Karen Martin, BSN on Hospice Care and Faith

Author(s): Scott Douglas Jacobsen

Publication (Outlet/Website): The Good Men Project

Publication Date (yyyy/mm/dd): 2025/01/06

Karen Martin, BSN, a former hospice nurse, talks about her experiences in end-of-life care and prison ministry. Martin shares insights on hospice care’s evolution, emphasizing its shift from a personal vocation to a business model. She highlights the importance of love, peace, and preparation at the end of life, encouraging families to focus on the present and cherish moments. Martin also discusses the healing power of poetry, journaling, and mentorship, noting that people value relationships and forgiveness over achievements. In prison ministry, she parallels her approach to hospice, offering empathy, faith, and support to those struggling. She is the author of Everyone Dies: Journey of a Hospice Nurse.

Scott Douglas Jacobsen: Today, we are here with Karen Martin, BSN. You have a collection of stories that you gathered from your notes as a hospice nurse. My first question, of course, is: How was your time as a hospice nurse?

Karen Martin: Oh, I loved every moment. It was probably the hardest thing I’ve ever done, but it gave me far more than I could have ever given to anyone. It has been a truly rewarding experience.

Jacobsen: Has hospice care changed much from the start of your career to now? Or has the focus remained the same?

Martin: Yes, it has changed—and I wish I didn’t have to say that. When I started, our census was typically around 20 to 25 patients. We were on call for long stretches—sometimes a full month at a time. Now, it’s much different. Most hospices manage between 100 to 150 patients, with separate on-call nurses. While that’s positive in some ways, it does change the personal nature of the work.

Hospice has increasingly become more of a business than a personal calling, which changes how care is delivered. I could go into the financial and political side of things, but the shift has made hospice feel less intimate.

Jacobsen: How do you address that shift, especially as the workload grew from 25 to 125 patients? That’s a significant increase. What impact does a more “business-oriented” approach have on the spirit of hospice care?

Martin: That’s a great question. Before I retired, I hired, trained, and educated nurses, especially about the admission process and patient care. I always told my nurses, “If you don’t have a heart for this work, you’re not meant for it.” I emphasized that every family is unique and incredibly important.

You must be in the right profession if hospice care is solely about numbers and business. Shifting that mindset back to hospice care’s personal and emotional core helped many nurses stay focused. There are draining times—being on call and handling difficult cases—but if you see hospice work as a vocation, it changes everything. When you view it as an opportunity to bring peace, comfort, and dignity to families, it helps you stay grounded. I also educated staff on burnout. While burnout is real, the calling to serve is so powerful that it can often outweigh administrative frustrations.

Jacobsen: As a journalist, I interview people and learn about their lives, but it seems like it takes a truly special person to deal with death daily in such a caring role. What allows someone to handle that kind of work consistently?

Martin: That’s a very thoughtful question. I don’t think I could have done it without God. My faith was number one—it gave me the strength I needed in every situation. My husband was number two—he supported me during those long, sleepless nights when I was out in the field, caring for patients. His understanding and encouragement were incredible.

There was also a real sense of camaraderie among the hospice staff. We supported one another, lifted each other during hard times, and shared in the understanding that we were making a meaningful difference. I can’t count the many thank-yous and heartfelt acknowledgments I received from families. Those moments kept me going—they reminded me why I was called to this work.

Over time, I learned that life is precious and that every day is a gift. If you live with that perspective, hospice work is no longer about focusing on the sadness of death. End-of-life care is difficult, yes, but it can also be beautiful. Death can bring peace and dignity and be filled with love and gratitude.

And the families working together at the end of life, caring for someone, is phenomenal to observe and be a part of. 

Jacobsen: What are your biggest lessons on love, despair, and loss in those moments?

Martin: Do you mean from the perspective of the person dying, the family, or something else?

Jacobsen: All of those.

Martin: Well, I started every visit by telling the family that there is no such thing as a perfect family. It’s incredibly difficult when someone is dying, especially if it’s a young mother or a young person in the family. In those cases, the family dynamics often escalate by 100%. Let them know that their journey is their journey. I promised to walk alongside them, never to judge them, and to help them in any way I could.

I don’t know if you’ve read my book, but many situations would change dramatically in the moments or hours before death. It becomes easier if the family is on board with what is happening. I often had to remind them that no single person can care for someone 24/7 alone. Taking it one day at a time became a cornerstone of my approach.

