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

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Juggling Crises

Many days Campbell is busy juggling crises -- one patient has fallen down, another is vomiting, and another is close to dying. Other days she delicately navigates the fears of patients and families with her gentle, grounded spirit. In home after home she finds that people want to know the same things: how long they have left and what the final moments will be like. Some only want to know if she can keep them calm and out of pain. She can. Others want details, so she'll explain that after they stop eating and drinking, for example, they will become semicomatose and just gradually slip away.

Some still wonder if they could be the rare person who survives. "Has there ever been a case where somebody walks away from this?" one 75-year-old grandfather asks her hopefully. "I don't know," Campbell says after a moment. She explains that it's hard to say with his kidney disease. "Live each day," she tells him. Then, noting his jokes about eating whatever he wants and having his daughter and wife wait on him, she adds with a smile, "And obviously you are."

Because many people see hospice care as the end of hope, there are even some doctors who are reluctant to bring up the option. As a result, more than a third of hospice patients don't start palliative care until they have just days left to live. Ironically, some patients who get hospice care live longer than those who don't, studies show. But many wait until it's nearly too late, and those people often sacrifice the chance for closure.

One day Campbell gets a message: The man she'd just seen for the first time two hours earlier has already died. "Ooh," she says, letting out a long, frustrated sigh. She knows what she could have done for him if she'd had more time -- the same thing she wants for herself when her life is ending: a chance to have those last conversations, to be comfortable, at home, surrounded by loved ones.

That's why she tries to focus on what patients want. And when a terminally ill person hangs on longer than seems possible, Campbell has learned that the patient is often waiting for something to be resolved. In one case a dying woman's adult children are gathered at her bedside. One of the daughters, in particular, is heartbroken and distraught. The chaplain leads them in prayer and then the children, leaning on each other, leave the room. "Look, they're together," Campbell whispers to the woman, sensing she is worried about them. "If you want, it's okay to go. They're going to be okay." Within minutes, the woman dies.

"People are so afraid of how it's going to end," Campbell says. "But when you've been there and held their hand and watched them take their last breath, you see that it's a really powerful moment -- powerful and peaceful."

 

 

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