Influencing Death: Reframing Dying for Better Living

by Penny Hawkins Smith

A hospice nurse’s unflinching look at life, death, and redemption.

Death is undeniable and unavoidable. We must accept it; there is no other choice. But coming to terms with our mortality can profoundly influence how we live—and how we die. Having been a hospice nurse for decades, Penny Hawkins Smith is an expert on death and dying. As a recovering alcoholic and former drug addict, she knows what it means to change course and become a meaningful contributor to society. Through her work with death, Penny found her purpose in life.

In Influencing Death, Penny brings transparency and levity to the grim topic of death while revealing truths about the reckless past that influenced her decision to become a hospice nurse. Using down-to-earth, compassionate storytelling, she transports readers into the room with dying people and their families, laying bare the raw and real human emotions and behaviors people have when life and death are hanging in the balance.

Weaving together dual narratives of death and life, Penny challenges us to see how embracing our own mortality—and the mortality of the people we love—can help us live more fully and approach the end of life with greater acceptance, grace, and peace.

Genres: Nonfiction, Death, Memoir, Medical, Audiobook, Self Help

224 pages, Paperback

Published January 14, 2025

About the author

Penny Smith, BSN, RN is a (US) nationally certified hospice and palliative care nurse with 20 years of experience. Penny has worked in a variety of care settings and roles within hospice including inpatient, home case management, education, quality and regulatory. She currently works as a hospice quality assurance nurse for an organization in Washington state.
Penny is a passionate advocate for hospice education with a mission to normalize the end-of-life process to remove the stigma and fear around hospice care, death and dying. During the pandemic she found her way to social media and discovered a unique way to utilize her death care expertise to provide education to a worldwide audience at a grassroots level. Using a variety of teaching styles including Tiktok trends, dark humor, dancing and storytelling, Penny has gathered over 2 million followers across her social media platforms as @hospicenursepenny.
Penny has 3 adult children and 5 grandpeeps. She currently makes her home in an off-grid cabin on a mountain in Eastern Washinton with her husband, Randy, Pam the cat and Kevin the cattle dog. She loves to garden, cook, and go on cruises.

Reviews

[Chelsylynn91 · Rating 5 out of 5]

My mother passed away when I was 14 years old. I was in the hospice room with her when she passed and it was one of the most surreal experiences I had had in my short life. I remember looking down at her and feeling like all of a sudden, she didn't look like her anymore. Now, as a 33 year old, I have experienced a similar feeling every time I have had to put a pet down. There's a certain absence to the body that can feel so unnerving and unnatural. They say that people look peaceful and just like they are sleeping, but I have never thought that. I have always thought they look empty and fake, like a wax replica.

After that experience with my mom, I developed death hyperfixation and anxiety as a result of undiagnosed OCD. It plagued me for years and then when I got married, I hyperfixated on my husband's death. It was all consuming and extremely distressing. I have been able to curb some of these fears with proper medication and psychiatric care. The fear was still there, however.

I saw this book on NetGalley and was approved to listen to an advanced copy. I jumped at the opportunity because of those prior experiences and it was honestly so cathartic for me. Hearing Penny's experiences in her own voice allowed me to think about the death of my loved ones and my own death in a more calm and logical way. Her matter of fact view combined with her empathetic and caring candor comforted me in a way I didn't expect. This is a really powerful account of Penny's journey that has certainly changed my life for the better. I highly recommend this book if you have death anxiety or are just curious about the hospice process from the viewpoint of a nurse.

Thank you Net Galley, Penny Hawkins Smith, and Dreamscape Media for access to this inspiring and comforting book.

