It Doesn't Have to Be Sad: The Life of a Hospice Nurse

What does it feel like to help dying patients through their final days? Experience it through the eyes of hospice nurse Jill Campbell, who does her job with grace, compassion, and gratitude.
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Outside, it's noisy on this busy block of row houses in Baltimore. But inside one tidy living room, all is quiet except for the sound of a woman's raspy breathing. The patient is huddled in an easy chair under a handmade pink-and-blue afghan, a knit cap on her head and booties on her feet. She has trouble staying warm these days. Her cancer has returned with a vengeance and she has only a few weeks to live. Hospice nurse Jill Campbell kneels down beside her patient, listens to her breathing, and then checks her blood pressure. Campbell has already hauled in oxygen tanks, showed family members how to work them, organized the medicine, and assessed how her patient has been eating and sleeping.

But now is a moment to connect one-on-one. Campbell wraps her hands around the woman's hands and rubs them together to warm them. She looks into her face. "Are you feeling a little better?" she asks softly.

Getting to know her patients and helping them through the toughest time of their lives is what Campbell, 43, appreciates most about being a hospice nurse. "I don't know of another position where you can do more for people," she says.

Her patients have all been told that they have six months or less to live. Rather than continue with often-difficult or painful treatments that probably won't extend their lives, they have decided to stop trying for a cure. Instead, with the help of hospice care, they'll focus on comfort and on living whatever they have left of their lives to the fullest -- usually in their own home.

Being able to die at home is a major part of the appeal of hospice, but patients and family members may not see it that way at first. "A lot of people still view hospice as giving up and letting the disease win," says Campbell. That's why the decision to call in hospice care can be an incredibly difficult one for a family to make. Once they do, though, most patients and their families soon understand the value of having a team of dedicated professionals -- including social workers, health aides, chaplains, and nurses -- work together to provide not only physical but also emotional and spiritual support. When Campbell took the job at Gilchrist Hospice Care three years ago, she had the same fears as anyone about hospice. As a mother of three and a veteran nurse who'd worked in operating rooms, she expected it to be unbearably sad. But on her first home visit, she was surprised that the family members were relaxed and sharing funny stories about their dying father. "There's still happiness in the sadness of it," she says.

By spending time inside patients' homes, Campbell has witnessed the blessings of a peaceful ending to life. She's seen family members resolve longstanding, hurtful disputes and be reunited. For some patients the victories have been smaller but equally profound: a visit to a hair salon or being able to sit outside on a nice day. But getting patients and their relatives to that place of peace and acceptance can be tough. Some families are divided or resistant to the idea of hospice. One family asked Campbell to cover her badge, thinking that if their grandmother saw the word hospice she'd give up and die.

Others, unnecessarily worried about drug addiction, won't give their sick relative pain medicine when it's needed. And some patients are afraid of taking morphine, thinking it will stop their breathing or make them feel out of it. "Did you take the medicine?" Campbell asks a cancer patient, who is holding her rib cage in agony. Campbell squats beside the hesitant woman and assures her she'll stay with her while she takes it, to make sure she's okay. The patient is worried she'll just sleep away the time she has left, but pain medicine often allows a person to feel better and actually do more.

Continued on page 2:  Juggling Crises


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