“Hospice” is a scary word for many, given that it often signals someone is at the end of their life. But Hadley Vlahos, R.N., has worked in hospice for seven years, and says she’s learned a lot about life and caregiving in the process.

Vlahos is the author of the New York Times bestseller, The In-Between, which breaks down unforgettable moments she’s experienced while caring for people who are dying. “I kind of fell into being a nurse, but in the best way possible,” she says, noting that she originally wanted to be an author. But she became a single mom at 20 “and I decided that being an author was not going to cut it to support us. So I started looking into options and nursing seemed like it was an amazing option.”

Vlahos discovered hospice care while trying out specialties during her training, noticing that hospice nurses seemed to actually get to know their patients. “I just said, ‘Whatever that is, that is what I want to be doing,” she says. Vlahos admits that her job “can be very heartbreaking” but she’s learned to see the positives in her role. “What I tried to keep in mind is that heartbreak is really just that you love something so deeply—that is why your heart is hurting so much,” she says. “For me, getting to know these patients and being a part of their life and hearing their advice matters more to me.”

Vlahos has built a huge following on TikTok and Instagram, where she will often do reenactments of experiences she’s had on the job, as well as those of other nurses. In one popular recent post, she acts out the story of a woman in hospice whose husband suddenly died of a heart attack. The couple’s daughter pointed out that her father always opened a door for her mother, and saw her father’s death as helping to lead the way for his wife. 

A post shared by Hadley Vlahos (@nurse.hadley)

Vlahos says the most impactful patient for her was a man named Carl. “He was like a grandfather to me,” she says. “At the end of his life, his deceased daughter appeared to him, and he was playing hide and seek with her,” she says. Carl’s daughter had drowned when she was two, Vlahos explains, and his wife says he always felt guilty that he wasn’t able to protect her. “It was an amazing thing to experience,” Vlahos says. 

Carl also started writing notes for Vlahos about the latest in sports and news after he discovered she was a busy single mother who didn’t have time to stay on top of everything. “The day before he died, he told me, ‘Thank you for giving me something to look forward to instead of death,’” she says. “That was the moment that I said, ‘I’m where I’m supposed to be. This is what I am called to do.’”

Vlahos says that it’s important for caregivers to know that using hospice doesn’t mean they’re giving up on a loved one. “I see that a lot where they feel like by calling in hospice, that they are giving up on their mom or their dad or their spouse and they’re carrying guilt about that,” she says. “The way I see it is that you’re making sure that your loved one at the end of their life is comfortable and getting what they want and desire. Because studies show that the majority of people want to die at home in a hospice situation, they do not want to be dying in a hospital.”

Vlahos now has a 10-month-old and says planning her workday around her son’s schedule can be difficult. “Healthcare is 24/7,” she says. “You do have to work sometimes nights, weekends, holidays.” Vlahos says she will also go into a home with a plan to leave in an hour for daycare pickup. “You will get in there and you cannot leave,” she says. “They are in pain and they need you immediately. …Sometimes you really have to sacrifice your own needs or your family’s needs for patients.”

Vlahos is in the process of opening a nonprofit that is aimed to help caregivers. “It’s a nonprofit hospice respite house that aims to provide a home where both patients and their caregivers can come and stay and get a break and rejuvenation,” she says. “I want to open them everywhere.”

Ultimately, Vlahos says she’s glad she decided to specialize in hospice care. “I have not looked back,” she says. “It has been amazing.”

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