Hospice nurse Carole B. was traumatized at age 16, as she watched her grandmother suffer in pain from the cancer that was eating away at her bones. The doctors refused to give her grandmother more morphine because "she might become addicted," although she had only a few days to live. Carole vowed at that moment to learn how to help people die pain free and with dignity.
Carole began her nursing career 40 plus years ago with a diploma in nursing, followed by five years of working with patients at Bellevue Hospital in New York City. She continued her education and received her BSN and public health certification so she could become a home health nurse. (In the 1970's, you had to have a BSN to work in home health care. This is not true today.)
In the 1990's, Carole finally found her niche with a small hospice in the Midwest. She helped individuals live out the rest of their months and days in their own homes. She became a pain management specialist and worked closely with the medical director and staff to ensure that patients had adequate pain control, yet were not so sedated that they couldn't have any quality of life. It was often challenging, but Carole was dedicated to the cause.
Today, Carole enjoys working with her patients and educating caregivers and her colleagues about new ways to help control symptoms such as pain, dyspnea, nausea and vomiting and bowel issues. She notes that she likes her job even more now because the tools have improved tremendously, and she sees her patients living out their lives with dignity and grace in a symptom-free manner. Carole loves learning new techniques to share with her patients, and she knows that her role as a hospice nurse demands she stays knowledgeable on advancements in the medical field.
Some patients present extreme challenges because of dementia and associated behavioral manifestations that don't allow clear-cut communication of needs and responses. Nurses have to rely on visual clues and verbalization that isn't always coherent to assess pain and other symptoms, and then to evaluate the success. The rewards are immeasurable to see these patients find comfort, and the families and caregivers are forever grateful.
Educating the public as well as physicians about the benefits of hospice care represents a huge need in the community and everywhere. Carole notes that far too many patients still come to hospice with only hours or days left to live, and it isn't always possible to achieve full symptom control and peaceful deaths. Carole's wish is that more patients could begin hospice care with a prognosis of six months to live. Given the time, their symptoms could be better controlled, and their last days would be spent in peace.
Hospice nurses are special. Not everyone can deal with death on an ongoing basis, but Carole wouldn't trade her role for anything.
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