A Day In The Life

We live in a world where healthcare leaders must move as fast as they can to keep up with the changes that confront them daily.  It is easy to get so caught up in the budget shortfalls, the regulations, the competition and so much more, that the actual work done by the hospice staff may be overlooked.

My friend Christy Whitney Bourchard, CEO at HopeWest in Grand Junction, Colorado sent me this story written by one of their nurses working in their Hospice Care Center (HCC). I was struck by her honesty and eloquence in sharing a day in her life at work. It is a beautiful reminder of the fact that death is so much more than a medical event. Hospice workers face multiple losses and deaths every day while supporting families through one of life’s most difficult times, then they must try to cope with their own emotions over what they have witnessed.

The author, hospice nurse Barb Hedges said late one night she wrote down her thoughts from that particular day because, “I just needed to get some of the day out of my head, so I could go back to sleep!”  How many people on your staff are faced with similar days? And how do you support one another to continue to offer this amazing care called hospice?  Here is some of Barb’s day that makes me thankful for her and people like her all over this planet…

“Rough day at the HCC yesterday, November 29th. By the time I went home 3 of my 4 patients had died; 3 red dots turned to butterflies. I didn’t have any tears – no time for that now. Sad. Hope everyone is okay.

Close the other doors so they don’t see the covered gurneys going past. They still know, and hope that their family member won’t be the next one wheeled away. Beds are emptied and refilled as fast as possible. We need to stay full. Who is coming in next? Smile and welcome them. Make them comfortable. Quickly…

Back to my deaths; strange way to say that, but true. They are deaths that I am responsible for and need to make sure are peaceful, and that the family is prepared. Lots of drugs and time at the bedside, where I should be.

Room 2 has a large family and they are hoping for a move to a bigger room so they will be more comfortable. Sorry – no room available right now, but as soon as there is one, we will move you.

Room 4 with just her daughter and son in law; so anxious and afraid. Death will be peaceful, no pain. Likely today. They feel better knowing what to expect. Patient has a fever of 103. Is she uncomfortable with it? Don’t know at this point, but we’ll try to bring it down a little. Nice little Christmas tree.

Room 8 with her spouse and nephew. BIG decline from yesterday. Family is not seeing it. Unresponsive today. So gurgly all of a sudden. Find out family is still trying to feed her ice chips. What?! Educated again and again and again.  Something is wrong with spouse; ETOH (alcohol) too? Sad. So young. Breathing is changing.

Back and forth, in and out, room to room, giving meds, information, listening, offering chaplain and ice. They are all changing. It will be today for all of them.  Prepare the family. Make sure they have a funeral home.

Room 4 is first. Perfect; peaceful, predicted and expected, quick and quiet. Family at bedside. Harpist playing “What Child is This” with the Christmas tree lights twinkling. Beautiful. Hopefully a good memory for the daughter. Patient has a poinsettia in her hands. Is the volunteer okay?

Room 2, now room 3, is next. They got the next big room and he died 40 minutes later. They all seem okay, thank goodness. He went quickly – just stopped breathing. Good for him. He can finally lay flat. Their faces are finally relaxed; they have been so worried about him. Good tears and stories as he lays there.

Room 8 is last. Just as I am ready to leave, the red dot becomes a butterfly. No surprise. Hope the spouse handles it okay…Sad to see someone so young die. She looked pretty, though, in her blue gown and braided hair.

Meanwhile, meals have come and gone. 2 new admits are here and someone transferred out. The phone is ringing. Hannah is making charts and trying to keep the census up to date. The front desk volunteers get really upset if someone comes or goes without them knowing it.  Rooms to be cleaned for someone else to fill.

So I sit here with a glass of wine at 0100, thinking: Did I have a good day? I wouldn’t call it good, but I would call it successful. Death with dignity and comfort, and families that were okay. Did I get my charting done? Are you kidding me? I tried, really I did, but the educating, supporting, listening, re-positioning, medicating, bathing and everything else came first. That part feels good and was a success. How do I chart it all?…”

Thank you Barb, for dedicating yourself to serving people and families facing death, for caring and loving and being strong for those who need your strength.  You did have a good day, and…you did good.

HopeWest Care Center

Post By: Patti Moore

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