[Meghan Cronin · Rating 5 out of 5]

“Influencing Death” is an honest and authentic look at Penny’s resilient journey, as well as the moving stories of her patients and their families along with education on death and dying in a way that is so reassuring and understandable. I have followed her for years as I have suffered with death anxiety for as long as I can remember and nothing helped until I met Penny on TikTok and started going to her live streams and watching her content. The way she uses trends and dark humor to educate is nothing short of brilliant and has changed the narrative surrounding death and dying.  She has created a community on social media where people feel safe sharing their most vulnerable thoughts, usually about losing their person and having some sort of regret or guilt that her videos have alleviated, allowing people to realise these feelings are a normal part of the death/dying process. 
In “Influencing Death,” the stories about each patient are so synergistically intertwined with the stories about Penny’s human experience and is proof that past mistakes do not define you, that it is never too late to make a difference, to change your life and the lives of those around you. The book flows so well and is so captivating that I finished it in 24 hours, which I haven’t done since high school.  You will laugh, you will need tissues and you will not be able to put the book down.  Penny makes all of us with death anxiety feel seen.  She’s relatable in such a way that will make you root for her from the Authors Note.  This is definitely a book I will be sharing with everyone I know. It will help you see the importance of celebrating life everyday while also encouraging the reader to have those important end of life conversations with your people, both about what you may want when the time comes and what they would want.  “Influencing Death” is full of stories, insights and end of life education that integrate harmoniously and is mesmerizing, emotionally touching, insightful and the best book I’ve read in a very long time.

[Halley R · Rating 5 out of 5]

This memoir is an engaging blend of a life journey, anecdotes, and great end of life education. I really love how it moves between these 3, keeping me engaged and also learning… with a few laughs along the way. Great read!

[Lisa Brandl · Rating 3 out of 5]

The first few chapters are more memoir-focused with some anecdotal stories of caring for patients. It’s about the midway point that there’s an emphasis on hospice care. It’s for that reason I have it at three stars. I appreciated the author’s candor about her life struggles and personal journey, which is a hard thing to share with strangers. I wanted more of a focus on hospice care and what to expect, and starting at the middle, the book did focus on that.

[Julie · Rating 5 out of 5]

This memoir is an extraordinary blend of humor, heartfelt storytelling, and valuable insights. Penny’s wit and engaging style make even the most challenging moments feel accessible, while the touching anecdotes offer a deep understanding of end-of-life care. It's not only an enjoyable read but also an educational one that guides the reader to look at their own mortality without dreading it.

[Sara Smith · Rating 5 out of 5]

Like so many other people, I found Penny on Tik Tok. I wasn't following her for very long before the app got shut down, unfortunately. The last time I saw Penny on Tik Tok was when she went live to talk about her book. I immediately added this title to my TBR list and looked for it on Amazon, too. This is the first book I have ever read that was very autobiography-esque. Non-fiction usually isn't my jam. But this book read like I was sitting down with Penny and having a chat with her about the kind of life she's had. Her writing style is very down-to-earth and blunt. Motivated by my own morbid curiosity about the hospice field, and because of spiritual encounters I've had with passed loved ones, I knew this was going to be a good read for me. I learned a lot of things no one really wants to talk about. It's a shame that doctors also don't want to or are not properly trained on how to talk about death, come to find out! I can say now that I really do want to be a hospice volunteer after reading this book. Thank you, Penny, for writing this book and sharing it with us.

[ashley and the never ending TBR · Rating 5 out of 5]

nurse Penny is the hospice nurse I aspire to be, she’s knowledge, funny and has found that sweet spot to being exactly what the family (and patient) needs! I loved that she tells her story but in a way that flows cohesively with her hospice anecdotes. You will learn, you will love and you will get chills.

In comparison to The In-Between, Influencing Death (to me) embraces death in a different way, that most of us can digest. My husband just lost his grandfather on services and while I was able to help be his guide at times, I’m sure this book would’ve saved him so much confusion at the end. I’m recommending this to all my families on service!

[Christine Cazeneuve · Rating 5 out of 5]

This is one of the best books I have ever read. Penny holds nothing back about her life and experiences. I admire and respect her so much. I lost my husband to cancer 3 years ago and he only had one visit from hospice before he passed. However, those that choose this field truly make a difference in everyone's life - whether short or long. Penny is honest, funny, compassionate and opinionated and I adore her. Everyone needs to read this book no matter what stage of your life you are in. Thanks to NetGalley, author and publisher for the honor of reading this advanced copy in exchange for my honest opinion

[Gillian Brass · Rating 1 out of 5]

A disappointment.