When I entered a home, I would say, “I will walk this journey with you, but we will take one step at a time. We won’t worry about what might happen five months from now. We will focus on today, and I will be here with you daily.” That approach reassured families and helped them stay grounded.

For example, if a patient could walk one day but were bedbound the next, I would make an extra visit. I would ensure they were comfortable and teach the family how to care for their loved ones. Walking that journey without looking too far ahead made it more manageable for everyone.

As you might already know, within hospice care, you often deal with preparatory grief. Families start preparing for the loss long before the death occurs. I don’t want to say that makes it easy—because it’s never easy to lose someone you love—but it can make it easier. Families get the opportunity to say goodbye. They can say “I love you,” address regrets, and have those important conversations.

Compare that to sudden loss. If someone were to tell me, for example, that my husband had died today, I would have so many thoughts of “I wish I had done this” or “I wish I had said that.” However, with hospice, families often get the time to resolve those feelings beforehand, and it’s beautiful to witness that kind of closure.

Jacobsen: What should people avoid when preparing for death? Specifically, when they are emotionally overwhelmed or unprepared—what mistakes should they try to avoid?

Martin: That’s an excellent question. One of the biggest things to avoid is pushing emotions away or trying to deny the reality of the situation. Sometimes, families want to “hold it together” so much that they shut down emotionally, which doesn’t help anyone.

Another thing to avoid is neglecting self-care. People often feel guilty about stepping away for a moment or taking time for themselves, but no one can effectively care for a loved one without first caring for themselves.

Avoid creating unnecessary conflict or revisiting old grievances. I’ve seen families bring up long-standing arguments during these times, and it only adds stress to an already emotional situation.

Finally, avoid “future-tripping”—worrying excessively about what will happen in days, weeks, or months. It’s natural to fear what’s ahead, but it takes away from the time you have now. I always encouraged families to take it one day, or even one hour, at a time.

Focusing on the moment allows you to be fully present with your loved one and appreciate your time together. It’s in those moments that the most meaningful conversations and connections happen.

Jacobsen: What should people do when someone is dying? 

Martin: There isn’t necessarily a “right” or “wrong” way, but what advice would I give: Any preparation you can make for your loved one is incredibly helpful. That includes legal documents like power of attorney, advance directives, or a will. It is important to know what your loved one wants for their funeral, what they love, what brings them comfort, and what doesn’t.

I’ve already written out my funeral plans. I don’t care if they follow them to the letter, but I know it’ll make things much easier for my family when the time comes.

It’s harder to answer what not to do because everyone is different. But this: try to walk the journey as a joy rather than a burden, as hard as that may sound.

Let me share a personal example. My brother-in-law is dying of Parkinson’s, and my sister has such a beautiful attitude about it. She cherishes every moment they have together, and he appreciates everything she does for him. That’s the heart of it—not sweating the small stuff. Don’t get overwhelmed by thoughts like, “How will I do this? This is too much for me.”

It’s like any major task or project. Tackling 100% of it all at once will feel impossible. But if you take it one day or even one hour at a time, it becomes more manageable. I encourage people to focus on the day before them, enjoy the moments, and view life as a gift—even in hospice care—rather than a death sentence.

Jacobsen: How does poetry help people deal with that process?

Martin: Oh, I love poetry. I’ve found it phenomenal in helping me through the hardest times. Writing a poem lets those emotions flow out. Sometimes, the feelings I share in my poetry are even deeper than what I include in my stories. Poetry has a way of capturing things that ordinary words often cannot.

Whether you write traditional rhyming poetry, free verse, or other forms—what’s it called again? Oh yes, haiku—it doesn’t matter. Any poetry can help. If you’re poetry-minded, it can be incredibly healing.

Even journaling can be a powerful tool. Many of my families kept journals. When I would visit, they would tell me exactly what had happened over the past two or three days, and that journal helped us all stay on the same page. It also gave families a way to process their emotions.

Sometimes, journaling can feel time-consuming, and a few families told me they didn’t want to look back at it. But eventually, they often do, and they cherish those memories. Everyone is different—some prefer journaling, others prefer poetry—but for me, poetry has been profoundly healing in every aspect of my life.

