By Rachel Sherman, DNP, FNP-BC, Director of Nursing and Clinical Advocacy


I talked with my grandmother all the time. We were very close, so even when I was going to school eight hours away from home I still talked with her often on the phone. While I was away, she got cancer. Soon, I noticed our conversations were different. So, I got on a bus to drive home. When I got there, I found her in a hospital bed in her living room with a hospice nurse and a social worker. My family had kept things from me to protect me. But it had done the opposite. Seeing my grandmother so sick and so weak was so upsetting. 

The nurse and social worker had with me what I now call a courageous conversation. They talked about what was happening with my grandmother. I was 16. That was my first exposure to hospice and palliative care. I already knew I wanted to be a nurse and a caregiver, but it was in that moment that hospice professionals supported me. I decided that I would want to give that kind of support to others. 

When I’m having courageous conversations as a medical professional, I figuratively take off the white coat and scrubs, because death and dying is not a medical event for most people. It is a human experience. You must have courage to share bad or devastating information without hiding behind medical jargon. 

When I’m having courageous conversations in the community, I, literally, take off my white coat and scrubs. Especially in churches, where it’s a sacred space to talk about transitioning to the end of life. You need to do some research and learn about the culture you’re walking into. 

There are some cultures where people feel like suffering brings them closer to God. Or, it’s a punishment for something they’ve done. Or talking about death and dying means it’s going to make it happen. And so, we may not even talk about death and dying. Instead, we talk about life rituals or how your family and community cares for one another. Knowing my audience, understanding their priorities and respecting their beliefs equips me to ask how I can best help them in their life journey. 

Courageous conversations are not all doom and gloom. They’re a gift to your family to help them prepare for the time that you will no longer be here. Research shows families whose loved ones had advanced directives and conversations before they transitioned experience less anxiety, less depression and less of a burden at the end of life.

A courageous conversation can be uncomfortable, unexpected and unwanted. But it’s necessary. Talking about life-limiting illness and death before it happens means accepting that this will happen to you or someone dear to you. Once you have these conversations, the door is open to preparing for every milestone in your life. Not just education, marriage, children and career, but the final milestone of your death.

Hospice of the Chesapeake is a not-for-profit organization that is caring for life throughout the journey with illness and loss in Anne Arundel, Calvert, Charles and Prince George’s counties. Its affiliated programs include Chesapeake Supportive Care and its bereavement services, Chesapeake Life Center. For details, visit or call 410-987-2003.

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