Early in her hospice days, Helen had a patient she called Mrs. C who would ask, "Do you want to come in and have a cup of tea?" Helen had ten patients to see. She said yes anyway. Mrs. C opened up over that tea, and it became their habit at every visit. Helen started asking other families, "Do you want to sit down and have a cup of tea before I go up and check on your wife?" That cup of tea became a hallmark of her care.
Helen Dunkle is a nurse with more than four decades at the bedside, and she is a friend of mine. She started in labor and delivery and ended up in hospice, and today she is a certified end-of-life doula and the founder of Pinnacle Doula Services in Easton, Pennsylvania. We talk about what changes when a nurse sets the clinical checklist down and leans into being human, why calling 911 can rob someone of the death they wanted, the grief that cracked her open at twenty-three, and the Reiki work that surprised her clinical mind.
From labor and delivery to hospice nursing
Helen was 23, a brand new nurse with a two year old of her own, when she chose labor and delivery. She wanted to be there as a new soul arrived and took that first breath, and she cried through every delivery.
Hospice wasn't the plan. Years later, as a single mom doing home health nursing, she needed extra weekend hours, and hospice shifts were available. She told me that in the early 90s there wasn't much focused hospice training for nurses. What frustrated her was time. She rarely got to be with patients when they died, families expected hospice to be there around the clock, and it was heartbreaking to tell them she couldn't come back until next week. As a doula, she gets to be the through line.
Caring for caregivers and calming a panicked room
I asked Helen if she cries as a doula. She does. She said tears say, I am feeling you, I am right here with you. A lot of what she does now is sit with the caregiver, away from their dying loved one, often over a cup of tea. Caregivers are tired, afraid, and frustrated, and often can't say so to family for fear of being judged. Helen offers what she calls a judgment-free zone.
I see the same thing. I can't tell you how many times someone has told me something they feel is shameful. I look them in the eye and say, you are not the first person to tell me that, and you won't be the last. This is hard. Helen said you can almost watch the guilt leave them.
When a family is panicking at the bedside, Helen looks for where the panic is coming from, because often it's one person and everyone feeds off it. As a nurse, her go-to was the stethoscope. She'd start listening to lungs and the room would go quiet. As a doula, she sits next to the most agitated person and gently touches their arm or takes their hand. If that doesn't settle things, she suggests stepping outside for some air and a talk.
Medications, comfort, and calling hospice
Helen is careful to say she isn't the clinical person anymore. But she can hear when a family is scared of a medication and report it back to the hospice team. Morphine is the big one, with fears it will kill their person or cause addiction. Helen's view is that people are starting to understand morphine is there to help smooth out breathing and ease some pain. She also asks what nobody wants to talk about, like when their person last had a bowel movement, and sends that question back to the hospice nurse.
Nearly all my clients say some version of "I don't want to bother hospice." Helen and I agree: hospice wants that call.
Why calling 911 can change the death someone wanted
Near the end, breathing changes, and that's where panic tends to happen. Helen prepares families ahead of time, away from the dying person, so they know what they are likely to see. Her view is that the person making those sounds is not struggling or suffering, and repositioning can help. She makes sure they know where the comfort kit is (she tells them to keep it in the refrigerator).
If a family isn't sure they can handle it, she talks with them about calling hospice and not 911. Calling 911, Helen said, means the person likely won't die at home, and if home is what they wanted, the death plan has changed. Staff will start working on them, and even if there is a do-not-resuscitate order, by the time they track it down the peaceful death the person wanted has been disrupted. The emergency room is bright, loud, and cold. Families are often moved out, and Helen said there's a good chance the person dies alone.
Even after a death in the ER, families don't get much time. Staff need the room, so people are shepherded out the door. That's a very different memory from a hand being held and family telling stories at the bedside.
Dying at home is a luxury and a privilege
When someone dies at home on hospice, Helen said, the only call the family has to make is to the hospice nurse, and she can make it for them. They can stay at the bedside, wash their person's face, comb their hair, and invite the people who couldn't be there to come before the funeral home is called. There's no rush.
Helen and I compared how long a body can stay at home where each of us lives, and it differs by state, so ask your hospice team. Helen shared that in her faith, a priest comes to say prayers before the body is moved. Then she said the line I put in my pocket: dying at home is a luxury and a privilege.
Red lipstick and the grief that cracked her open
Helen told me that at 23, death was a horrible, scary thing to her, and in medicine, a failure. Her grandmother, her bingo buddy, died unexpectedly during Helen's last year of nursing school, and Helen was one of the first to see her in the emergency room. Her grandmother was an Avon lady who wore bright red lipstick, and on her face was the most incredible smile. Over the years, Helen said, that smile has taken on the red lipstick in her memory, and she thinks of it as a parting gift. She believes hospice work helped her resolve that death.
Reiki, energy work, and what nurses aren't taught
Reiki came to Helen through Tang Soo Do, a martial art she started in her late thirties to support her son. In a class about qi, she felt the energy pulsing in her hands, and she went on to study Reiki. She offers it only with families' permission. She told me about a client named Tara whose dying mother was anxious; after Reiki, Tara couldn't believe how her mother's face had changed. My own first doula client surprised me the same way: I heard myself suggest an energy clearing for a mother who had been holding on for fourteen days, the family said yes, and she died the next morning.
I asked Helen what she wishes nurses were taught. Nursing school teaches you to lead with medicine, she said, and she wishes someone had told her not to forget the human side. At the inpatient hospice where she volunteers, nurses ask her to just sit with people. One man named Frank spent two hours telling her how he met his wife, and the next week, with his wife there, the two of them told the story together.
About Helen Dunkle, RN
Helen Dunkle, RN, is the founder of Pinnacle Doula Services in Easton, Pennsylvania, a registered nurse with more than four decades of clinical experience, a certified end-of-life and elder care doula, and a Reiki practitioner. Her work grew out of hospice, home health, and healthcare consulting. She walks beside families through serious illness, caregiving, grief, and the end of life, in person and virtually.
In this episode
- 00:00 Meet Helen Dunkle
- 01:11 From birth to hospice
- 03:08 Crying and presence
- 05:05 Cup of tea care
- 07:50 Supporting caregivers
- 09:46 Calming bedside panic
- 13:24 Hospice and the doula as a bridge
- 14:42 Medication myths and comfort
- 17:26 Preparing for breathing changes
- 18:45 Why not call 911
- 20:53 After death in the ER
- 21:40 An emergency department reality check
- 22:16 Sacred home death care
- 23:10 Time and legal windows
- 24:36 The shift from nurse to doula
- 28:33 Grandmother's parting smile
- 30:45 Reiki as a portal
- 33:35 Energy clearing stories
- 38:27 What nurses aren't taught
- 40:32 Presence in hospice rooms
- 43:15 Closing and where to find Helen
Feeling the pull to do this work? Pay attention to that. I teach it at Compass Doula Academy.
Caring for someone near the end? You don't have to figure out the last days alone. Book a Guided Care Planning Call and we'll talk through what's ahead.
Listen: Spotify · Apple Podcasts · 44 minutes
If there's anything else you're dying to ask, let me know: christy@christybraun.com