I had expected more stories about the experiences and lives of those who were passing. Instead, it was mostly a self-absorbed account of the author’s life, difficult as it was, before she became a hospice nurse. Also, because the author is a self-proclaimed atheist, the spiritualist aspect of dying was, without surprise, non-existent. Regardless of whether you believe in an afterlife, the number of recorded experiences of those passing over cannot be ignored. I kept waiting and hoping it would improve. It didn’t.

[Lisa Pahl · Rating 5 out of 5]

What a read! The storytelling and humor woven through this book will engage you from the first page. I loved how the author, who is a hospice nurse, shares so much of herself and her fascinating life story while also educating on a topic that many of us fear; death. You would think this book would take some time to make your way through, but I was so engrossed, I finished it in a day! You will laugh, cry, and feel inspired to live your life fully!

[Rachel A · Rating 5 out of 5]

This book has such a great take on death and life. Amazing, funny stories.

[Felicia Charbonneau · Rating 5 out of 5]

I have followed Penny for years and have always loved her approach to educating others about hospice care and death. It’s such a taboo and sensitive subject many people find uncomfortable to discuss and it tends to be that you don’t understand hospice care until after you’ve experienced it. Penny’s honest demeanor and approach is clear and to the point while also incredibly empathetic and compassionate to all walks of life. Her book is a memoir and therefore includes parts of her own life outside of hospice and it’s all part of who she is and how she’s gotten to where she is now. Her own struggles help her relate to people who might have a harder time.
I really loved the stories she shared in the book and how she handled the wide range of responses to death individuals and their families have. She does a great job normalizing the experience and bringing peace to those who struggle with guilt over their loved one’s end of life experience. She does a really great job also showing how to advocate for patients, honoring their wishes and ensuring family is there for each-other as long as that is what’s best for the patient.
Truly a must read for everyone because well.. death is obviously relevant to everyone! 💕

[Finley Muratova · Rating 5 out of 5]

This was a brilliant book. I’m just really grateful to Nurse Penny for taking the time to share her unique experiences with us, her followers and readers. I particularly enjoyed Penny’s audiobook narration. She spoke with the kind of cadence you would tell stories to your friends with, and it made me feel a level of closeness to her narrative. I would highly recommend this book / audiobook to anyone worried about the concepts of death and dying. It’s enlightening, to say the least!

[Ali · Rating 5 out of 5]

A hard but necessary read. Beautiful in every way possible.

[Kkaaccyy · Rating 5 out of 5]

Not rating author's personal story I am rating based off engagement and how much I enjoyed how she told the story

[Peggy Dougherty · Rating 5 out of 5]

Penny gave an honest and compassionate look into a subject that many people want to avoid, death and dying. Her story is truly inspirational. I thoroughly enjoyed reading Influencing Death: Reframing Dying for Better Living.

[Haley Shankin · Rating 5 out of 5]

Can not put this book down one of the best books I’ve read in such a long time!

[Ashley Perera · Rating 5 out of 5]

10/10 great read!! Puts everything into different perspective!

[Cathy Summelin · Rating 5 out of 5]

I loved this book. She has a great style that makes it easy to read and stay focused on it.
I highly recommend this book

[Danielle Gibson · Rating 5 out of 5]

A-MAZ-ING

Amazing book, such lovely story telling yet so educating about death. Everyone should read this book! You will not be disappointed! Also give hospicenursepenny a follow on social media! You won’t regret it!

[Tara Woodward · Rating 5 out of 5]

My husband recently passed away and everything she says in this book was spot on.

[Christine H · Rating 5 out of 5]

An amazing book from start to finish, perfect balance of authors life story and stories of hospice care. Such a refreshing read, we need more books like this!

