|6/19/2017 9:01:00 AM|
Care for the dying
A day in the life of a hospice nurse
MOUNT ANGEL — In Caroline Lindstedt’s experience, patients approaching the end of their lives often talk about travel. Trains to be boarded, airplanes to be caught, luggage to be packed or journeys to be taken.
Lindstedt has a job that most people would find difficult. “Your job must be so hard. How can you do it?” It’s a question she often hears. Her answer is simple.
“I worked in an emergency room and saw how death should not be,” she says. “Our job is to facilitate a good death.”
Lindstedt is a nurse for Providence Benedictine Hospice in Mount Angel. She cares for patients nearing the end of their lives.
Every two weeks, Lindstedt starts her morning with the other staff at Providence Benedictine Hospice to review each patient’s care plan. How is this person’s health? Do we need to change medications? What is the patient’s reaction to massages or baths? Is the patient seeing volunteers? How is mental health? How is spiritual health? How are caregivers and family members handling this transition?
For this hospice team, health care isn’t limited to the physical ailments. The patient’s total health picture is considered. After the meeting has concluded, Lindstedt begins her day’s work.
The visits today are not long. For each patient, Lindstedt checks vitals, talks about any changes in medications and asks about concerns.
Lindstedt approaches Martha McLain who is sitting on her couch. McLain, who has cancer, is the first patient of the day. “How are you?” Lindstedt asks, kneeling down at McLain’s feet. The two talk through McLain’s symptoms and concerns. Lindstedt is cheerful and honest.
“What’s going to happen to my body?” asks a troubled McLain. Lindstedt pauses for a moment and then tenderly and scientifically talks McLain through the answer to her question. The two part ways until the next visit.
Lindstedt’s car is essentially her office. She keeps with her a medical bag holding her laptop and all her needed medical supplies for the day’s patients.
This is a light day. Lindstedt is seeing only three patients. The next, Agnes Furlow, has chronic respiratory failure. Lindstedt greets Furlow in her room and performs the same procedure: vitals, changes in medications, discussion of concerns. The entire time, Lindstedt stays kneeling at Furlow’s feet, gently speaking to her. She offers to help Furlow cut her nails, but the ailing woman says she can manage. Some cords are lying around Furlow’s room. Lindstedt moves them out of the way so Furlow won’t trip.
“Is there anything I can do for you before I leave?” she asks. Nothing, says Furlow. On to the last patient of the day.
Lindstedt says she came to nursing late in life. The Portland native has been a hospice nurse for five years, after working as an emergency room nurse for six. It was a rough transition, she says. Caring for those nearing the end of life is different than treating illnesses or injuries in the emergency room. In hospice, she strives to make patients nearing end of life feel comfortable physically, mentally and spiritually.
For Lindstedt, the work is her life’s calling. In our society, we are afraid of death, she says. “People don’t want to talk about it, but we need people to talk about it.”
Is it hard? Most of Lindstedt’s patients have had full lives. So treating them isn’t terribly sad, she says. And everyone deserves a good death.
Lindstedt pulls up to her final patient’s house. She mentions she and her next patient discussed cars at length on their first visit. She wishes she could talk with him about their mutual passion again. The patient lives with his wife and has cancer. Their home is a tribute to their lives together. It is filled with knickknacks, inspiring quotes and photos of family members.
The man’s wife leads Lindstedt back to his room. He lies in a hospital bed and looks out the window at his home’s peaceful backyard. The man in the bed looks only a little like the man in the photos spread around the room. Lindstedt asks him how he is and if he has pain. He shakes his head. She asks his wife about how the week has been and asks if they need anything. With this patient, Lindstedt stands next to his bed, softly examining his body. He doesn’t want pain medication. He asks for very little from Lindstedt. She looks into his eyes and tells him goodbye and to call her if he needs anything. He nods farewell.
In the hallway outside the room, Lindstedt tells the man’s wife that he’s getting very close. Lindstedt talks her through what will happen, what she’ll need to do at the end and how the hospice team can and will help the family.
When death occurs, Lindstedt and the other nurses can help wash and prepare the bodies of their patients for burial. They help the family emotionally and spiritually through the funeral and grieving process. Throughout the patient’s time in hospice care, the hospice team provides pain control, comfort care, emotional, social and spiritual support to patients and their caregivers. The team at Providence Benedictine Hospice consists of doctors, registered nurses, a nurse’s aide, social workers, volunteers, a massage therapist and a chaplain.
“Our primary goal is to provide the support that people need to allow them to spend their time living as fully and completely as they wish, in their own surroundings, and in the company of family and friends,” says the Providence Hospice website.
Throughout the day, Lindstedt recounts some of the stories of the patients she’s had in her care. Each of them has left a mark on her, but some she’ll never forget. She mentions the patient who taught her how to be a hospice nurse and the patient who loved motorcycles. There was the patient who wrestled with forgiveness and the patient who loved to fly.
After returning to the office, Lindstedt talks with David Horn. He was the chaplain for the Providence Benedictine Hospice until last December. He now works at the Providence Benedictine nursing center down the block from the hospice office.
The two talk about their ministries in end-of-life care and share more stories of patients who’ve really touched them.
“We walk into their rooms and we walk into their lives at a time that is very vulnerable,” Horn says. “And it is an honor.”
Sitting in the chapel of the nursing home, the two are presented with the question: Why is end-of-life care an important ministry?
“The dying matter,” Horn says. Lindstedt agrees.
“They need us,” she says. “For me, I get a lot of fulfillment because I know I’m helping people in a very fundamental way.”
“The dying are some of the most vulnerable people in our world,” says Horn. “They are people who are forgotten. They are people who are sometimes mistreated.
“It is our calling. It is our privilege to walk alongside them and to accompany them. We give them dignity. We give them respect. We say that they matter.”
Horn adds, “[The patients] have lives and stories, and if we can help their families and if we can help them to die well, we’ve accomplished our mission.”
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