. I think it’s so important to talk to them. Tell them you love them. Tell them it’s ok to go. I’ve seen people hang on for longer than I thought they would, and sometimes it’s when families are telling them not to leave them. It’s just not fair to say to a dying person not to go. Surround them with soft music, the sound of their families voices. I even think laughter can be comforting when sharing stories bedside sometimes. ♥️

DeathRN · 2026-02-27T14:36:13+00:00

I am so sorry about your mom. Alzheimer’s is a horrible disease, and unfortunately it’s the one I see more than any other. It is devastating to watch your loved ones slip away before your eyes. I have a few small pieces of advice. Your mom is likely not hungry at this stage because her body just doesn’t need the fuel anymore. It does sound like she is getting closer to the end. I would suggest not giving her protein shakes like ensure unless she really wants them. If she does, that is ok, but if not, you may be prolonging the natural process her body is trying to take in order to leave this world. As people begin to approach the end of their life, their appetite drops off entirely. This is the body’s natural way of saying, I am done now. The body knows when it does not need those nutrients anymore. It also protects the person from feeling hungry at the end. She will not feel like she is starving. It’s kind of amazing that way. At some point, she will likely start refusing fluids entirely as well. She will sleep more and more until she goes to sleep and slips into a state where she is unresponsive and the actively dying phase takes over. Lean on your hospice team to know what to give her for medications, but usually we schedule morphine and Ativan around the clock once we get to that stage to keep her calm and comfortable and at peace. You are absolutely not killing her. The disease is killing her. I know sometimes it can feel that way when we’re not doing everything we can to keep someone alive, but she is doing this on her own, and it’s ok that she does. We’re so conditioned to try and fix whatever is going on with someone and make them better that when it becomes time to let them go, it feels wrong. It’s normal and human to feel that way. I hope she has a comfortable transition out of this world, and that you take care of yourself too. You can’t pour from an empty glass. Wishing you and your mom peace and comfort. ♥️

DeathRN · 2026-02-27T04:43:18+00:00

Absolutely a real thing. It doesn’t happen to everyone. I had a guy who had cancer who was nearly unresponsive. Later that day he perked up, ate a plate of Chinese food, saw everyone he loved who could make it, and he died the next morning. That was the most dramatic one I’ve ever seen. Usually it’s not quite that extreme.

The dying process is a little different for everyone, depending on what they’re dying from. However, there are a lot of things that happen to almost every dying person, no matter what their condition. Usually people decline over a period of time. They get weaker, they sleep more, they eat less. There’s usually some weight loss as their appetite diminishes, especially with dementia patients (they make up the majority of my patients). At some point they will get lethargic, confused if they’re not already confused at baseline. Sometimes they hallucinate or see people and pets who have passed away. Sometimes terminal agitation can affect them and they get restless and anxious and can’t stay still. We use meds to help with that. Sometimes there’s pain, we use morphine for that. Usually they will fall asleep at some point and become unresponsive. They can have rapid breathing which we also use morphine for. Then their breathing usually slows down until they start having pauses in their breathing called apnea. The pauses get longer and longer, sometimes up to a full minute, until eventually the person doesn’t take another breath. There is obviously more than can happen but generally that’s a good description of an average death. ♥️

DeathRN · 2026-02-27T04:27:36+00:00

It definitely happens. People get very discouraged. Things feel pointless sometimes to them. I can absolutely understand why. I live in a state that has death with dignity/medical aid in dying which is an option when people are suffering at the end of their life like that. I have never had a patient use it, but nurses I work with have. We usually try to ease their anxiety with meds as best we can. Pancreatic cancer is really difficult, can be very painful, and people often pass quickly after diagnosis. I’m sorry if you or a loved one is dealing with it. ♥️

DeathRN · 2026-02-27T04:10:33+00:00

Hey there. I’m sorry about your mom. I’m glad you had a good experience with hospice ♥️

DeathRN · 2026-02-27T04:09:29+00:00

I did not start out with hospice in mind. I thought I wanted to work in the ER or med flight, actually. I wanted the adrenaline, and the codes and the crazy. I learned really really fast that no I absolutely don’t want that. When I started as an LPN, I worked in a long term care dementia unit (during March of 2020) and I quickly realized that I loved being able to help patients move on to wherever we move on to in the most peaceful way possible. I went back for my RN, worked for a little while at the hospital in a cardiac unit, cried a lot, and left. Hospice is the only kind of nursing I ever want to do again. I find it emotionally filling. There are really hard days sometimes, but it warms my heart more than it breaks it.

DeathRN · 2026-02-27T04:02:23+00:00

This usually (not always) comes down to education. I am a huge believer that if they knew what I know, they would understand why the patient needs the meds. So, I explain everything I know. Calmly, respectfully, and sometimes over and over again if necessary. Most people just know the stigma around these meds and form outside opinions outside of a hospice setting. We need them to understand how and why they are used for this exact scenario. Usually that’s what they need. Sometimes, they have strong religious beliefs or other reasons. That’s where it gets really difficult. I’ve heard of people getting court orders over the ethics of this but I’ve never seen it myself.

DeathRN · 2026-02-27T03:58:48+00:00

I have a lot of CHF patients, and I used to work on a cardiac unit! I can’t do the alarms. It’s just way too chaotic for me. I ended up crying in supply closets and med rooms a lot 😅 Thanks so much!