[Emily Koenig · Rating 3 out of 5]

Different than what I was expecting (did we need it to be a memoir?) but some good info about dying.

[judith · Rating 5 out of 5]

I read this book in one sitting (granted I was on a 5 hour flight). That said this book is captivating for multiple reasons:

1. The blatant honesty about what death is and some of the real life details (like how horribly painful CPR is to someone who’s actively dying)
2. The interwoven personal stories of Nurse Penny that acknowledge she is far from sainthood or piety, despite her career choice. She discusses some of her most vulnerable and harmful mistakes. This tells the story of her path from her youth to making a mid-life vow to service through her hospice nurse career.
3. The variability in the death stories. Death can be beautiful and peaceful, or drawn out and excruciating. Each story she tells usually had a mix of both. Our actions and regrets, relationships we’ve forged or neglected, family dynamics, and ability or inability to embrace vulnerability will follow us all to our death beds.

I appreciated that the author acknowledged she had no religious background and still touched on her spiritual experiences and opinions without trying to convince the reader one way or another. (Spoiler: she believes some part of us carries on when we pass, but past that is a mystery!). The author also did a great job advising both the dying and the supporting family/friends on how to best support each other through the death process.

I feel that it’s human nature to be drawn to/terrified of the topic of dying. To address death and to sit with others who are dying or experiencing the grief of a loved one’s death, is one of the most raw human experiences we get. This book can help us all to reflect on our previous experiences with death and give us tools to prepare to be intentionally involved the next time death greets a loved one (or ourselves).

A few of my favorite quotes from the book:

“One of the greatest gifts life has to offer is the ability to acknowledge that it is ending. That is the only way to ensure meaningful conversations, closure, and goodbyes.”

“Acknowledging the truth about dying and its inevitability can make the difference between a terrible death experience and a beautiful one”

“There’s only one way to not regret your own inevitable death: to live as fully as possible, in the moment, right now.”

[Wendy · Rating 4 out of 5]

Thank you to NetGalley, Dreamscape Media, and of course, Penny Hawkins Smith, RN for the advanced copy of Influencing Death.

Penny Hawkins Smith’s Influencing Death is a heartfelt, multifaceted exploration of life, death, and the spaces in between. Drawing on decades of experience as a hospice nurse and her own journey of recovery from addiction, Penny invites readers into a deeply personal and universal journey. The book is layered with poignant stories from her professional life, insights into her tumultuous past, and reflections on how embracing mortality can lead to a more fulfilling life.

I was particularly excited to read this book, having followed Penny on Instagram and already knowing some of her stories. Influencing Death felt like a natural progression, offering more depth and transparency than social media can provide. The book’s multilayered structure, however, may divide readers. While I appreciated how seamlessly Penny weaves her personal, professional, and educational narratives, it’s true that each layer could have stood alone as a separate book. Readers unfamiliar with Penny might find this structure a bit scattered, but for those of us who know her, the layers provide a fuller picture of her life and work.

The audiobook, narrated by Penny herself, is a highlight. Her warm, familiar voice carries the weight of her stories with authenticity and passion. Hearing her narrate adds an emotional resonance that might have been lost with another narrator. Through her voice, listeners can sense her vulnerability, strength, and dedication to demystifying death and living with purpose.

Influencing Death is a powerful and thought-provoking read that encourages readers to reflect on life’s ultimate inevitability. Those already familiar with Penny’s journey will find it deeply moving, while newcomers may gain valuable insights into the profound relationship between accepting death and living a meaningful life.

[Jade · Rating 5 out of 5]

This was so good! I came across nurse Penny in the early days of TikTok. I was in the process of losing one of the people closest to me, and her videos brought me comfort. I appreciated the dark humor that she often uses. I’m one of those people who has severe death anxiety, so I started trying to learn more, and remove some of the taboo feelings I have about death. Great work Penny! I think you may have more than one book in you.

