By SLMorrical
My name is Sandra Morrical and this is my story about being a Hospice Nurse. Being a Hospice Nurse isn't for everyone, and I get told that all the time. My friends and family constantly tell me they don't know how I do it day in and day out. You know the old saying someone has to do it. Well, it's true someone does have to care for terminally ill people up until they die. This is the job of a Hospice Nurse.
What makes a Hospice Nurse? First, you have to have a Hospice heart. This is a term that stuck with me, after a family member of a patient I was taken care of; told me I had a hospice heart. The nature of nursing is caring, and this is specifically true of a hospice nurse. Nurses that work in the hospital help patients and their families in times of sickness. Nurses that work in the long-term, rehab, and assisted living facilities deals with patients in the long term with an illness that is not terminal, but needs skilled nursing care. Hospice Nurses help terminally ill patients and their families at a time when the patient had decided to stop life-prolonging medical treatments.
One of the largest parts of being a Hospice Nurse involves helping patients, and their families, feel more comfortable about death and providing them with the emotional support they need. I use patient center care as a hospice nurse. Patient-center care is providing care that is respectful and sensitive to the individual patient's preferences, needs, and values. A hospice heart ensures the patient's and families' values and wishes to guide all care decisions. The one important aspect of hospice care is ensuring the patient has pain under control and is comfortable for the remainder of their life. It comes down to the quality of life, not the quantity of life.
Yes, it does take a special type of person to be a hospice nurse, but a hospice continual care nurse takes a hospice heart. The continual care nurse has an important job. The care a CC Nurse gives has a meaningful impact on many individuals. I believe becoming a CC Nurse with hospice was a calling. A calling like a Nun or Priest has a calling to follow God and teach his word. It's a calling to be present as the hospice patient transitions to the next phase of life/death and to help their family with the emotional distress of dealing with their loved one dying. I believe it is a calling because I feel privileged and honored to assist the patients and their families move through the transition from life to death.
Many cultures treat death as a part of life to be celebrated with family and friends. My hospice heart's philosophy is to be the angel that comforts and tries to ease the patients in the final stages of life. As a hospice CC nurse, I have been called a guardian angel or just an angel by patients and by families. Whether Hospice Nurses are angels or not is not the question. It's the spirituality of the Nurse that creates the angel identity. Spirituality is a huge part of hospice care. It's not important what you believe or what the family or patient believes, just that the nurse has some kind of spiritual belief. This is what creates a hospice heart.
I am a spiritual individual and it gives me as a hospice nurse, especially a Continual Care Nurse, an advantage when dealing with the end of life. A spiritual person can often read into things more than a person who is not spiritual, especially when a patient is in the dying process. As a spiritual person, I see and feel things happening to the dying patient. I understand that talking to someone who has passed on is not a hallucination. Just because we can't see it doesn't mean they aren't there. This is whereas a spiritual person I talk to the patient and ask questions. If they can't answer me I just acknowledge there is something there. I have felt the presence of people and things throughout my hospice care. This will be discussed later in the book.
If a patient can answer the question, the answer may range anywhere from angles to relatives reaching out to them, motioning them to come and join them. These answers may also assist the family with the acceptance of the patient death. The family hears the patient believes they are going to be with loved ones when they pass. This helps the family believe the patient is going to a loving and peaceful place. This is good for patients who are in a lot of pain for years. The family feels the patient will be out of pain, and at peace with love and comfort. I have made an enormous difference in helping families and patients with the crossover from here to the other side. I know this because I have seen the difference between patients and families that have a spiritual belief and ones who do not. The patients and families that don't have some kind of spiritual belief have a hard time at the end of life.
The reason these families and patients have a hard time is due to fear. It's the fear of the unknown. The families feel it's the end and their loved one is gone forever. Like I tell my patients' families, death just ends a body, not a relationship. This at least gives them some peace at this time. The patients have fear because they don't believe they are going anywhere. Many people are afraid to die because they feel it is the end. A spiritual belief gives them hope. It gives them hope because faith nurtures hope. If a patient doesn't have the faith in where they are going when they die, they become afraid of dying. The belief that something or someone is waiting for you does make it easier for the patients and their families.
