Palliative and Supportive Care

Original Articles

Impact of a contemplative end-of-life training program: Being with dying

Cynda Hylton Rushtona1 c1, Deborah E. Sellersa2, Karen S. Hellera3, Beverly Springa4, Barbara M. Dosseya5 and Joan Halifaxa6

a1 Johns Hopkins University School of Nursing, Baltimore, Maryland

a2 Education Development Center, Inc., Newton, Massachusetts

a3 Consultant, Framingham, Massachusetts

a4 Vancouver General Hospital, Vancouver, British Columbia, Canada

a5 Holistic Nursing Consultants, Santa Fe, New Mexico

a6 Abbott, Upaya Institute, Santa Fe, New Mexico


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 task-oriented 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.

(Received March 11 2009)

(Accepted May 18 2009)


c1 Address correspondence and reprint requests to: Cynda Hylton Rushton, 2312 Henslowe Dr., Potomac, MD 20854. E-mail: