Palliative and Supportive Care (2009), 7, 405–414.
CYNDA HYLTON RUSHTON, PH.D., R.N., F.A.A.N., DEBORAH E. SELLERS, PH.D.,
KAREN S. HELLER, PH.D., BEVERLY SPRING, B.A., M.D.,
BARBARA M. DOSSEY, PH.D., R.N., F.A.A.N.,
AND JOAN HALIFAX, PH.D.
ABSTRACT
Objective: Health care professionals report a lack of skills in the psychosocial and spiritual
aspects of caring for dying people and high levels of moral distress, grief, and burnout. To
address these concerns, the “Being with Dying: Professional Training Program in
Contemplative End-of-Life Care” (BWD) was created. The premise of BWD, which is based on
the development of mindfulness and receptive attention through contemplative practice, is that
cultivating stability of mind and emotions enables clinicians to respond to others and
themselves with compassion. This article describes the impact of BWD on the participants.
Methods: Ninety-five BWD participants completed an anonymous online survey; 40
completed a confidential open-ended telephone interview.
Results: Four main themes—the power of presence, cultivating balanced compassion,
recognizing grief, and the importance of self-care—emerged in the interviews and were
supported in the survey data. The interviewees considered BWD’s contemplative and reflective
practices meaningful, useful, and valuable and reported that BWD provided skills, attitudes,
behaviors, and tools to change how they worked with the dying and bereaved.
Significance of results: The quality of presence has the potential to transform the care of dying
people and the caregivers themselves. Cultivating this quality within themselves and others
allows clinicians to explore alternatives to exclusively intellectual, procedural, and taskoriented
approaches when caring for dying people. BWD provides a rare opportunity to engage
in practices and methods that cultivate the stability of mind and emotions that may facilitate
compassionate care of dying patients, families, and caregivers.