Nurses in hospitals and nursing facilities give emotional support. As a hospice nurse, I give spiritual support. A hospice heart is intuitive to the clues the dying patient is giving when close to the end and can help the family notice these clues to get as prepared as they can. As a hospice heart, my spirituality plays an important role in caring for the hospice patient and their families. Empathy and compassion show when dealing with dying patients and their families. People can see if you care or not.
Another thing that involves having a Hospice Heart knows what hospice is and how it helps patients with a terminal illnesses. Many people including nurses have no idea what hospice is. When you say hospice the first thing people think of is the end. They think their loved one is dying today or tomorrow. This is not true. Hospice is implemented whenever the need exists and usually where the patient lives. Hospice helps individuals that have been diagnosed with a terminal illness, and the doctor has given them a life expectancy of a year or less.
Spirituality and knowing what hospice is and how both are used to help patients and their families are just the surfaces. A hospice heart looks at care as a patient/family center care. You are not only caring for the patient, but also the family. Keeping a patient pain-free and comfortable during the transition from this world to the next is one part. A hospice heart also understands the family is also in need of care and support. The family needs the reinsurance they did the right thing by putting their loved one on hospice. They need to know they have the right to grieve how they want and feel how they want. A hospice heart assures them of this.
The last thing is a hospice heart realizes they can sympathize with the patient and family, but can't understand what they are going through unless they have gone through it themselves. Many nurses don't consider that. A hospice heart will have families look back on their hospice experience with gratitude and knowledge that everything possible was done to give their loved one a peaceful transition to the other side; in other words, a peaceful death.
| Author Notes | I have been gone a while from FanStory. I was injured at work and couldn't write because of the injury to my left shoulder and left wrist. I did start this book before I was injured, and once I could write again I worked on this and completely rewrote the first three chapters. Thanks for taking the time to read. |
By SLMorrical
The calling for a Hospice Nurse can come at any time. When I received the call, I didn’t know it. I had only been a nurse for six months. I was working in a nursing facility and had a patient that was in distress. The patient’s noisy breathing sounded very wet. The patient was filling up with fluid and of course, was uncomfortable. I had called the doctor and the family and was told nothing was going to be done and the family would be in the next day.
I went to the employee break room sat down and cried. I had to let this patient drown in their fluids, and there was nothing I could do. This was not why I went into the nursing field. Since I was upset because I could not make that patient comfortable, that was the start of the calling to a Hospice Heart. Hospice Nurses try every, and anything to make a patient comfortable.
I left that facility six months after that because I was just pushing pills and doing paperwork, also not why I wanted to be a nurse. Some nurses like the hustle and bustle of the emergency room. Others like trauma, surgery, and even just working in a facility. Nurses like doctors can have specialties. I have worked in many different specialties. From a long-term, rehabilitation facility, to assisted living with memory care.
I also worked as a nurse in our county jail. None of these fulfilled why I became a nurse. Unhappy nurses become burnt-out nurses. A burnt-out nurse is a dangerous nurse. A burnt-out nurse can make mistakes that can be life-threatening. I was becoming a burnt-out nurse and wanted out of nursing. I didn't want to be a danger to my patients or myself.
Many nurses get burnt out working in long-term care facilities. Many of these nurses keep working in them burnt out. I was not one of those nurses. I went back to school to get out of nursing. While working on my Ph.D. online, I started working for hospice on an as-needed status. My first case was following another hospice nurse. I saw how much of a difference she made for the patient and their family that I was instantly hooked.
Working as a Hospice Nurse is nursing for me. This is why I became a Nurse. Nursing can mean so much to each nurse. Finding where you fit as a nurse makes all the difference. I make a difference to the patients and their families. I also get to see the difference I make. I don’t do this for any recognition or praise. Most nurses don’t get either anyway.
I enjoy being a Hospice Nurse and I am rewarded by knowing the patient is comfortable, peaceful, and out of pain. I am also rewarded by the comfort I can give to the patient’s family. Being a Hospice Nurse is not for everyone. I hear every day from different people, “I couldn’t do what you do.” I have always been an emotional and spiritual individual, and I can always tell when someone needs comfort.
