There from the Start: A Hospice Nurse Looks Back

A painting of Dianne Puzycki, RN, hangs in Connecticut Hospice in New Haven.

At age 82, Dianne Puzycki has yet to retire from nursing—she still works the night shift once a week at Connecticut Hospice in Branford, where she’s been employed since the organization’s inception in the 1970s. Founded by Florence Wald, it was the first hospice in the United States.

Puzycki started her career in 1955 at Memorial Hospital in New York City, caring for patients with cancer at a time when death and dying wasn’t openly discussed. “We weren’t allowed to talk about that. It really haunted me for years,” she told AJN in a July profile. Several years later, she encountered two influential women: Dame Cicely Saunders, who founded the first modern hospice, and Elisabeth Kübler-Ross, who introduced the concept of the five stages of grief in her groundbreaking 1969 book On Death and Dying. Seeing them speak piqued her interest in the hospice movement, and she began volunteering for Connecticut Hospice, which eventually led to a full-time job.

Throughout the decades, says Puzycki, she’s witnessed hospice care constantly change and improve. She recalls that in the past, more patients used to stay […]

2017-07-26T09:35:44-04:00July 26th, 2017|Nursing, nursing career|1 Comment
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Blogging: As Many Voices as There Are Nurses

By Jacob Molyneux, AJN senior editor

Blogging - What Jolly Fun/Mike Licht, NotionsCapital.com, via Flickr Creative Commons Blogging – What Jolly Fun/Mike Licht, NotionsCapital.com, via Flickr Creative Commons

A recent check reveals that a good percentage of the blogs on our nursing blogs list have been relatively active over the past few months. A few have been less so. I didn’t see any posts about the ice-bucket challenge, and that’s okay. Here are a few recent and semirecent posts by nurses that might interest readers of this blog:

Hospice nursing. At Hospice Diary, a post from a few weeks back is called “Dying with Your Boots On.” An excerpt:

As I drove down a switch-back gravel drive in the middle of nowhere, I pulled into a driveway and there in a sun-warmed grassy yard sitting perfectly still on a garden swing among buzzing bees and newly bloomed flowers was a fellow in a crisp white shirt, a matching white cowboy hat, black leather boots and a crooked smile.  I stepped out of my car and told him for a moment I thought he was the garden scarecrow, until he tipped his hat.

Nurse-midwifery. A post on At Your Cervix: Tales of a New CNM, First Year […]

2016-11-21T13:04:03-05:00August 20th, 2014|healthcare social media, Nursing, nursing perspective|1 Comment
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Some Observations In Response to the NY Times Article on Palliative Sedation

By Judy Schwarz, PhD, RN*  


The NY Times article of 12/26/09 that described use of palliative sedation in hospice institutional settings provided helpful and clinically accurate informative—for the most part. These few notes are meant to address those issues raised by the article that may unduly alarm dying patients, their families, and their clinical caregivers.


1) There is a consensus among palliative care clinicians that “palliative sedation to unconsciousness” (a descriptive term that eliminates some of the visceral reaction elicited by use of the term “terminal sedation”) is an intervention used only when other therapies that do not compromise patient consciousness have failed and the patient continues to experience intolerable and intractable suffering that cannot otherwise be relieved.

2) Use of palliative sedation to unconsciousness has NOT been shown to cause a hastened death. Research showing that patients at the very end of life who receive palliative sedation do not die more quickly than patients who are not sedated has been published in such peer-reviewed journals as Annals of Oncology, Journal of Palliative Medicine, Journal of Pain and Symptom Management, Archives of Internal Medicine, and Palliative Medicine. (In response to the Times article, the National Hospice and Palliative Care Organization has made available a bibliography of these articles.)

This intervention is generally only provided when patients are “imminently” dying (a condition the recognition of which requires experience and clinical judgment) and is distinct from “respite sedation,” which is used when clinicians plan to awaken a patient from the unconscious state to […]

2016-11-21T13:20:16-05:00January 7th, 2010|Nursing|1 Comment
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The ER Exit vs. the Long Goodbye: Notes of a Hospice Nurse on the Morning After

“Mourning Dove Bailing,” Bob MacInnes/ via Flickr. “Mourning Dove Bailing,” Bob MacInnes/ via Flickr.

I’m exhausted and shaky, and the “pssssht!” sound of the pneumatic doors of the ER closing behind me on the way out sounds final, and just fine. I didn’t used to feel this way when I worked in the ER. Of course, that was at the other end, the beginning, of my nursing career, when I was young(er) and callous and every code was a challenge and a rush—as if the people were characters in a play, and I got to join in each evening. I hadn’t a clue what they were going through. Now, 30 years and two dead parents, a dead best friend, and a score of minor players later, I’m beginning to understand. I suspect that this glimmer of connection and compassion is what makes hospice nursing sometimes so draining. […]

2016-11-21T13:33:13-05:00April 27th, 2009|nursing stories|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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