What being an end of life doula means... to me.
Updated: Sep 18, 2020
I am writing this on the day of my graduation of a program that certified me to become an end of life doula. I have spent most of the morning really embracing what this means to me and how I will move forward now that I have completed seven months of deep and powerful training about the philosophy, theory, practices and principles of conscious dying.
When I started, I made a promise to myself that I would put both feet in, not being fearful of the unknown, and give in completely, opening myself up to the possibility of evolving in this work I was called to do. I am proud of myself for completing the program, but more for the way I trusted it to take me in a direction that would inspire me... and it has.
There is a certain look people have when I tell them I am a hospice nurse; it is usually one that equates to a sense of concern for me that I work in and around death and follows with a curiosity as to the why. I have found that the look I receive when I talk about becoming an end of life doula, is definitely one of curiosity, but I also find it a little entertaining to watch as they try to process it internally as to what that actually means.
I come across many people who have no idea what an end of life doula is, so I can appreciate the lost look in their eyes. I believe we are going to start hearing about this a lot more in the future and doulas will be a common site at the bedside. I have known about them for many years and have yearned to learn more about their work and how I too can provide the delicate and lovely care they are known for.
In many ways, at least for me, being the hospice nurse that I already am, can only be enhanced by what I have learned through this program. I took this course with the intention of deepening my knowledge about the dying process and fine tuning the skills I already have to be able to continue to provide comfort and support to those who are nearing the end of life. You do not have to be a nurse, to be an end of life doula, in fact you do not have to have any licensing to do this, which is why I find myself encouraging others, who are naturally gifted with enormous amounts of compassion and who are also drawn to the bedside, to follow this path. I think for me, being a nurse is complemented by being a doula.
Over the past seven months I have been given many writing assignments that required me to be incredibly vulnerable as I shared the deepest parts of my soul that is the foundation of who I am and what I can give to patients and their families. It has opened me up and exposed me to more depth than I was even aware existed, and I am so thankful for that, because that is what guides me to be fully present for someone else.
During the process of becoming an end of life doula, I found that what I was drawn to most was the opportunity to help patients and their families choreograph a beautiful death; one that can include everything they wish for, down to the care they receive, the music they listen to, the textures and fabrics of the blankets they are covered with and the last words they are able to express to one another before the last breaths are taken.
One assignment in particular, which was my favorite, had us “interview” three people about how they saw their last few months. When anticipating our own death, most of us initially focus on pain, which we do not want to have. We also (usually) don’t want to die in a hospital and sometimes we go as far as to think about who we do or don’t want at the bedside. During these interviews I was inspired to encourage them to go deeper, to embrace the idea that they could set the stage so to speak and design a dying experience that could be beautiful. I sat with each of them for hours talking about their wishes and if given the time, which we unfortunately don’t always have, it could truly be on their terms. We talked about last conversations, last sunsets, last walks along the beach if allowable, and of course the last breaths. These were some of the most beautiful conversations I have ever experienced, and they will be kept safely tucked inside my heart, waiting to inspire me in the future.
As a hospice nurse, it is important for me to say that I would encourage this work to be shared with a hospice team and I would also encourage hospice teams to embrace and welcome the work of the doula. But know that it gets to be your choice whether you use one or the other or both… they complement one another well. I would want an end of life doula at my bedside.... but there are a few hospice nurses I work with now who I would want there as well.
Moving forward, I will take my skills and experience as a hospice nurse and tie them together with everything I have learned (so far) about being an end of life doula. My vision moving forward is that I honor each human that trusts me with their care, that I listen to their words and truly hear them, that I respect them and those who love them, and whether I have months, weeks or only a few short hours with them, that I do my part to fulfill their last wishes and help them to achieve a death that is gentle, kind and without discomfort. And I will support those that are left behind, understanding that their grief will require gentle care for a very long time afterward.
To me, being an end of life death doula is opening up the gentle compassionate places inside me and sharing them with someone who is dying. It is being fully present for someone else, honoring and respecting their needs, their space and their last moments. It is taking a pause at the bedside, remembering that this is not about me. And if I am asked, I will help to choreograph their last dance in a way that will leave beautiful memories for those who are left behind.