Hospice

Alberta Davis, Figure 1

   "Honestly, I believe being with somebody in their final moments is what makes being a hospice nurse so hard," recalled Alberta Davis who's been a registered nurse for nearly 25 years. With her violet, curly bangs outlining the front of her long, brown curly hair while surrounding her pale, round face (See Figure 1), I caught a look of pain flash through her emerald eyes, "I'm the one that the patient and their family depends on to make sure the patient gets all the right treatments while still getting to be at home surrounded by family. Some of these people don't even have family. I'm their family and to be honest, they become mine too," she states.

    A hospice nurse is someone who travels to the patient's home to make their final transition in life more comfortable instead of spending their last final days in a hospital. These nurses are on-call 24/7 to make sure every need is met and all questions find answers whether it's 3 in the morning or 3 in the afternoon. Their offices consume their vehicles. Alberta's own car looks like Mount Everest with medical bags and papers upon papers consuming her front seat (See figure 2). She always warns the incoming passengers of her car to bring a hazmat suit to even get anywhere near her car. She snickers while even suggesting maybe getting a tetanus shot wouldn't be such a bad idea either.


Alberta's front seat, Figure 2

 She herself has a personal navy bag she carries that has all the supplies she'll need for an upcoming patient. It can consist of anything from needles and tubes to collect blood for testing, a stethoscope, a blood pressure cuff, Band-Aids, alcohol wipes, etc. Each one of these nurses are given a Samsung Note 5 to stay in sync with their patients. With each patient's diagnose, it'll determine what supplies they'll need for sure. Not every patient a nurse will see will need the same provisions so each hospice nurse must plan accordingly the night before and stay up-to-date with each incoming patient.

   "On average, I think I see anywhere from 30-40 patients a month. Some I have for a couple days, others a couples weeks, and sometimes I even have patients on and off for a few years. We constantly have to sync our phones. Some days are literally never ending. It's call after call after call or you can't get ahold of the patient because they went out when they said they'll be home but they went to get milk instead. Or then you have the family telling you how to do your job. That's the worst. So of course I tell them to do the job themselves and I get up to leave and their family is practically begging me to stay. I just laugh to myself and think yeah, that's what I thought, " a smirk creeping across Alberta's face while hovering over her steaming red coffee mug. To respect her patients and their privacy, we it is best to talk in her actual office located on the corner of 9th and Mulberry Street in Berwick. It's a brick building with a conference room/office space on the main floor. We sat in what she calls her "escape from reality"  which is a tiny, square room crammed with a desk piling high with papers and binders with a computer peeking out of the mess. (See figure 3). She laughs while mentioning how she sometimes dreams about escaping through the window that lurks behind her so she could run off to become a veterinarian like she really wanted to be. "Would they even notice? Animals are probably friendly anyway most days."



Alberta's office, Figure 3

   When questioning why she became somebody who is surrounded by death around the clock, she shrugged and said, "Well, it's cheaper and quicker to become a nurse than a doctor. They get paid more, but we as nurses probably do more work than them. I wasn't even planning on becoming a nurse. When I first attended Bloomsburg University, I was just in Pre-Med, but there was a shortage of nurses so it's pretty much a guaranteed job after graduating." She graduated in 1991 with a nursing degree and would actually miss graduating with Cum Laude by .05 points. "Yeah, kinda sucks you bust your ass and still miss graduating with honors. I didn't even show up to my graduation. Too much time wasted sitting there while I had to save the world," she laughs as she gets up for another cup of coffee.

   After college, she landed her first "big girl" job as she called it at the Berwick Area Hospital on the Medical/Surgical Floor where she was bouncing between different floors for nearly 10 years. She thought she needed change and left to work as a dialysis nurse for 8 years until finally coming to Home Health and Hospice which she's called home for the past 6, going on 7, years. When asked why she choose to come to Hospice as her current job, she was silent trying to find a answer and twirled her thumbs while biting her lower lip. She says how this job would give her a more flexible work schedule so she can be there for her family if something is to happen and how it's opening her eyes that she is becoming the "Guardian Angel" to lead these people to a non-suffering, pain-free life. She just hopes somebody is there for her when it's her time to go "Home."

  Giving Alberta a break to work on some paperwork, I turned to Jillian Stout Welch, a petite woman no bigger than a twig and represents a rocker chick with her short, brown pixie cut, is new to the whole Hospice thing and utters out how overwhelming it all is. "I'm actually beginning to realize how overwhelming nursing is in general. You pretty much have to be in the force for at least 10 years before you can even think about becoming comfortable with what you do. I've only been doing this whole nursing thing for 4 years and only been here maybe 6 months as a Hospice nurse. It's not easy. Far from it. I'm just thankful all the ladies I work with are there to help me when I don't understand something," her radiant smile flashes across her face, "I'm just glad I'm part of a team that doesn't put you down no matter how stressful it gets. Alberta's own sarcastic attitude literally keeps me sane here."


   All the ladies depend on each other with each patient. When the nurse pronounces the patient deceased, it's always their job to call the coroner and the funeral home of the patient's family's choice along with the doctors and whoever else might need to know about the passing and to even call a backup nurse just incase something was to happen. Jillian and Alberta both say this could take anywhere from 1 to even 3 hours. Alberta states it probably takes the longest when the death happens in the middle due to people being asleep or the funeral director being an hour away from the house. She recalls how it took 4 hours for her one patient due to the director getting lost along the way. She sits there trying to relax the family and help them cope with their now turned upside down life. "It's so hard to be strong for a family when they lose their loved one, especially when you've formed a connection with them yourself. But it's my job and that's what's heartbreaking because you know the day is coming even if you don't want it to."


    Both Jillian and Alberta hope that with each patient they encounter, that they made a difference in their brief time of knowing them. "I just wish there was a more peaceful way of leaving this Earth but sometimes you just need a little bit of sunshine to make the days a little better. That's what we try to do here. We are that ray of light that peers through your bedroom window to ensure that everything is going to be okay," Alberta drifts off with sadness filling her voice, "I just hope we made their journey more comfortable with their loved ones. I'm just trying to make a difference with each passing day."