I just do my job without thought or hesitation. It just comes naturally. I don’t get scared or freaked out by the strange occurrences that come with the job. I will go over those in a later chapter. I believe I was destined to be a Hospice Nurse because it does come so naturally. I love my job and wouldn’t stop doing it unless I couldn’t do it anymore. I am a Hospice Nurse and I have a Hospice Heart. I was called to be a Hospice Nurse and wouldn’t change anything, except to have found my calling earlier. I believe in fate and destiny, and being a Hospice Nurse is my fate and destiny. Unfortunately, I had to stop working as a Hospice Nurse, due to an injury that prevented me from working as a Hospice Nurse anymore.
| Author Notes | Thank you for all and any feedback. I am writing this book on being a Hospice Nurse, because a friend suggested I do it. I was a Hospice Nurse for 13 years until an injury prevented me from preforming my job as a Hospice Nurse. I enjoyed working as a Hospice Nurse. Thank you Google images for the picture. |
By SLMorrical
A Hospice Nurse can acquire an attachment to patients without difficulty. It is the hospice heart that reaches out to the patient and family and cultivates the bond. Families and patients can equally develop an affection for the hospice nurse. Many families and patients have told me I was like a guardian angel watching over them, being at the bedside for a 13-hour night shift.
During the shift, I am up and keeping an eye on the patient. I am ensuring the patient is comfortable and doesn't need anything. In addition, I am also there for the family as emotional support by being an ear that listens, or arms that hug. Being a Hospice Nurse is not just taking care of a patient, but also taking care of the patient's family. I believe a person shouldn't die alone, and the family shouldn't feel defeated. The family needs to know it is okay for them to feel and react however they feel or react.
A hospice nurse that validates and supports the patient and their family becomes part of the family for the period of hospice care. I always consider my patients and their families as family, and I always treated them that way. This is the foundation of a hospice heart, guardian angle. It is hard for a person to take care of a loved one, and keep their emotions in check. This is why families are grateful for the hospice nurse who treat them like family. Working as a hospice nurse I wasn't allowed to take gifts and such things from families or patients, but I also didn't want to offend patients or their families. They would get upset if I said no, so many times I had dinner or breakfast, coffee, and such with them just like family.
Comfort comes in many forms and is delivered in many ways. Treating the patient and their loved ones like family is a way to comfort them. In addition, it helps the family express what they are feeling. It's very important that the family and the patient feel comfortable expressing their emotions, and it's up to the hospice nurse to validate those emotions, and reactions they have, no matter what they are. It's also up to the Hospice Nurses to comfort them.
The hospice nurse is not the only person that can get very close to another person, the family and patient can become attached to the hospice nurse. An example of this would be a patient I will call Alice, (not the real name to protect the patient and family). Alice was on and off continuous care for a year before she passed away. Continuous care is 24/7 care for a hospice patient. This 24/7 care is for any type of change or crisis the patient develops including the end of life. Alice and her family grew very fond of me and requested I come back to take care of Alice. Every time I showed up they were happy to see me as you would be happy to see a loved one you haven't seen in years or months.
In addition, after I took Alice's vitals and made sure she was dry and comfortable and in no distress or pain, I would sit down to chart for the beginning of the shift. After I started charting in would walk Alice's daughter and granddaughter with a TV tray and dinner and a drink for me, and insist I eat. I was considered family, so after traveling to their house they made sure I had a meal for my long night.
To me being treated like family not only touches my heart but also tells me, I am doing my job properly and doing it extremely well. When individuals don't feel like someone is taking care of them or their family members to their standards they aren't going to treat you like family. They are not going to be nice and will want you to leave and not come back. I have listened to many families and patients complain about other nurses and CNAs.
Patients and families can also develop an attachment to the hospice nurse. The hospice nurse can be a comfort to the family even after the funeral. Some hospice nurses keep in touch with the family years after the patient has passed. It's hard sometimes for hospice nurses to block out their emotions and continue to do their job. In retrospect, it is the emotions that make a hospice heart.
