What the dying can teach us: Hospice nurses bring end-of-life care into the open

The best way to stop fearing death, it turns out, may be to learn about it from hospice nurses.

This realization has turned some hospice nurses into social media stars, as thousands follow them to learn what dying looks like — and why it doesn’t need to be feared.

Hospice nurses have seen their personal stories reach the New York Times bestseller lists since their rise in popularity after the COVID-19 pandemic, such as Julie McFadden, author of “Nothing to Fear: Demystifying Death to Live More Fully.”

“I think it’s because people are actually interested and there’s something about maybe the privacy of [the phone] like they can scroll on if they want to, or they can listen … it’s a little less harsh if it’s on your phone versus someone just talking to you,” she told The Washington Times.

Ms. McFadden, 43, works as a hospice nurse in Los Angeles and has created videos about death, dying and “a day in the life as a hospice nurse” after two close friends whose parents were dying around the same time were surprised by her insights and encouraged her to start a podcast.

Her nieces introduced her to TikTok, where she noticed people her age educating others on various topics.

Inspired by her friends’ encouragement and what she saw on the app, she decided to post a few videos that quickly went viral.

Hospice nurse Penny Hawkins Smith, author of “Influencing Death: Reframing Dying for Better Living,” also discusses death, dying and her personal experiences on social media.

She started nursing school at age 40, looking to turn her life around. Now in her 60s, she reflects on why she went into hospice nursing to begin with.

“I had severe death anxiety and I felt like working in a field where I was exposing myself to dying and death would be helpful for that. And I also wanted to make amends for my past. I was kind of a rotten egg when I was in my 20s. So I really wanted to do something that I felt was more redeeming work or service work,” she said.

Ms. Smith, a Washington state resident, explains that many are intrigued by hospice nurses and their work because it helps quell their fears surrounding the dying process in many ways.

“Death anxiety, by the way, is very, very common. And a lot of people follow me because they have death anxiety and watching my content helps them with that. It was crippling for me. I couldn’t sleep at night. I had fear around what happens after we die,” Ms. Smith told The Times.

Hospice treatment focuses on providing comfort and care for individuals with a life expectancy of six months or less. It can be provided at home or in a dedicated facility, allowing patients to spend their final days where they feel most comfortable.

The subject entered the national conversation when former President Jimmy Carter entered hospice care in February 2023 — ultimately spending nearly two years in hospice before dying at 100 in December 2024.

Ms. Smith and Ms. McFadden remarked on their shift in perception on life and death based on the experiences they had.

Ms. McFadden says witnessing so many end-of-life experiences with her patients has helped her radically accept death and learn to live fully in the present moment, treating life as a gift.

“I’ve had so many patients say to me I wish I had appreciated that I was able to walk around my block. You know, that I could taste coffee and it tasted good and I wanted it because towards the end, it gets harder and harder to do the simple things. And it helped me really learn to live. And really on a day-to-day basis, really appreciate the fact that I am alive today,” Ms. McFadden said. “I can taste the coffee that I love so much. I can walk to the beach with my legs and they work. I don’t take that for granted. I think I’ve seen it enough that it really has cemented in my mind that life is a gift, for real.”

Ms. Smith healed her deep-seated fears of death by witnessing what many of her patients experienced at the end of their lives. She has been retired as of June 2025.

“Being with dying people and seeing these phenomenons that we see with them, where they’re having death bed vision, seeing deceased relatives and even pets and, you know, reaching in the air and doing these things that we have no explanation for really helped me to believe,” Ms. Smith said. “I believe that there is something more after this life that we do live on in a way. I don’t know what that is, but I do have that belief now. And that really helped me.”

The nurses emphasized that death is not something to be feared and is not inherently painful. The disease causing the death usually causes the discomfort.

Ms. McFadden has found that what helps patients most is their willingness to openly discuss their feelings about dying, even if those feelings are anger or frustration. Faith — not necessarily religious faith, but a general trust in something, whether family, a higher power, or something else — also tends to make the process easier.

Strict religious belief didn’t necessarily make the dying process easier, both nurses said. Depending on the specific belief, it could sometimes make it harder, especially if patients are reluctant to take medications due to religious beliefs or want and expect to experience death in a particular way, they said.

Comments on Ms. Smith’s and Ms. McFadden’s posts include words of appreciation and gratitude for wisdom and insight into the dying process. Others remark on their previous experiences with loved ones in hospice and how much hospice nurses provided invaluable support.

Ms. McFadden and Ms. Smith emphasize that their videos aim to spark conversation about death and why it should not be feared but rather seen as a natural, meaningful and even beautiful aspect of the cycle of life.

“Death is normal and we should talk about it. If we don’t talk about it, we create more fear about it. And if we do talk about it, it does not cause us to die faster or the person who’s dying to die faster,” Ms. Smith said.