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Hospice Worker

Typical Day

Elena Empathizer's blaring smartphone jars her out of a sound sleep. Elena groggily rolls over and grabs the phone on the nightstand, realizing she's been awakened at 3 a.m. by her special hospice emergency ringtone. She picks up just as the voicemail feature takes over. Now Elena is fully awake, and listens as one of her patient's night nurses informs her that the elderly woman has just taken a turn for the worse. The nurse has called the patient's family, and would like Elena to meet them at the hospice facility immediately.

Elena takes a two-minute shower, slips into some comfortable clothes, and grabs a couple of energy bars as she races out the door. This could be a long day, she muses as she backs her car out of the driveway. Elena reaches the hospice in 15 minutes flat, and has a few minutes to meet with the nurse before the family arrives. They are understandably anxious, wondering if the wife's mother will rally once again, or if this crisis will mark the end of her journey.

Elena consults with the woman's physician, who has already received a medical update from the woman's night nurse. The physician recommends that Elena call the family's priest, just in case he will need to give last rites to the patient. Elena realizes she must stay at the hospice for at least the next couple of hours, as she must help the family sort through their wild range of emotions. Although the patient seems to stabilize during the next hour, Elena knows she must remain nearby to support the woman and her family through this difficult time.

Finally, the patient's physician arrives at about 8 in the morning. After examining her carefully, he believes her condition is stable, meaning Elena can leave the hospice to attend to her other clients. She meets with two hospital patients who will be transitioning to the hospice within the next few days. Elena carefully assesses the patients' personal and emotional needs, and reviews the reports and prognoses prepared by the patients' physicians. She makes extensive notes that will help her coordinate medical resources for the patients when they arrive at the hospice facility. Elena spends some time alone with the families, discussing the logistics presented by the patient's hospice stay. Elena also counsels the families, determining how she can best assist them as well.

Good heavens, it's lunchtime, thinks Elena as she glances at her watch. No wonder I'm so hungry. She grabs a soup and salad at the deli across the street from her hospice office, and prepares for an early afternoon meeting with her hospice care team. She listens carefully as the hospice's on-call physician, charge nurse, home care agency head, and hospice chaplain discuss the dozen or so patients currently under hospice care. Although the hospice facility houses most of the patients, a couple of them receive full-time hospice care at their homes.

Following Elena's hospice team meeting, she speaks with the hospice charge nurse about the status of the elderly patient who was in crisis last night. The patient's condition has not changed, so Elena takes the opportunity to wrap up some financial logistics for two other incoming hospice patients. She'll need to coordinate payment for their hospice care, and speak to their families about the need for legal and/or financial counseling services.

Just when Elena thinks she can wrap up her day on a positive note, the hospice charge nurse calls her about a nurse-family conflict at the hospice facility. Elena gets there in 10 minutes, and finds that an elderly man's family is demanding more pain medication for the patient, who clearly is experiencing some severe discomfort. The nurse has already administered the prescribed level of medication, and cannot give the patient any more pain meds without the hospice physician's approval.

Unfortunately, the family is quite upset, and interprets the nurse's adherence to the physician's orders as a callous disregard for their loved one's pain. Elena instructs the nurse to contact the physician for instructions, and takes the family into a small sitting room, where she listens to their concerns and helps them understand the nurse's dilemma. Meanwhile, the physician has indicated he will arrive within the hour to assess the patient's condition and decide whether to increase the patient's pain meds.

Elena is looking forward to a quiet evening at home when she receives an urgent call from the hospice facility. The elderly woman from the previous night's visit unexpectedly passed away while the family dashed out for a quick dinner. They received the news after returning to the hospice, and are understandably experiencing a whole gamut of emotions. Elena rushes to the hospice to support them, knowing she'll be there for several hours. She's relieved to see the woman's priest there as well, as he can provide spiritual guidance that Elena is not qualified to give. Elena leaves the family and priest alone for a private discussion, as she takes time for some meditation and reflection in a nearby sitting room. When the family emerges an hour later, they are ready to discuss funeral arrangements, satisfied that their loved one is at peace.

Finally, Elena's day is winding down. She grabs a quick dinner at the Italian restaurant near the hospice facility, organizes the next day's paperwork, and heads home to curl up with her cat. Elena's day has been exhausting. However, she feels enriched by the chance to help patients and their families when they need it most. Hopefully, Elena will get a good night's sleep tonight. She wants to be well rested for the patients and families she'll meet tomorrow.

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