The team's commitment to person-centered care is evident in the way they approach each veteran as an individual. When a newly admitted veteran expressed his love for painting and his sadness at the thought of never having the chance to paint again, the nurse not only encouraged him to have his family bring in some of his paintings to display in his room but also brought it up to the team. Recreation therapy set up a "studio" in his room and coordinated with his family to get his supplies set up, allowing him to enjoy painting once again, even if only for short periods.

Similarly, when the team learned that a veteran with dementia loved buses, they collaborated with the veteran's son to bring in some of his beloved models. These models brought joy and comfort to the veteran and provided a meaningful way for him to connect with the nursing staff. Another veteran, an avid Harley Davidson rider, proudly displayed photos of himself and his wife with their bikes, sharing stories with the nursing staff. These examples demonstrate the team's dedication to understanding and honoring each veteran's unique interests and passions, ensuring that their final days are filled with moments of joy and fulfillment.

The nurses' leadership is evident in every aspect of the team's work, from the weekly rounds where they share invaluable bedside observations and insights, to the close collaboration with Hospice Palliative Team physicians and NP in achieving optimal symptom control. Their commitment to evidence-based practices, such as employing non-pharmacological measures like aromatherapy, white noise, hand massage, and soothing bed baths to promote comfort and reduce symptoms, and their ability to anticipate and address potential issues before they escalate, have resulted in measurable outcomes that set this team apart.

The team's expertise in symptom management is another testament to their dedication. They understand that each veteran and family may have preconceived ideas and fears about hospice care, particularly regarding pain management. The nurses take the time to listen, educate, and communicate with veterans and their families to alleviate these concerns. They collaborate closely with palliative care providers to ensure that pharmacological interventions are tailored to each veteran's needs, resulting in a remarkable 95% success rate in achieving optimal symptom control within 48 hours of admission.

The team also recognizes that medication is not always the answer and employs creative solutions to meet veterans' needs. For example, when a veteran who loves orange juice becomes anxious and yells out around bedtime, he can be soothed with his favorite beverage and a few minutes of conversation with a familiar nursing staff member. When a veteran with dementia who had trouble speaking would become agitated and combative, a nurse made communication cards for him with simple statements such as "You are wet, and we are going to change your brief now" and "Would you like a snack?”

This innovative approach significantly reduced the veteran's irritability and made it easier for staff to work with him, demonstrating the team's commitment to finding personalized solutions that enhance each veteran's quality of life.

Under the nurses' guidance, the LVNs, CNAs, social workers, and recreation therapists form an unbreakable bond with veterans and their families, providing not only physical care but also emotional support during this most challenging time. The team understands that while many veterans would prefer to die at home, it is often impossible for loved ones to provide the necessary around-the-clock care. They support families as they adjust to inpatient hospice care, working with them to establish care schedules, provide education, respect preferences, and maintain open communication. The nurses empower and inspire their team members to go above and beyond, creating cherished moments and lasting memories for veterans and their loved ones.

Several of the nurses on the team are certified in geriatric nursing, one is in the process of re-certifying in Hospice Palliative Nursing, one is certified in Wound, Ostomy, and Continence, and all staff have been trained in the End-of-Life Nursing Education Consortium (ELNEC) for veterans. This expertise allows them to provide specialized care, such as recommending treatments that provide comfort and relief for wounds and skin issues, further enhancing the quality of life for the veterans they serve.

The team's success is rooted in their continuous collaboration and the value they place on each team member's contributions. The weekly Thursday morning rounds provide an opportunity for nurses to share information gathered from their bedside interactions, as well as observations from LVNs and CNAs, with NP, palliative care physicians, social workers, and psychologists. These collaborative discussions allow the team to problem- solve, identify unmet needs, and plan interventions that support both veterans and their loved ones.

