Dear Barbara, I was just diagnosed with cancer. I am a hospice nurse and I know too much about severe illness.  I am terrified. How do I prepare myself and family for the fact that I could be dying?

I’m sorry you are facing life threatening challenges. It is even more challenging for you being in the healthcare profession (sometimes we know too much). 

What to do? First, look at the wording you wrote to me “could be dying.” Actually, everyone is dying. Everyday we are one step closer to the end of our life. You’re just being reminded how close to death we all are. Also, just because you have been diagnosed with cancer doesn’t mean you need to jump to dying from it. Yet, I know, that is where most minds go when we hear the word cancer.

My ideas: Live your life as best as you can. Yes, you are afraid and that is so normal. Actually, I would be more concerned about you if you weren’t afraid. The thing is to recognize and address that fear rather than carry it around like unwanted baggage. Acknowledge it, accept it as normal, talk to it as a friend, “We are going to get through this. I’m in charge. You’re really active today but I’m stronger than you. We can do this.”

Find a listener, a support person you can share your fears with, someone you can “download” with so you aren’t carrying all this alone. Pick one person as a “designated listener,” that is their job, not to have answers but to just be there and listen. 

With a designated listener you aren’t using everyone you meet for emotional support. You can maintain some semblance of normalcy with your friends and family. You don’t want your life to be all about illness and treatments, and “how are you?” You want support but you want normal living, normal activities as much as possible.

As a hospice nurse it would be better if you did not have direct patient/family contact. Talk to your employer about what else you could be doing (work in the office, community outreach). You won’t be able to be objective with patients and their families. You will tend to identify with them, see yourself in their life situation. It will be better for your personal well being to avoid seeing end of life unfolding in others.

Concentrate on living, make each day worthwhile, and find beauty.

Something More About…  A Hospice Nurse Diagnosed With Cancer

I suggest my palliative care booklet A Time To Live: Living With A Life Threatening Illness. 


Originally Published on

Barbara Karnes Registered Nurse

Barbara Karnes, RN Award Winning End of Life Educator, Award Winning Nurse, NHPCO Hospice Innovator Award Winner 2018 & 2015 International Humanitarian Woman of the Year

While at the bedside of hundreds of people during the dying process, Hospice Pioneer Barbara Karnes noticed that each death was following a near identical script. Each person was going through the stages of death in almost the same manner and most families came to her with similar questions. These realizations led Barbara to sit down and write Gone From My Sight, "The Little Blue Book" that changed the hospice industry.