As a hospice nurse being in tuned with your emotions and your surroundings assists when dealing with the strange things and unusual things that are seen and felt. There has been many a night when the atmosphere just felt weird. Times when the room would all of a sudden be cold. Some things go bump in the night and it is usually when there is complete silence.
| Author Notes | Attachments to a patient or their family can happen. It is a Hospice Heart that has the empathy individuals are driven to. The empathy connects with the patient and the family and the attachment is born. |
By SLMorrical
There are times when things happen not logically explainable. My first experience with strange happenings was when I had a patient die. It was my first death working as a hospice nurse. The gentleman, I'll call him Charlie was at the end of his life and on comfort medications. Comfort medications are different medicines to keep a patient out of pain and not having terminal agitation, so they can have a peaceful passing. As a hospice nurse, it was not only my job but my responsibility to make sure a patient was comfortable. I was able to get Charlie comfortable, not in pain, and not having any terminal agitation.
It is said that the hearing is the last to go, and Charlie proved that when his wife told him she called their daughter and she would be arriving in about 45 minutes. Charlie had not been verbal at all up until this time and said to his wife "Why?" I was taken aback at this time. His wife explained their daughter, has not spoken to them for many years. She only lives an hour away, but never comes and visits because of the rift between her and her father. I tell this part of the story because it shows how precious relationships are. Charlie passed away 15 minutes before his daughter arrived, and needless to say, the daughter was devastated. The guilt of not talking to her father before he did was so obvious, and I felt so sad for her.
This changed me and made me realize that not only is life precious, but the relationships we have are precious. I started to take life one day at a time, along with trying to repair any relationships that I could. I also realized it is a two-way street with any relationship, and I needed to ensure I do what I can. I also realized I should not feel guilty if the other person doesn't want to repair the relationship. This has also helped me with my everyday life, and how I live it.
After everyone arrived to see Charlie I stepped out of the room into the living room/dining room to do paperwork giving the family time together and with the patient. As I was sitting alone concentrating on paperwork the room began to get cold. I had to put on my scrub jacket because it was getting very cold. Cold enough to feel like winter in the house. Then suddenly the radio turned on and was playing gospel music. The room is cold and the radio clicking on was weird enough, but a family member came out of the room and states Charlie was sending them a message that he was alright.
I kept my cool and continued to take care of the patient and ready him for transport to the funeral home. The family waited for transport to say their last goodbyes. After transport picked up the patient and I said my condolences and gave my support to the family any way I could, I climbed in my car and just sat there for a minute trying to make sense of the whole thing. I know patients will talk to people who I can't see, or anyone else can see. I have had family members tell me that the name said is a name of a person who has already passed away. So maybe it was Charlie who turned on the radio to gospel music as a sign. The radio was playing in the 50s and 60's when I first arrived at the house, and then it was turned off. In addition, I was the only one in the room and I didn't turn it on or even see a remote for the radio. This is the first of many weird and strange things I have experienced as a hospice nurse.
I always talk to my patients whether they answer or not, even when they have passed. Strange and unusual things don't bother me, because my family has always had strange and unusual things happen to them. My grandmother, I was told, had second sight as they called it. My heritage comes from Spanish Gypsies. I believe this has added to my having a hospice heart, and being able to deal with the strange and unusual that happen at times.
I was so good at dealing with strange and unusual events, I had many of my colleagues reach out to me to assist them with some strange and unusual. In addition, if something crazy would happen to me my bosses would say, "I'm glad it was you it happened to because you don't panic and can deal with crazy." As I stated in the beginning I was a natural, so I had a hospice heart. The next few chapters are incidents of the strange, unusual, and crazy I have dealt with as a hospice nurse.
| Author Notes | In my 13 years as a hospice nurse, I have seen my share of strange, unusual and crazy. Not everyone can deal with this. I had no trouble with this. |
By SLMorrical
This next story is not about a weird experience, but a laugh-at-yourself moment. My patient, I will call him George. George had four daughters and all four were at his bedside when he passed. I let them have time with him and made my phone calls to the hospice main office, and the doctor's office, so the death certificate could be signed. Called the funeral home to be ready for transport when George was cleaned up and dressed.