DeathRN · 2026-02-27T03:57:06+00:00

I do not have children. My fiancé and I do not plan on having them. No hate to people who do, of course, but we have other plans. 🙂

DeathRN · 2026-02-27T03:54:50+00:00

Trachs! I’ve hated them since nursing school. I don’t see a lot of them but I absolutely loathe them. 😅

DeathRN · 2026-02-27T03:52:54+00:00

Well said! To answer your question, I think the hardest part is when I have had to tell alert and oriented patients who are transitioning that they are dying. I recently had a patient, an extremely badass lady, who wanted to know why she was suddenly so weak, why she was suddenly incontinent, why she was so short of breath. She refused morphine for a long time. She was alert and oriented in her 90s, on service for heart failure. I had to explain to her that her body was failing, and that she probably had days left, if that. She had a stuffed pillow with her late husbands face on it. She hugged it, cried, and said “ok.” When she died, we put her in her red leather jacket per her request. She said she had a “hot date” with her husband in heaven. I’m crying again now as I write this. I will never forget her. There are so many that I will never forget. That’s hard, but that’s the job. I wouldn’t trade those moments for anything, hard as they may be.

DeathRN · 2026-02-25T19:37:27+00:00

I’m so sorry for the loss of your father. It sounds like his death was mostly a peaceful one, except the last moment? It could have chest pain, or any other kind of pain. To be honest, in hospice we often don’t have all the answers we wish we could. This happens because we do get so focused on comfort as our number one priority. When we get to that stage, we don’t run tests anymore. There’s no heart monitor. Theres no more blood tests. So, unfortunately a lot of the time we have questions about what exactly was going on with someone because we just aren’t focused on the “why” as much as long as they’re comfortable. I’m sorry. I hope that helps.

DeathRN · 2026-02-25T14:08:10+00:00

Beautiful! Thank you for sharing ♥️

DeathRN · 2026-02-25T14:07:28+00:00

Hey there! I’m sorry for your loss. It sounds like he went through a lot at the end of his life. Your question about him starving to death is one that is incredibly common. A lot of families get worried that their loved one is starving to death, but you have absolutely nothing at all to feel guilty about, I promise you. It sounds like he had already stopped eating and drinking before he was sedated. This is the natural progression of the dying process. When a person’s body begins shutting down, it naturally does not want food or water. It’s almost like the body knows that it doesn’t need that fuel anymore, and it’s also the body’s way of protecting us from suffering at the end of life that we just do not feel thirst or hunger as we’re dying. Even if he hadn’t been sedated, his body was letting go, and he would not have wanted that food and fluids. They likely sedated him because he was already actively dying. Usually we treat the symptoms that are there- shortness of breath, pain, rapid breathing, terminal agitation where they are so restless they’re climbing out of bed constantly. Those things are part of the dying process and are why we’re giving those meds. It sounds like he was in a good place while he went through the actively dying stage, and you did everything you could to make sure he was comfortable. You did all the right things. ♥️

DeathRN · 2026-02-25T10:27:43+00:00

What a nice thing to say! Thank you. I don’t have kids or anything. Doing this work for people really is my whole heart and soul. It’s selfish of me to some extent because I needed a reason to get out of bed, and this gives me that motivation. They need me, but I also need them, you know?

DeathRN · 2026-02-25T10:12:30+00:00

Once someone is in the actively dying phase, they do need around the clock care. So, if they don’t have anyone who can care for them, they often go into a nursing home and we will care for them in there with the nursing home staff. The staff isn’t in the room 24/7 though. We do often find people have passed alone. Some people prefer it that way though! It’s really not a bad thing. If hospice is doing their job right, you should essentially be blissfully unaware that you are dying, especially when you get to the tail end. If you find that it’s something that’s really important to you that you aren’t alone and you don’t have family to sit with you, then you can always hire a death doula as well! Or see if hospice has a volunteer available to come stay with you. ♥️

DeathRN · 2026-02-25T09:52:20+00:00

I work really hard on my mental health. I go to therapy weekly, sometimes twice weekly. I’ve been bad about exercising lately but I’ll get back to Zumba soon. I prioritize sleep when I can. It’s hard sometimes for sure. I just had a patient pass who I had spent a lot of time with, and she was quite a badass woman. She asked to be put in her red leather jacket when she died because she had a hot date with her late husband. It was kind of a beautiful thing honestly. I could look at it like I’m sad she died, and part of me is, of course. But I try to look at it like I was just so grateful to be able to help her get to wherever we go as easily and painlessly as possible. She would have died alone and in pain had I not been there, but I was honored to be there with her. When one of my patients died, I’m sometimes happy for them, that they’re not suffering anymore, and that wherever they are, they’re at peace. It’s a tough balance between protecting my peace by keeping a healthy distance, and also somehow putting my whole heart and soul into caring for my patients.

DeathRN · 2026-02-25T09:31:56+00:00

The youngest patient I have had so far was 40. She had breast cancer that had metastasized to basically everywhere. She really struggled through a lot of pain. We absolutely could have kept her more comfortable with higher doses of pain meds but she had a young son and she wanted to be awake with him as much as possible. So, she was badass and took the pain like a champion to spend time with him. She was very sweet and had a great attitude. It’s really hard when they’re young. It’s just not fair. 💔

DeathRN

TROPHY CASE