Care Dimensions RN Case Manager Ana Sanderson checks on a hospice patient in his home.
As a hospice nurse with Care Dimensions, I feel fortunate to have found my home in nursing--and to have found it so early in my career. End-of-life care is the practice area that I love and intend to stay in. Also, it’s a privilege to work and practice in the community in which I grew up and now live. I am taking care of my own neighbors and neighborhoods--and that’s very important to me.
A Career in Nursing
When I started college at age 18, I never really considered any other career. My aunt and my grandmother were nurses, and I just knew that nursing was for me. Then, after college, in my first, (non-hospice) roles, I witnessed what I would call unsuccessful end-of-life experiences which were mainly due to lack of education about patients’ real needs. Then, when I was still a new nurse, I met Mary Patchett who became a real mentor to me. As a Care Dimensions hospice nurse, Mary was warm and compassionate, and we had many conversations about meeting patients’ and families’ individual needs.
I went to an RN open house at Care Dimensions, which was a great, low-pressure way for me to explore a career switch to hospice nursing. That walk-in visit was five years ago now, and the rest is history.
Hospice Nursing: Joys and Challenges
Often, my patients have a family or a group of caregivers. But, sometimes there’s nobody. I’m working with a man right now who has no family, so he’s singularly involved in his own end-of-life care. Whatever the patient’s diagnosis or family status, it’s all about listening to the individual story and being able to read the cues and signs. Then, I develop a care plan to fit that patient and family’s unique needs. Sometimes the care plan is a blend of services from the Care Dimensions interdisciplinary team (nurse, social worker, chaplain, aide, volunteer, complementary therapy) and other times, there might be additional referrals to other community services, such as those provided by the local Department of Elder Services and spiritual supports.
Last year, I took care of a 32-year-old patient and her mom. It was a heartbreaking story, but in her final months, that young woman brought nothing but joy and love into the world. Also, despite the mother’s grief, we had what I would call a very successful end-of-life care experience. Now, when I think of that patient and her mom, it’s with a mix of warmth and sadness.
Understanding End-of-Life Care
In my personal life, with friends and family, it can be challenging to talk about my work as a hospice nurse. I suspect that many people feel it’s too sad, and the topic can certainly clear a room quickly.
Even when it’s not too sad, I find there are many misconceptions and generalizations about hospice care. As patients, we visit our physician or provider. We sit in the waiting room and then, following an office-based visit, we are given a plan of care to follow. This is the sequence of care that many of us have grown used to.
However, as hospice providers, we are right in people’s homes. We are discussing the patient’s personal goals. We are putting that patient’s desires and talents ahead of everything else. Hospice care is very broad-based and holistic. It encompasses the physical, emotional and spiritual aspects of healthcare, and no one aspect supersedes the other.
Actually, even within the larger healthcare community, there are many misunderstandings about end-of-life care. It’s not about the patient giving up and it’s not confined to the final weeks of life. Instead, it’s about giving that patient the level of care that’s most appropriate at that time in his or her life to support their quality of life and goals as they are dealing with an advancing illness.
Future Career Plans
I love working at Care Dimensions because this is an organization that takes care of its staff and colleagues. I love providing end-of-life nursing care to patients and their caregivers--right in my local community. Many nurses change practice areas and jobs until they find the right fit, but as a hospice case manager, I know that I’ve arrived at exactly the place I’m meant to be.
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About the author
Anastacia Sanderson, BSN, RN, CHPN, is an RN case manager for Care Dimensions.