The daughters want George to leave the house by transport wearing a certain pair of pajamas, socks, slippers, and underwear. The patient always has to be bathed and dressed in what the family wants them to be wearing when picked up by the funeral home. The patient gets put in funeral clothes at the funeral home. This is more about dignity for the patient and comfort for the family. We may all come into this world naked, but no one wants to leave their house or the nursing home that way.
I bathed the patient and dressed him in underwear, and pajamas, and combed his hair. He looked just like he was sleeping. Upon completion of this and waiting for one daughter to find the socks and slippers, I called the funeral home for transport of the patient. The daughter brought me the socks and slippers to put on George. It had been forty-five minutes since I pronounced George dead.
After I was off the phone, I started to put socks on George's feet. I was at his feet with my back facing the head of the bed. All of a sudden I heard a big heavy sigh behind me. I didn't know that one of his daughters was behind me. It felt like my biggest fear as a hospice nurse had finally come to pass and I missed pronounced. I slowly turned towards the head of the bed expecting to see the patient alive.
There were three of his daughters sitting on the couch across from the hospital bed the patient was on. When I looked up and started to slowly turn, they started laughing at me. I didn't understand what was going on until I saw the one daughter at the head of the bed looking at George. I was relieved I didn't miss pronouncing the patient. At this moment all four were laughing at me.
I let out a big sigh of relief and joined in the laughter. One daughter was laughing so hard that she was in tears. The reason they were laughing was the look on my face. One daughter said to me the look was priceless and she wish she had taken a picture. I can only imagine the shock or fear on my face. I learned from this experience it's good to laugh at yourself no matter what the situation.
Another patient, I will call Barb, had started having some apnea, and she did stop breathing for exactly one minute. I believed she may have passed. I took my stethoscope and placed it on her chest to listen to her heart. Sometimes the patient stops breathing but their heart beats for a bit. I put my stethoscope on her chest, and right after that she grabbed my stethoscope and pushed it off her chest saying, "I'm not going anywhere." Yes, it startled me more than just a little. I had to laugh at myself, especially since she was nonverbal the whole shift. There are times when everyone has that moment of Shock.
| Author Notes | This is a short chapter. Everyone is worried about making a mistake at work. I was always afraid I would miss pronounce and send someone who is still alive to the funeral home. These two incidents address that fear. |
By SLMorrical
There were times when things happen, I would tell myself it is all in my head. It did get dark and quiet on many of those thirteen-hour night shifts. There were times when a family member would stay up and talk with me. They needed support and that is why I was there. It did help the night go by faster, and it was great to have help when turning or changing a patient. I wouldn't watch television unless the patient wanted it on all night to sleep, or the family would turn it on and tell me to watch it. The television did help to keep me awake when it got quiet, but even with the noise and the company, there were still times when I felt the room get cold and see things out of the corner of my eyes. There were times when I would even smell things. These things would happen when I was alone with the patient, and when I wasn't alone with a patient.
I would smell things like perfume or smoke, and sometimes even aftershave. Sometimes I would hear things like whispers and people talking. There were many times when I just knew someone else was in the room, but it was just me and the patient. A perfect example is when I was taking care of a dying patient I'll call Sophie. I had been with this patient for a couple of days and knew it was going to be a little while before she would pass. This was my third day with her and the family was all there and had told her it was okay to go and be at peace.
Telling a dying family member it's okay to go and everybody will be fine, actually helps the patient to pass easier and not hang on. I have learned in my thirteen years as a hospice nurse, dying patients do hang on and wait. They wait for someone alive to come and see them, or for someone who has already passed away to come and guide them to the afterlife. There was none, according to the family, who still needed to visit the patient. Therefore, I figured she was wanting for her guide. Her husband was my first guess. The family had placed a big portrait of her husband at the end of the bed facing her.
The family all said goodnight and let me know who to wake up first if something happens, and the lights were turned down low. I had the light on next to the chair I was sitting in so I could chart. I believe it was around one or two in the morning and I saw something out of the corner of my right eye. I turned to see what it was and I was looking straight at the big picture of her husband that was at the end of the bed. Of course, I told myself my mind was playing tricks on me because the picture can't move and there were no animals in the home, so it was nothing. I am always telling myself it is nothing when I know it is something or someone.
