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"There is something incredible about working with
a 5-year-old who is concerned about others and is looking
forward to being with the angels," Torkildson said.
"It's like working with angels on earth."
Even though hospice care is a vivid experience for
the nurses and families that use it, many people still
are unaware that it's an option. In response, hospice
organizations often use a share of their resources to
spread the word about their services.
To educate families and doctors about the value of
hospice, Elizabeth Ford Pitorak, MSN, APRN, CHPN, director
of the Hospice Institute of Hospice of the Western Reserve
in Cleveland, introduced a hospice team to Ireland Cancer
Center in Cleveland, where patients receive aggressive
chemotherapy. Before the team entered the center, about
13 percent of patients typically died under hospice
care.
The team spent about two years with patients and, by
the end of the project, about 80 percent were dying
under hospice care. Pitorak hopes these experiences
left an impression on families and physicians about
the importance of facing death before it's too late.
"There is hard work we need to do at the end of
life," she said. "We need to figure out what
our meaning and purpose have been, maybe do reconciliation
with someone."
Although it may mean giving up the search for a cure,
Pitorak has seen the fruits of making this difficult
decision. "I am absolutely amazed when patients
say the last two months of their lives have been the
best ones."
While hospice nurses are eager to point more people
to the benefits of their services, increased awareness
will likely heighten demand for RNs who provide hospice
care. Kathy Egan, MA, CHPN, RN, vice president of The
Hospice of the Florida Suncoast, works for an organization
that's experimenting with new ways to handle patient
loads.
One idea is to spread some of a nurse's responsibilities
to other people in the hospice team. For example, they
could train volunteers to help patients with bathing
or eating, rather than leaving these tasks to the nurse.
This would free up nurses to focus on other responsibilities,
such as pain management.
The Florida hospice also is partnering with community
organizations to train volunteers who can help hospice
families with daily life, activities such as grocery
shopping, cooking or providing respite for caregivers.
"We need to plan ahead so we are ready to serve
the future population, and these are ways to get more
people helping," Egan said.
Nurses like Fabricius are among the few who know just
how much emotional and logistical help these families
need.
At Gates' home, the living room that was a flurry of
activity just six days ago is now empty and quiet. Fabricius
sits with Gates at a kitchen table as the recent widow
recounts the story of her husband's death-and the nurse's
vital role until the end.
"Her compassion for me was amazing," Gates
said as her eyes filled with tears. "She gave me
the tools I needed to care for him, but the first thing
she did was to give me a hug. She was not here just
as a nurse, but as a friend. I will never forget that."
Contact Heather Stringer at heathers@nurseweek.com
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