[Shannon Schuler · Rating 5 out of 5]

I have been following Hospice Nurse Peny for a while now & found out about this book! I couldn't wait to read it or listen to it (which is what I did). This book is amazing! I highly recommend it! She made is laugh and made tears in my eyes!

I have now enrolled in CNA classes to becomes a Hospice Nurse at some point in my life and even doing my own fundraising to pay for my classes, just like Penny!

I love this book, and I look forward to reading it again!

[Valleri · Rating 5 out of 5]

Coming to terms with our mortality can profoundly influence how we live—and how we die. Boy did I learn a lot by reading Influencing Death! I requested the book from NetGalley because my husband and I are getting up there in age, and my husband's health has become worse in the past year. We have had discussions about hospice and that's what we both want.

I don't know what I was expecting - maybe that we'd go quickly and quietly in the night. My eyes have been opened and not in a bad way! If I hadn't read Influencing Death, there would have been things that both shocked me and scared me. I would have certainly have said the wrong things and maybe even done the wrong things. I feel more at peace, now.

Influencing Death is an important book for every person to read, no matter their situation in life.

Thank you #GirlFridayBooks for providing this book for review consideration via NetGalley. All opinions are my own. This book has an expected publication date of Jan 14 2025.

#PennyHawkinsSmith #Hospice #Death

[Molly · Rating 5 out of 5]

I read this book because I am afraid of death and cancer, and I believe in hospice services and the value they provide. In that regard, there was nothing new-acceptance, society's death phobia, the importance of having a living will, death comes when it feels like it but never at the right time, dying sucks but you might get lucky and hallucinate at the end, religious jackasses want to keep you from your right to die or that is, your right to not be in horrific pain in your final days. None of that was new and has perhaps been more eloquently expressed elsewhere.
Rather, what I really loved about this book was the author's personal story and connection to her work, and her frank leveling with the non-dying about our inevitable end. Her ordinary life is laid plain, she believes in herself, she is bold and honest. Many bios and memoirs are about extraordinary people, famous politicians or scientists, trailblazers, artists, or people who were murderous monsters or were murdered by murderous monsters. This was about a nurse with perhaps more spunk than most people, but other than that, she is just a normal person, living as much as she can, clearly flawed, average American. She is perhaps unusually determined, reflective and good at self-promotion. I was absolutely inspired by her self confidence and conviction. She also appeared to actively work on her empathy, which I thought was good food for thought. Her profession is truly heroic, and that is a fact.
She remarks at her discomfort when people call her an angel given her past, (which is in my view was not that wicked at all) but this angel of death, for some reason, made me feel better about my own ordinary life, even proud of it, and she succeeded in giving me some peace about death. She gave me hope that ordinary people can do extraordinary things like write books, maximize themselves, keep chickens and attend to the dying, and that however unlikely, maybe but probably not, there is an afterlife. I hope she finds time for a few more cases.

[Cassie · Rating 4 out of 5]

I’ve seen some of “Hospice Nurse Penny” and her videos on social media, and when I saw she had a book coming out, I jumped on it. My first thought is a reminder that everyone is the hero of their own story. Even if people are able to critically reflect on their own behavior, most of their stories will still be infused with the undertone of ‘I did the right thing’, ‘people were so grateful I was there’, and ‘I was the best person for this particular situation’. I found some of her reflections with patients to be a bit grating for that reason, but I think that’s really a ME problem - not an issue with the book itself. That said, she’s got a great dark, wry humor that has a way of keeping a heavy subject light and even enjoyable at times. This is really more of a personal memoir infused with some poignant reflections on hospice, but I didn’t mind it. Her life story is kind of wild and very interesting. I had no idea that she was essentially a first-round crowd-sourcer with her “Help Me Leave My Husband” website, and her struggles with drugs and alcohol provide an incredibly human backdrop for her time as a hospice nurse. It felt like it was really written for the lay person, but it really aligns with a lot of my own experience as an ICU nurse. Overall, I thought it was rich with emotion and deeply personal, and engaging on a really practical level. Definitely enjoyed this listen!