This went on for a couple of hours. I would see something out of the corner of my right eye, I would turn and look straight at the image of her husband. Then I smelled something like aftershave and turned my head again and looked directly at that representation of her husband. I started to believe that her husband was here to help her cross over to the other side. As I continue to monitor the patient, she was showing more and more signs of passing. She was comfortable and peaceful. At five am she passed.
I woke the family who gathered at the bedside grieving in their way. The family left the room so I could prepare her body for transport to the funeral home. Sophie's son and daughter wanted to help prepare her. As a hospice nurse, I don't recommend this, but they insisted. The three of us bathed and dressed her for transport. As we did this and we talked about their mom and dad, I told them about my experience with the picture and the smell of aftershave. The son states he felt his dad in the home for the last week.
That made the hair on my arms stand up. I felt the coldness again when her daughter stated her mom and dad were together again. She also said she saw them standing hand in hand, and left. No matter if you believe in ghosts or an afterlife, it sometimes gives people comfort knowing the person who has died is with another family member. In this case, the son and daughter were comforted by the knowledge that their mother was with their father.
| Author Notes | I appreciate any feedback. I thought writing this book would be easy and it's not even thought it is based on true events that happen to me when I worked as a hospice nurse. Many things are not logical or explained. |
By SLMorrical
As noted in previous chapters, strange things occur when sitting with a dying patient. Sometimes it is your imagination, but most of the time it is not. How do you deal with the real strange or supernatural stuff? Well, that depends on the hospice nurse and their beliefs and how open their mind is. I have always believed just because you can't see it doesn't mean it's not there. Some nurses that try hospice find they can't deal with the strange and unusual things that can occur.
I have heard it said that every nurse has a ghost or supernatural story because they work in an industry that deals with life or death. I have had many strange things happen in my thirteen years as a hospice nurse, but I would have to say my scariest moment happen when I was with a patient in a nursing home. I was with a patient I'll call Amy and another hospice nurse was next door with another patient.
We were long-time friends In fact, I believed I talked her into being a hospice nurse. Well, it was about three o'clock in the morning. It seems everything happens between two and four in the morning. I remember the time, because I made a note of when my patient was medicated and I changed and repositioned her. I would never move a patient around if they were in pain, so I schedule myself to change if need be and reposition the patient after they are medicated, and her medication was every three hours.
We were outside the doors of the rooms talking. We could still see our patients from the door. We started talking and I saw what looked like some people walking down the hall. I did a retake and realized they were shadow people. They had no features. They look like what a shadow looks like when you block the sun. Needless to say, I was a little scared. I told my friend to back into the room and don't look at them, and she did just that. I was trying to ignore them and back myself into the room I was in. In my research on the supernatural, I read that you do not acknowledge them. I saw them go into a room down the hall and I went into my patient's room at the same time.
I text ed my friend a little bit later and told her what I saw and for her to try and stay in the room until daylight. She acknowledged and we stayed in our patient's rooms. I did find out three hours later when the facility nurse came in to medicate my patient, that the room I saw the shadow people go in the patient passed away. I went to the door of the room she was in and told her what had happened. Sometimes strange and unusual things can happen, but that was the first time I questioned if I wanted to keep doing the job of a hospice nurse.
| Author Notes | I am a pretty brave person, and I always try to prepare for the unexpected, but nothing can prepared you for this. I did continue being a hospice nurse. It was a job I loved doing. |
By SLMorrical
Working as a hospice nurse is a job I loved doing. Every time I had a trainee nurse, I would explain the paperwork because it was important. Most of the time I would tell stories like the ones I mentioned in earlier chapters. The most important thing I would stress is taking care of the patient and the family as if they were their family. I would discuss patient center care. This is care that is centered around the patient and sometimes around the family.
I would always tell the training nurses to ask what kind of music the patient likes, I always had Pandora on my phone without ads to play for patients. It was very soothing to the patient and the families loved that I would play music for their loved one, especially if it was something the patient just loved. The main philosophy I gave was it is the little things that will be appreciated by the patient and their family. A perfect example of this, I was taking care of a lady in her late forties, I'll call her Sally. Well, Sally was alert and oriented and could hold a conversation with no problem. Her husband was sitting next to the hospital bed and rubbed her legs and mentioned they were a little hairy. She had a look on her face that said I can't shave them and I want to.
