Dan was dying. His family knew he was dying. Everyone knew. But hardly anyone visited him in his home because of COVID-19.
Except of course for Wanda, his hospice nurse.
“That’s the hardest part about COVID,” said Wanda. “People dying really need loved ones to tell them it’s okay to go. But this stupid virus…”
Since the pandemic began, Wanda has been Dan’s main friend. She’s been hanging out beside him during his last days, entertaining him.
When I called Dan, Wanda was busy telling knock-knock jokes.
“Knock, knock,” said Wanda.
“Who’s there?” said Dan’s graveled voice.
“Little old lady.”
“Little old lady who?”
“Mister Dan, I had no idea you could yodel!”
Wanda says this isn’t her best comedic material, but it works in a pinch. After all, she has to remain upbeat. Other people might be able to show up for work in bad moods, but not hospice workers.
During a pandemic, hospice nurses are a lifeline to the dying. It’s hard work. Not only do they have normal duties—wound cleaning, administering meds, documenting vitals, telling knock-knock jokes—many have been going above and beyond their job descriptions.
Take Lydia, for example, in Houston. She sometimes types emails for her patients who dictate them to her. Often these are goodbye letters.
“It’s the least I can do,” said Lydia.
An international quarantine may have paused the world, but it didn’t slow anything down for hospice professionals. It couldn’t. Helping people die is part of their job.
A hospice nurse does their work with the same pride a steelworker applies a bead of weld; or a teacher explains the Battle of Gettysburg; or a feeble redheaded writer tries to turn a weak idea into a column.
Every year about 1.6 million people enter hospice care, and all you have to do is imagine how many nurses they need. There are only 3.8 million registered nurses in the U.S. today. You do the math.
“You don’t just wake up and decide to be a hospice nurse,” says one veteran. “Something drives you to it. I was in my forties when I decided to be one.”
All this got me thinking: What makes a person choose this career? How does an average individual decide to help people to the End? Especially when most average people (I’m speaking of myself here) are afraid of death.
“No one goes to nursing school to work in hospice,” says Kaylie, a longtime hospice nurse. “All my classmates wanted to deliver babies or work in the ER. I wanted to take care of old folks and give a voice to the dying.”
And Kaylie has. After working in a regular hospital for three years, her father was diagnosed with pancreatic cancer. She watched the disease whittle away at his body and she became his advocate. It changed her.
“That’s when I decided to work for hospice,” she said. “I actually had to reschedule my first hospice-job interview because my dad was still dying. I started being a hospice nurse four weeks after he died.”
The philosophy of end-of-life medical care is simple. It’s about companionship, touch, comfort, friendship, and kindness. These nurses are trained to be tough as roofing tacks, but sweet as Almond Joys. They can do everything from play backgammon to treat a UTI.
But then along came COVID-19. The protocol changed. Nurses started suiting up in plasticized protective gear. Everything was different. It’s pretty hard to comfort someone when you’re wearing a Darth Vader costume.
“My PPE (personal protection equipment) outfit is kinda freaky,” said one nurse. “I have an N95 respirator, hair cover, eye protection, disposable gloves, face shield… It’s nuts.”
But it’s hardest on the dying. Many die without families nearby. And this is where hospice nurses shine.
Sarah, a hospice nurse in Rhode Island, says, “I recently cared for a patient in the intensive care unit, she had COVID-19, so her family couldn’t see her.”
The elderly patient was in a coma-like sleep, approaching the end. Even though the old lady was unconscious, Sarah treated her like her own mother.
“As a sign of respect,” said Sarah, “I introduced myself, told her I needed to take her blood pressure.”
Later that day, the old lady’s son called the nurse’s station and asked Sarah questions about his mother. The young man was a mess. Imagine not being seeing your mother before she breathes her last.
“He knew time was short,” said Sarah. “He asked to see her, and I told him we’d make it happen.”
Sarah donned her PPE attire—hair cover, facemask, respirator, gloves, gown, moon boots, space helmet, lasso, forcefield, cowboy hat, and light saber.
She went into the old woman’s room with a cellphone in her hand. She dialed the old lady’s son.
On the cellphone’s video screen appeared a young man and his children. Everyone was crying. The young man told stories to his mother over the phone, recalling childhood days. He told her how much he loved her.
Sarah held the phone near the old woman’s face while he talked.
“I cried, too,” said Sarah. “I just hope she understood what he was saying.”
Something inside tells me she did.
As it happens, Wanda has been doing the same thing all week with her patient, Dan. Making video calls. Until yesterday morning when she walked into Dan’s room and sensed it was getting close. A hospice nurse has a feel for this.
“I held his hand, I told him that his family loves him, even though they aren’t here. I told him I love him, too. I told him it was okay to go to heaven.”
He passed that afternoon.
And he went to the famous place where all hospice nurses come from.