ABSTRACT
If nurses are to offer spiritual care it is vital that they too receive appropriate care. This chapter illustrates a paradox in the availability and need for support in different end of life care settings. Hospice nurses' experience of end of life care is 'intensive' in that all patients are terminally ill and many have challenging symptoms. The skills of supervision are not dissimilar to those needed in developing trust and rapport with patients. Participants' sense of living 'in hope' seemed to be driven by integration of hospice philosophy in their end of life care practice. Hospice philosophy incorporates not only the concept of holistic care in practice, but also a commitment to the dissemination and development of end of life care practice through education and research. The value of education in the fundaments of holistic philosophy are evident in promoting work culture that embraces a positive focus of care on the facilitation of 'living' until the event of death.