Her daughters made the comment their mom always had smooth legs and they felt she was embarrassed. I walked over to the bed and spoke with her and her husband and politely asked if she would like me to shave her legs when I bathed her in the morning. Her face lit up so much and she had a small tear in her eye. "Will you do that for me?"
I told her "Yes of course I will." I shaved the lady's legs when I gave her a bed bath in the morning. I always worked the night shift.
Afterward, her husband rubbed her legs and smiled and stated "Smooth." She smiled and he smiled and the daughters smiled and I didn't need a thank you the smiles were enough. That's an example of patient center care and a hospice heart.
The lady passed away a month later, and even though I was only with her that one time, her daughters sent in a customer comment card stating that she would always tell anyone who came in to take care of her, that I shaved her legs and it made her so much more comfortable.
I had another patient, I am going to call Carl. Carl's family couldn't get Carl to eat anything they put in front of him. He would just sit up in the hospital bed and look at the food on the bedside table. They could get him to drink, but that was all. I asked his family if they even asked him what he wanted to eat. They stated he was on a certain diet because of his health issues.
Carl was dying. The doctor gave him three months. The night I was with him and until the morning, I talked with his family and tried to explain it didn't matter about his special diet anymore it was not going to stop his dying, but my words fell on deaf ears. The morning came and I bathed him. After the bath, he said he was hungry, so I asked him what he wanted, he said he wanted ice cream. I went into the freezer and made a bowl of ice cream for him. He ate two bowls. His family was shocked I gave him ice cream for breakfast, and the fact he ate two bowls.
After that, the family feed him ice cream until he became unresponsive and passed away. Hospice may deal with patients that have a diagnosis of six months to a year, including end-of-life issues but it is all about the comfort and the quality of life/care the patient has in hospice not the disease. Patient center care treats the patient, family, and the disease to create comfort.
| Author Notes | Patient center care is the philosophy that nursing care or any care center around the patients wants and desires. I also use it with the families. It's treat the patient and family and the disease. |
By SLMorrical
For some jobs, it's the same thing day after day, even with nursing. When I worked in a facility it was like that, Every once in a while, there would be some excitement with an emergency, but hopefully not too often. Working in a facility I did learn you don't say quiet (the Q word). Saying the Q word was always a sure way to get the excitement. It's a superstition in the medical field.
I have always liked to learn new things, but working as a hospice nurse sometimes what I learned was not something I was glad to learn. Things like humans especially family can be cruel and manipulative. I know human beings can be either cruel or nice, but I would think the family would be at least somewhere in between. I learned that when it comes to family they are all over the spectrum. It was hard at times to be professional and not say something to someone. I mean when people are dying, family comes out of the woodwork like cockroaches.
One time I had to call the after-hours number to get a social worker out to the house because the family was arguing over who gets what, and they were doing it right next to the patient's bed. Well, needless to say, the family of course complained about me because I made that call. The good thing in the thirteen years of working as a hospice nurse I had only three complaints against me, and they were because of doing for the patient and not the family. Most of the families and patients asked for me to come back.
There were times when I would see a very loving family all at the bedside or somewhere near, and it filled my heart to see the love and compassion. It also helped me still believe there are good and caring people in the world. I believe I have seen human nature at its best and its worst. Of course, I prefer to see the best of human nature, but you can't pick and choose with family.
Talking about families and how they are when someone is dying. I remember a case that made me feel bad for a lady whose significant other was dying. The patient, I will call Ben was dying and his significant other I will call Mary had been with Ben for 20 years. They weren't married, and Florida doesn't have common law. They didn't get married for financial reasons.
Mary and Ben were both widowed when they met and if they got married Mary would have lost money in her social security. They had bought a house together and both were on the mortgage together they made that house a home for them. The sad part of this story is Ben's son who didn't have time for his father when he was well, had more time when his father became sick and more interested in what his father had, including the house. I was taking care of Ben when he passed, and Mary was so upset, because not only did she lose her love, but she was going to lose her house also.
