Hospice nursing shifts focus to comforting whole family
By SHARON KERR Staff Writer

LVN Cathy Stout checks a patient's heart

Any nurse will tell you that there is more to nursing that taking a person's temperature, administering a shot, or keeping a body fed and clean. Nursing involves interacting with the people and their families, giving them hope and comfort along with meeting basic needs and treatment.

Being a nurse for a hospice is the same but goes one step further: helping people to let go and die with as much grace, dignity and comfort as is possible. Hospice care is for those with a terminal illness estimated to have six months or less to live.

Mike Neel, chaplain for Lakes Area Hospice, says, "To do this job you have to be a compassionate person, which is true of any nurse, but you have to know going into it that you can't fix these people."

The goal in hospice care is palliative (making people comfortable) versus curative as in traditional nursing, Neel explains. That takes not just nursing the patient, but becoming part of the family.

"You don't hear a hospice nurse say 'that's not my job.' They may pray with their patients, they may drive to be with the family at the funeral," Neel said.

Neel's favorite story is of a hospice nurse who responded to a call in an elderly woman's final hours. All the family was gathered, the pain-easing medication was working, but the woman kept complaining she was cold in spite of the heat being turned up and the quilts piled high.

"When the nurse arrived and the family told her, 'we just can't get her warm,' the nurse took off her shoes and climbed in bed with the patient and held her until she died, Neel said.

"The wonderful thing is that we're providing what the patient wants," Neel said.

"People always seem to think what we do must be depressing," said Jeanette Coffield, executive director of LAH. "But it is a joy to me to think of all the good things we can do to help families.

"It is an emotional job," Coffield said. "To combat burn out we try to set up a system of paid time off. We encourage our nurses to take the time for their kids' soccer games, to have family time. They need that."

Dee Watson is a registered nurse and patient care coordinator at LAH. She became involved with the hospice program when she was a school nurse in Kirbyville and there was a child with a terminal degenerative disease. She saw how the program supported the family and the child.

"As nurses, we learn new skills helping people at difficult times, Watson said. "Nurses start out thinking they will help cure patients, but what we do is symptom management. We go in with a plan to help the families in whatever setting is best for the patient, whether that is their home or an assisted living facility or a hospital. We go in when everyone else has backed off."

Watson has worked in emergency rooms and at Avalon, a nursing home, and with the disabled and special needs children in KCISD.

Watson there are no special requirements, characteristics, training or experience she looks for in a hospice nurse.

"We have a mix of personalities, and I think our nurses have to be extra compassionate because they become so involved, but there is no one trait I look for. You just have to hire them and see how they work out," she said.

"We work odd schedules and long hours, and you need to be there when the need arises, but the flip side is we can accommodate more family time, too," Watson said.

Each nurse manages 10-12 patients at a time, and that includes admitting patients. At first, it may be a once-a-week visit, but sometimes it's full-time, around the clock, and that may happen on a holiday or a weekend.

"Our nurses are very autonomous. We respect them and they have to be very trustworthy. The dynamics in the home can make it hard for nurses to do their job if everyone in the family isn't on board," Watson said.

Nursing staff take turns taking answering the calls that may come at 3:30 in the morning.

"You don't know when your day ends," Watson said. "At some levels it is harder, but it makes you fell better when you see how you have helped people die with dignity."