Hospice Nurses Are Not Just Hired - it is a Calling

Pulling up the driveway to the little house hidden behind neglected brush, she leans over and ruffles around on the passenger seat to find the assessment for her first patient.

This was her first patient on her own and she was questioning whether she would have the stamina to keep up with this job.

She glanced over the assessment sheet and it read- "77 year old married female, malignant breast cancer with mets to lung--informational on hospice services and admission to take place. Patient needs lots of support, physically and financially. Husband will be present."

She has been a registered nurse for five years. Working in the NICU (neonatal intensive care unit) for two years and as a home care nurse for three. She thought she was fulfilled with her nursing career, but she knew deep down she was destined for a bigger challenge -- hospice care.

Hospice care is provided for individuals who are facing a life-limiting illness, and who are not expected to live more then six months if the disease process takes on its normal course.

In a brief moment she pondered-- What brought me here in the first place? The money? No, she makes $4 an hour less than she did being a home care nurse. The flexibility? No, she knows she can be called out at anytime 24/7 even on Christmas Eve -- hospice patients get sick and need immediate assistance even when our lives slow down and go on as planned. Is all this all even going to be worth it? She wondered what really brought her to hospice, other than responding to the want-ad in the paper.

Hospice workers seem to be called, not hired, and she knew she was meant to do this. Her heart had led her to hospice.

Two years ago her mother was diagnosed with late stage cancer and the only option other than a nursing home was to go home and spend her last months with her family. She knew what is was like to be on the other side of the door, she remembers vividly the day she accompanied her mom to her oncologist's office. They both knew going in it wasn't good, her mom had lost so much weight since her last round of chemo and didn't seem to be getting any better. It seemed so cold and meaningless when the doctor told her the news that she only had a few weeks to live -- maybe a month at the most. He softly spoke and said "I can send you home with hospice and they will take care of everything for you, they will even set up equipment to make it easier on your daughter to care for you. They will give you medicine to relax you and make you comfortable." For a split second she thought that she couldn't take care of her mom, she was a single mom of two teenagers and she worked full-time -- there's no way she could handle this! "Mom has to go to a nursing home." she thought. Suddenly she remembers back to when she was ten and she herself was in the hospital very sick with meningitis, her mom stayed by her side day and night and always squeezed her hand when she was awake, letting her know how much she loved her and that she would be there until she got better and she could take her home. She remembers being very scared and looking around at the cold blue hospital walls and feeling so empty, it just didn't feel like home. She couldn't imagine placing mom in the nursing home with that same dark, scary feeling, especially at a time like this.

A Hospital usually won't keep a terminally ill patient inevitably, especially since it is costing them and insurance companies several hundred dollars each day to keep them there. Hospitals don't specialize in palliative care (making the patient comfortable without treating them to cure them) The hospital's main goal is to cure and treat the patient, and then send them on their way.

Nursing homes are an alternative, but they can be costly if the patient's insurance doesn't cover room and board.

A hospice inpatient care facility is a wonderful option if availability isn't a problem. Most inpatient facilities have minimal space and beds -- so they tend to fill up fast. Inpatient facilities specialize in individualized care with the goal that all aspects of the patients and their family's needs are met.

Hospice care itself allows the patient to remain in their home setting, surrounded by family and caregivers, to allow his final days to be private, personal and comfortable.

The goal of the hospice interdisciplinary team is to meet all the social, physical, spiritual and emotional needs of all patients. Not only is physical care given to the patient, but the team of qualified social workers, spiritual care advisors, nurses and home health aides, all work together to meet the patient and family's issues and concerns.

One of the most important backbones in hospice care is the team of volunteers who give their time unselfishly, to stay with the patients and lend a helping hand to relieve tired caregivers.

It was only three weeks later when her mom died at home with her family surrounding her. She went peacefully, and the hospice nurse made sure her mom was comfortable up to the very end-- allowing the family to spend quality last moments with her and to be with her in this experience only as extraordinary and miraculous as birth itself -- a metamorphosis into another stage of life and death from leaving this earth. As her mom took her last few breaths, she was there by her bedside, gently squeezing her hand, telling her everything will be ok for her soon and soon she will go home to be with God.

Walking up the driveway she said a prayer in her head; God, please give me the strength to help this family and leave my worries outside the door, and open up my mind and heart to try to give them exactly what they need -- not what I think they need. To make this experience for them and their family a positive one, not a scary and stressful one. God give me the strength, to not only be a nurse and offer my expertise, but to offer my heart also.

The door opened and an elderly gentleman with a tired but grateful smile opens the door, and invites her in; "We are so glad you are here, thank you so much for coming! I don't think we could do this without you."

She smiles and thinks to herself -- this is why it's worth it.