In the broader context of VISN 22, the VA Long Beach CLC Hospice Team embodies the excellence that our network strives for in palliative care. Their contributions help to bolster VISN 22's achievements, including a significant uplift in Bereaved Family Survey scores, where a leap from a national average of 79% to 84% families rating care as "9" or "10" showcases the high-quality care and support provided to veterans and their families. Additionally, the strategic focus on high-risk veterans within our network, enhancing palliative care services for those with the most significant needs, reflects the dedication and impact of our team's work. These achievements illustrate the critical role our unit plays within the larger success story of VISN 22, contributing to an environment where veterans receive the compassionate, dignified care they deserve at the end of life.

The profound impact of this nurse-led team is never more apparent than during the “Final Salutes,” where families express their heartfelt gratitude for the care and
compassion their loved ones received.

These emotional tributes are a testament to the nurses' ability to create an environment where veterans can spend their final days in comfort, peace, and dignity, surrounded by a team that truly understands and honors their service and sacrifice. As one example of many, Nurse Donna, mentioned twice in the Bereaved Family Survey for VISN 22, epitomizes the heart and soul of compassionate nursing. Her dedication and empathetic care have left an indelible mark on the families she has served, embodying the highest ideals of the nursing profession.

One family member shared, "This is the place he wanted to be." This simple yet powerful statement encapsulates the essence of what the VA Long Beach CLC Hospice Team achieves through their tireless efforts and dedication. They create a sanctuary where veterans can spend their final days in a place that feels like home, surrounded by compassionate professionals who become like family.

The measurable outcomes achieved by this nurse-led team are a direct result of their leadership and dedication to collaboration and person-centered care. They have played a key role in achieving remarkable rates of symptom control and family satisfaction, contributing to the high standards of care recognized across VISN 22. Veterans receive end-of-life care in an environment where their goals and preferences are respected, and families are supported, educated, and empowered to spend precious time with their loved ones without the overwhelming stress of heavy caregiving. Veterans without family find a place where they feel genuinely cared for, and nursing staff feel respected and valued by their colleagues.

In conclusion, the VA Long Beach CLC Hospice Team stands as a shining example of what compassionate, person-centered care truly means in the face of life's most difficult moments. This extraordinary nurse-led team is guided by the unwavering dedication and clinical expertise of the RNs and MDS RNs, many of whom hold certifications in gerontology, hospice and palliative care, wound care, and end-of-life nursing education. These highly skilled and compassionate nurses lead a team comprised of LVNs, CNAs, and the invaluable support of the NP, all working together in harmony to transform the end-of-life journey for veterans and their families into a meaningful, comforting experience filled with love, respect, and dignity. The nurses provide exceptional leadership, ensuring that each veteran receives the highest quality of care tailored to their unique needs. They empower and inspire their team, who offer unwavering support and comfort to veterans and their families with their compassionate hearts and gentle hands, creating a nurturing environment where every moment is cherished. The NP works collaboratively with the nursing staff, providing expert guidance and support to enhance the team's ability to deliver outstanding care. Through their tireless efforts, innovative approaches, and genuine compassion, this unified team, led by the skilled and dedicated nurses, creates cherished memories that will forever be etched in the hearts of those they serve. As veterans take their final steps, surrounded by the warmth and care of this exceptional team, their families find solace in knowing that their loved ones were honored, valued, and deeply cared for by every member of the hospice team. The VA Long Beach CLC Hospice Team, with its cohesive and dedicated staff, is not just deserving of the DAISY Team Award. They are a testament to the transformative power of nursing and a beacon of hope for all those who face life's most challenging transitions.

Some Family Testimonials:
“Thank you for all you do each day for these veterans. My dad was one of your biggest fans. GO NAVY!” “My brother loved the VA and was so grateful for the care he received from you, even when he got cranky and bossed people around. I will be eternally touched by your selfless, dedicated care.” “I also want you to know how appreciative I was when you helped me calm down one scary night.” “To all who made my husband comfortable and took such good care of him, my sincere thank you. I also appreciate you letting me stay with him every day.” “I am so thankful for all your time, work, effort, attention, and kindness you have taken to assist my husband along with myself. I loved him so much and human beings like you are hard and rare to come by!”