The Quiet Side of Hospice: What We Carry When the Room Falls Silent

The other night, I heard of the passing of a loved one of a friend—a loss far too soon. The news stopped me in my tracks and has stayed with me since. It shook something deep within me, stirring questions I hadn’t expected to face: Can I continue to work in a field where death is not only expected, but ultimately the desired outcome?

That moment sent me spiraling into reflection as so many moments tend to do—a deep, quiet kind of thought that lingers long after the world around you has moved on. I found myself questioning so many things: my purpose, my calling, the emotional toll that comes with walking so closely beside death every day. It made me wonder if somewhere along the way, I had built walls around certain emotions just to keep functioning. And in that pause, I realized how easy it is to forget that even those of us who make peace with death professionally are still human—still capable of being shaken by its reach, still learning how to sit with its weight.

As a hospice nurse, death is woven into my daily life. I speak about it, plan for it, support others through it. Yet somehow, hearing this news—someone young, someone whose time had not yet come—hit differently. It took my breath away. I didn’t know him personally, but I’ve known his brother for a large part of my life. Still, the concept of a life ending too soon, before it’s had its full chance, is something I don’t think I’ve ever truly allowed myself to sit with.

It happens every day. We see it, we live it, we carry it quietly. In hospice, we often joke about our “morbid sense of humor,” a coping mechanism we use to survive the heaviness. But beneath that, I wonder—how do we really process it all? Who helps the helpers when the weight becomes too much?

The Early Days: When I First Learned What Death Really Means

I’m going to take you back to the beginning of my hospice career. I was working in an inpatient unit, full of purpose and conviction that this was where I belonged. I loved the honor of guiding people and their families through some of the hardest days of their lives.

But there are two moments that have never left me.

The first was a woman not much older than myself—a mother of two young kids, just a few years older than my own. She was dying, though she and her husband could not yet accept it. The day came when those children had to say goodbye. The scene is forever etched in my heart. As the professional, I held it together, because someone had to. Afterward, I watched her husband walk out of that hospital without her—hand in hand with their children—trying to face a life that would never look the same again.

There was support for them, of course—bereavement counseling, family, community. But what about the staff who stood beside them in that moment? The nurses who wiped their tears before stepping into the next room? The professionals who carry those stories silently because “it’s part of the job”?

I never truly processed that loss. I read her obituary countless times, revisited the moment over and over, and eventually the sharpness faded. But the scar remained.

The Second Memory: The Words “He Is Dying”

The other moment came a little later—a young man in his early twenties. He hadn’t even had the chance to live a full life. When he came to the unit, his family believed he was there for pain management. Nobody had told them the truth: that he was dying.

That day, I had to make a choice. It was a weekend, and resources were limited. No social worker waiting in the wings, no team ready to jump in. Just me, this family, and the truth that needed to be spoken.

I took them into a small family room and said the words no one else had said: “He is dying.”

It was the hardest conversation I had ever had, and the first time I’d ever spoken those words to people completely unprepared to hear them. There were tears, anger, disbelief—but also connection, compassion, and an unspoken understanding that, in that moment, they needed someone to guide them. That experience became one of the defining “why” moments of my career.

The Unseen Toll

Why do I share these stories? Because we don’t talk about them enough.

Hospice work is sacred. It’s also heavy, heartbreaking, and deeply human. Death may be a part of life, but some deaths leave a mark that never fully fades. And while we surround grieving families with care and resources, we rarely extend that same depth of support to the staff who stand at the bedside—those who bear witness, hold space, and then move on to the next patient as though their own hearts aren’t cracked open a little more each time.

This is something I want to change.

As a hospice leader, I believe one of the most vital responsibilities we have is to see our staff—to hear them, validate their feelings, and give them the space to process the emotional weight of this work. Leadership in hospice isn’t just about metrics, census, or compliance. It’s about honoring the humanity in our teams, acknowledging that behind every visit, every chart note, every call—there are hearts that break and mend, again and again.

You can’t measure death in numbers. There are people behind every loss—patients, families, and yes, the nurses, aides, and staff who walk through it with them.

And sometimes, even those who’ve made peace with death need a moment to remember what it means to be human in the face of it.