Jacobsen: What do people typically want to be remembered for when they die?

Martin: That is such an interesting question. I’ve cared for people from all walks of life—millionaires, billionaires, people at the top of their careers, and others who lived quieter lives.

None of that matters. 99.9% of people know they aren’t taking anything with them. At the end of life, they want to be remembered for the love they’ve given, the joy they’ve shared, and the hopes they’ve held for their family. Those with regrets often spend their final days apologizing, confessing, and asking for forgiveness. I’ve noticed that if they don’t, they tend to have a much harder death.

The poignancy of dying brings what’s truly important into focus: making peace—with their families, themselves, and others.

Jacobsen: What do people typically say as their final words? Are there common themes in what people express near the end?

Martin: I see it in two ways. People who aren’t ready to go—spiritually or mentally—often have a harder time. In contrast, those who are at peace tend to say the most beautiful things.

They often see things or talk to loved ones who have already passed. They’re peaceful. They want their family around them. Some people request joyful, upbeat music. Others want something quiet and serene. Everyone is different, so it’s hard to generalize.

But most people don’t care about their achievements or material success at the end of life. They truly want to be remembered for their kindness, love, and the peace they brought into the world.

Jacobsen: So their achievements mean much less to them at that point?

Martin: Yes. Absolutely. I’ve cared for people from all walks of life—CEOs, doctors, highly successful professionals—and they’re just like you and me at the end of their lives. Death levels us all.

I’ve had people confess things they’ve carried for years. Many highly accomplished individuals find peace only when they make amends with others and themselves. I say “go to heaven” because that’s my belief. But I’ve cared for people from many faiths—Hindus, Muslims, and others. My role is never to convert them. I respect everyone’s faith and beliefs.

Most people want peace with their family, peace within themselves, and peace with their God. However, they define that relationship.

Jacobsen: How do you use these experiences from hospice care in your prison ministry?

Martin: Oh, wow. Prison ministry is a completely different experience—but there are parallels.

When I enter the prison, I tell the women, “There’s no such thing as a perfect family. I’m just as broken as you are, only in a different way.” That levelled the playing field. It helped them see that we’re all human and trying to help one another.

My goal is to help them find Jesus so they can have peace and maybe walk away from their addictions or destructive cycles. I’ll help them in any way I can.

The ministry might look different, but at its core, it’s about pointing people toward faith, love, and hope. That said, I don’t sugarcoat things. We talk about the hard stuff—how difficult it is to be in prison, the regrets they have, and the challenges they face. We face it all together.

I have a young woman now—she’s 21 years old—and she’s going to be in prison for 40 years. I’m going to visit her next week. My heart aches for her, and I cannot imagine what she must be going through.

So, you must have a heart for prison ministry and hospice work. You have to love people and find joy in reaching out to others and helping them in their hardest times—whether that’s being in prison or having a loved one who’s dying.

Jacobsen: One of the lighter aspects of your story, something not as difficult as prison or as tragic as hospice care, is your work in women’s mentorship programs at your church. Different demographics require different kinds of support. What do you find women need most in church mentorship?

Martin: Oh, wow. That’s a great question.

Again, it comes down to reaching out to people who are struggling. At my age, I do much mentoring with younger women in the church—women who may be wrestling with their faith or asking, “What’s life all about? What’s my purpose?” I let them know I was once in that same place and understood.

The key is walking the journey with them. It’s not about having all the answers—because I don’t. Sometimes, it’s just about being someone who can listen and say, “That must be so difficult.” It’s about showing empathy, not necessarily fixing everything.

For example, when a young father comes to me and says, “Why is my wife dying at 35? Why is this happening to us when we have four children?”—a hard question. That’s a very hard question. I don’t always have the answers, and it’s okay to admit that.

What I can do is listen, care, and pray for them. That gives them even a small hope to move forward.

Jacobsen: Karen, thank you for the wonderful conversation today.

Martin: Not a problem. I appreciate it.

Jacobsen: I will continue to pray for you and your family as you navigate death and dying as well.

Martin: Thank you. I appreciate it.

Jacobsen: Is there anything else you’d like to add?

Martin: No, I think that’s it for now.

Jacobsen: We’ll be in touch. Thank you so much.

Martin: Bye.

Jacobsen: Bye-bye.

Martin: God bless you.

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