• By Chelsea Maxwell, RN

As the support nurse at Hospice of the Panhandle on the weekends, I work Friday-Sunday from 8 a.m. to 8 p.m. to ensure that community members who are deemed to have a very short prognosis get the support they need. I want to assure that the families of the patients that are dying are supported, that the patients are comfortable and that the PN can rest on their weekend.

How I became a nurse: When I was 19 years old, I became pregnant with my first child. That is when I decided that I wanted to be a midwife and deliver babies. I went into my midwife appointment and asked her how to become one and she said to become a nurse first and do a RN to midwife program. That is what I set out to do.

I went to Shepherd College for my degree and there was no room for me in the nursing school. I was waitlisted but I knew in my soul this was my calling and things were going to work out. I got into the college of nursing that very semester I was waitlisted.

In the middle of nursing school, we had the dreaded “med surg” curriculum. We lost half of our class that semester; it was a very intense time. Then, my dad had an accident. He was skiing and hit a tree and ended up with a major head injury. They flew him from Massanutten, where he had been skiing, to UVA neuro intensive care unit where he had emergency surgery.

My mom and brother were present with him when he was extubated and died later.

While at the hospital I went up to see my dad, there was a nurse in his room and I asked that nurse how he could do this. I have no recollection of his response but all I knew what I did not want to work with neurology patients where the prognosis was poor.

I was the first graduating class of Shepherd University in Spring of 2005. I got my first job out of nursing school at Chambersburg Hospital where I worked med surg/urology (since I didn’t want neuro). I had a great preceptor named Beth McAllister who taught me the importance of rounding with the aides in the morning. She taught me the importance of quality care, time management and how to handle the craziness of a such a unit with humor and grace.

I left Chambersburg after just shy of two years to pursue my dream of being a labor and delivery nurse. I worked at City Hospital (now BMC) for 2 1/2 years and realized that to be a nurse midwife you are accepting a lot of responsibility and not much more pay. I didn’t love it that much.

My next step was Meritus Home health. I got to do a lot of different things. I taught new onset of disease processes, how to do wound care, wound vacuums, infusions, and I offered a lot of education to patients and families. This job would be one of the catalysts to my hospice journey. I learned to appreciate seeing patients in the home and getting the whole picture about the patient and their support system. I got comfortable going into patient homes and got better at teaching patients and their families.

After 4 1/2 years of home health, I was ready for a change. My Aunt Tammi has been with hospice as long as I can remember her being a nurse. She works in Olathe, Kansas and is now a hospice nurse practitioner. She loves her job and always had such glowing things to say about hospice, so I left home health and went to Hospice of Washington County where was I was an RN case manager for five years. I fell in love with hospice! There were so many things we could say “yes” to – Yes, we can get you a hospital bed, yes, you can have aide services, yes, you can have medication that will help you get more comfortable. It was a nice change of pace.

After some time, however, there was burnout. I needed to take a break. I started to struggle with whether I wanted to be a nurse or not. The landscape of the profession is changing so quickly and we are trying to keep up with everything and on top of that we deal with death and dying. This is a job with high burnout and if health care professionals are not taking time to take care of themselves, it is easy to become overwhelmed, stressed and resentful. It is as important that we take care of ourselves as the patient families that we teach to do the same.

I left nursing on Sept. 18, 2019. I wanted to start a family with my husband but the stress of the job made it difficult for us to conceive. After I left, I was pregnant by December. We thought my husband’s job would carry our little family through. Then COVID hit. Suddenly my husband’s jobs started drying up and business was looking grim. Then the protests and riots in DC started, suddenly it wasn’t safe for my husband to go into the city for work anymore. We ended up losing the business and struggled through the year making it just by the skin of our teeth. If it wasn’t for our support system, I shudder to think where we would be.

We talked about what to do with our lives now. I figured out pretty quick that I had to reenter the nursing world, so I started to work on myself. I started to meditate, focus on friendships and grow them, take walks outside to give myself positive outlets. I worked on myself and my mental health. Then I started to look for nursing jobs. I wanted to do 12-hour nights and Hospice of the Panhandle had an opening at the inpatient facility. It was perfect for our little family and I jumped at the chance and canceled all my other interviews. I knew this was my place from the start. I worked for a year at the inpatient unit, which I loved, and then came into my current position as support RN.

I am proud of this organization. I value the strong female leadership and support that we get. I feel heard here, I feel appreciated. Hospice care is so important to our community. The job satisfaction I get from educating families and empowering them to care for their loved ones is amazing. It’s different when we are in their home – in essence, their castle. Patients aren’t afraid to voice their opinions on their own turf. We can go into homes and immediately identify obstacles to care. We can educate families who have never cared for anyone before, much less a dying person, and give them confidence and skills to help them give the greatest gift ever given. That is how I feel about it. Hospice is a gift. The greatest gift.

Imagine loving someone so much that you ensure that they are as comfortable as possible in their final days. How much love goes into the act of caring for a dying loved one? All of it. It is a beautiful gift to give our loved ones to care for them at end of their life.

I have also learned that there is such a thing as a good death. That typically looks like a comfortable patient, family at bedside and patient wishes being fulfilled. I tell patients and their families that there are truly only three things that a dying patient needs: Comfort, needs being met and love.

I have watched patients get baptized prior to death. I have seen loved ones singing hymns around the dying patient as they pass from this world to the next. I have seen miracles of patients who are actively dying, opening their eyes and giving the closure that the loved one was looking for before they go comatose again.

Death and dying is so very sacred. It is q privilege and an honor that we get to be present in these lives for however long we have them. To get to teach and love patients and their families as they are on one of the hardest journey’s they may ever have to face and give them the peace that comes with knowing HOW to care for someone when they are in their final days.

I adore this job. It is the most gratifying form of nursing I have ever worked.

People say, “I don’t know how you do your job.” It reminds me of the nurse that was caring for my father. Sometimes I don’t know how I do this job either but most days it is the most rewarding thing to watch someone who was struggling with their loved ones decline become more understanding and accepting through our education and support.

So these days when families say to me “I don’t know how you do this” I tell them it is a labor of love. And it is.

Chelsea Maxwell is a registered nurse for Hospice of the Panhandle. To find out how Hospice can help your family, call (304) 264-0406 or visit the website at www.hospiceotp.org