Exploring the History of Hospice Nursing By Lisa Phan
This article won first place in the 2022 NSNA / American Association for the History of Nursing ( AAHN ) Essay Contest .
Few things are guaranteed in life , but we all can expect the inevitability and certainty of death . The death of a loved one is heartbreaking and never easy , but we should not fear death . Instead , we can welcome it with open hearts and find solace in knowing that our loved ones are no longer suffering .
Hospice nurses are pivotal in end-of-life care ; they facilitate the transition from aggressive intervention to comfort care and shift the focus onto alleviation of symptoms and pain . Pulling from various perspectives of death and dying from throughout history , we can create holistic , patient-centered experiences where the patient can die with dignity and the family can feel prepared and supported .
Hospice Introduced in the United States In 1963 , the concept of providing comfort for the terminally ill through pain control and symptom management was introduced in the United States at Yale University ( Krisman-Scott , 2003 ). It was based on the philosophy of eliminating “ ineffective ‘ cure ’ interventions and represents a return to natural approaches to dying ” ( Krisman-Scott , 2003 ).
In 1967 , Dame Cicely Saunders established the first teaching and research hospice institution called St . Christopher ’ s Hospice in London , England . Dame Cicely Saunders is widely regarded as the founder of the modern hospice movement , although she credits a patient of hers ( Nicoll , 2002 ). The patient was David Tasma , a Polish refugee dying from inoperable colon cancer with no family in England , who had supported Dame Cicely Saunders ’ idea of “ building a home for dying people , where scientific knowledge should be combined with care and love ” ( Richmond , 2005 ).
In the early 1970s , Dame Cicely Saunders visited the United States to lecture on hospice and share the practices at St . Christopher ’ s , which began the American hospice movement ( Nicoll , 2002 ). The first hospice in the United States , The Connecticut Hospice in New Haven , was founded by Florence Wald , an Associate Professor and Dean of the Mental Health and Psychiatric Nursing Program at Yale University . Wald was inspired by a palliative care lecture given by Dame Cicely Saunders ( The Connecticut Hospice , 2022 ). An interview with her in 1999 revealed that she had left her position as Dean to study with Dame Cicely Saunders at St . Christopher ’ s to understand the way the hospice cared for dying patients and to then adapt that model into what would become The Connecticut Hospice ( Krisman-Scott , 2003 ).
Upon establishing The Connecticut Hospice , Wald felt that “ terminally ill patients went through hell , and the family was never involved ,” so she aimed to change that by abiding by the 10 Principles of Hospice Care : the patient and the family are regarded as the unit of care ; services are physician direct and nurse coordinated ; emphasis is on control of symptoms ; an interdisciplinary team provides care ; trained volunteers are an integral part
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