Mary was losing her house because Ben's son told her to buy him out or sell the house and they split the money. I did all I could to console her when Ben passed but to no avail. I felt so bad for Mary, but there was nothing I could do. Mary's life changed in a matter of seconds, so you never know. After this experience I went home and discussed with my husband about getting all the necessary things in order, so when the time comes mine and his wishes will be done. My job as a hospice nurse also taught me to live one day at a time. Something I would always tell families they should do because we don't know what is going to happen.
| Author Notes | Working as a hospice nurse for 13 years was an experience I will always treasure. |
By SLMorrical
In the thirteen years working as a hospice nurse I continually heard "How can you sit with someone until they die?" My family and friends always told me they couldn't do it. It would be just too hard, just too emotional. I can understand feeling that way. I believed I could handle it because I believed it was an honor to assist the patient to the next phase of life, the afterlife. Sometimes we can fool ourselves until the time comes when we have to face the truth.
The truth for me is yes it is hard at times dealing with death. The purpose of this chapter is to address the two of the hardest deaths I ever had to deal with. It does occur that nurses get attached to their patients, but that is not why these two deaths were the hardest to deal with. I believe out of the two the first one was the hardest ever for me. It was emotional for me and it took everything in me not to cry and keep my professionalism intact.
My mom passed away in December 2013. I took the 32 hours the company gives for situations of family passing. On my first day back to work I am with a patient, I will call her Mary. She was just barely in her 50s and she had a teenage son. Her husband son, and mother-in-law never left her side. When families do this it always tugs on my heartstrings. I could tell she was in the final stages of the end of life and would be passing soon. This is where taking care of this lady started to become emotionally hard for me.
She passed around two I think. The time doesn't matter in this experience, it was the passing itself that was hard. After just losing my mom a little more than a week before, this lady was leaving behind a 14-year-old kid, and realizing this boy would not have his mom around anymore was like a blow to my heart. The husband and the mother-in-law wanted to help wash and dress her for the funeral home transportation. It's not recommended that the family participate in this unless it is part of their culture or religion, but I let them prepare her for transport.
The husband and mother-in-law were so gentle with her and spoke with her as they were bathing her. I just helped with turning and holding the patient in certain positions to bathe and dress. I felt like I was looking at myself getting a patient ready for transport to the funeral home because I do the same thing with my patients. I talk to them as I bathe and dress them for transport, and always gentle. They are still human even if it's just their body.
I could feel the emotions coming on and no matter how hard I tried not to cry I did. The husband was asking me if I was okay and if he could do something for me. It's supposed to be me saying that to the family, not the other way around. The husband helped transport get her on the stretcher and into the transport van. I didn't know what to do at this point. Even now years later as I am writing this the emotions are coming back. When the patient left in the transport van I gave my condolences to the family and got into my car. The husband once again asked me if I was alright. I told him I was fine, but I wasn't. Once in my car I drove down the street and stopped to take a deep breath. Instead, I started crying. I still don't know if I was crying for the loss of my mother or for the kid who lost his.
The next death that was hard for me was the last patient that passed away on me. It wasn't like the boy who lost his mother or anything like that. It was just a normal passing away. The only difference was it was also my very last patient and my very last day as a hospice nurse. I could no longer work as a hospice nurse, because of a workers' compensation lawsuit. I had a torn rotator cuff in my left shoulder and carpal tunnel in my left hand. These injuries are from working as a hospice nurse. The turning and moving of heavy patients alone over time caused the injuries. In addition, for the last 3 years of working as a hospice nurse, I was being treated for degenerative osteoarthritis.
It was getting harder and harder to do my job. The rotator cuff and carpal tunnel can be fixed by surgery. Unfortunately, my doctor said even with the surgery I couldn't do my job anymore. Thirteen years and forty-three days and I am no longer a hospice nurse. The patient who passed away was symbolic to me. He has transitioned to the next phase or the other side, and I have transitioned to another phase of life or the other side being the patient.
| Author Notes | This maybe the last chapter but it is also the end of an era for me. |
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