More than just a job: Hospice nursing is a demanding, but satisfying calling

MOSES LAKE — Maryann McCarty said nursing hospice patients is more than a job.

“Those of us who work in hospice feel that it’s a calling more than just a career,” she said. “It does take a special empathy and understanding, and I feel that most people who work with us in hospice have a very strong faith base.”

Marianne Zelinski said the goal for hospice nurses is different from nurses working in a hospital – just as the goal is different for their patients.

Normally the goal in a hospital is to cure what’s wrong with patients and send them home, Zelinski said. Qualifying for the Medicare hospice program requires a diagnosis from a physician that the patient will die within six months if their condition continues to progress in the manner it’s going.

“Our goal is not to get them well and send them home. Their goal is to stay home. We are to manage their symptoms for them and keep them comfortable. Our goal is now comfort,” Zelinski said.

The shift in emphasis requires some adjustment, she said.

“When I was new here I had trouble with that,” Zelinski said.

But she talked about it with her colleague BJ Jones.

“She advised me on that, which really helped me a lot. Our goal now is, how comfortable can we make them? It’s the comfort level,” Zelinski said.

Jones, Zelinski and McCarty work for Assured Hospice in Moses Lake. Assured Hospice cares for patients in Grant, Adams and Lincoln counties.

Jones said there’s an art to nursing, and hospice nurses are most successful when they use those intuitive skills, combine them with their technical knowledge and their compassion. When it comes to hospice treatment, the nurse and the support teams can treat the whole family.

“I remember when I first started nursing, my nursing instructor said, ‘Never forget that you hold life in your hands.’ And you hold many lives in your hands in hospice,” Jones said.

Zelinski, 69, Jones, 69, and McCarty, 74, bring a lot of experience to the job.

“I started my career in 1972,” Jones said.

“I’ve been a nurse since I was 30 (years old), so 44 years going on 45,” McCarty said.

“I went to nursing school at 60 years old,” Zelinski said. She has been a nurse for nine years.

“We’re the elder statesmen,” Jones said. “We’re certainly the oldest nurses here.”

They could retire, but they’re not interested in that.

“I’ve tried to retire three times, and it never works,” McCarty said. “I get too bored, I have to come back. This is what keeps me going.”

“I don’t think anybody in our agency looks at this as just a job, and a paycheck. Like Maryann and Marianne said, we look at it as a calling, a mission,” Jones said.

Zelinski and McCarty are registered nurses, and Jones is a licensed practical nurse. Licensed practical nurses and registered nurses perform most of the same jobs, although typically the training period for a LPN is shorter than for a RN, and there are a few jobs only a RN can do. As an example, Jones said she can’t admit patients to a hospital.

“There is truly no difference in what we do out in the field. We’re hospice nurses out in the field,” Zelinski said.

The goal of hospice care is to help the patient and the family through a tough time.

“It’s not just about medication management or the disease, it’s about how all of that is impacting a family,” Jones said.

All of a sudden, family members may have to learn how to operate a ventilator, or use a feeding tube, Jones said. Sometimes the disease progresses so fast family members have barely had time to absorb the news of diagnosis.

“The switch for a family member to all of that can be overwhelming,” Jones said.

As a result, hospice care involves chaplains, social workers, grief support groups, volunteers, and aides, as well as nurses.

“That whole team approach is very critical,” Jones said.

In addition, there’s a lot of misinformation out there about hospice and what it does, she said. People think hospice means their treatment stops, when in fact treatment just changes.

“Part of our job is to change that viewpoint and educate,” Jones said. “And people are so amazed. ‘Oh, you’re not going to take away my medicine. Oh, you’re not going to just give me morphine. You’re going to let me eat? Oh, I can go out? I can still go see family?’” Jones said.

“All of nursing is a lot of education, if you’re doing it correctly,” Jones said. “But in hospice it’s a truckload of education.”

It is a demanding job.

“For hospice it’s 24 hours a day, seven days a week,” Jones said. “There’s always a nurse on call, available to patients. If you want an 8-to-5 job, you should not be a hospice nurse.”

When they visit a patient, the nurses stay as long as necessary.

“You want to leave the situation as whole as you possibly can,” Jones said.

Even though it’s demanding, they wouldn’t trade what they do.

“It is very true that serving others gives you the opportunity to love them, and to grow in your ability to love others. And build your own self-esteem in doing so,” McCarty said. “It truly is a service.”

“And an honor,” Jones said.

“Yes. A privilege,” McCarty said.