Stephanie Malone, RN is our Hospice and Palliative Care Coordinator. She always consistently demonstrates the values of CARING, but I would like to tell you about one particular example of the "G" (going above and beyond).
A couple of weeks ago, she received a phone call from a case manager at a community hospital about a young Veteran who was dying. Just to give you some context - we usually take care of older Veterans on our unit, who have led full, rich lives. Their deaths are always sad for us, but we (and the family members) take comfort from a life well-lived. This Veteran, however, was different. He was in his 30s with a young family. He had a very bad cancer diagnosis and had received all available treatment. He had a tracheostomy and was on a ventilator. He woke up that morning and wrote a message to his wife asking to be allowed to die. He made the choice to be removed from the ventilator. It was clear that he would probably die quickly once the ventilator was stopped. But he wanted to die surrounded by Veterans.
When Stephanie told me about the phone call, late morning on a Friday, my first reaction was that it would be impossible to get him here the same day. But Stephanie wanted to try. She spent several hours on the phone with social work, case management at the other hospital, and transportation services. She spoke at length to the Veteran's young wife about our hospice unit and what we would do once he got here. She described step-by-step, in a very caring and sensitive manner, how we would withdraw care, prevent the sensation of air-hunger, and keep her husband comfortable. Our physician appealed to our Chief of Staff for approval to have the Veteran admitted directly to our unit in the Community Living Center (CLC) with a portable ventilator (The CLC does not ever take vented patients, so this was a huge decision).
After much effort and several hours, the Veteran arrived. We rushed him into a private room. His wife and about 8 family members also came. Stephanie set up a hospitality cart. She called the chaplain to come to administer Last Rites and pray with the family. The nurses rallied to administer medications to the veteran to control anxiety and prevent air hunger. Respiratory therapy arrived on the scene to work with the ambulance team on managing the portable ventilator. The patient was awake and aware of what was happening, but he was comfortable and prepared. When everyone was ready, the ventilator was disconnected. We all left the family and patient alone to be together, but we periodically checked-in to make sure he was comfortable, and that the family had what they needed.
The Veteran died after a couple of hours. He was comfortable and surrounded by loved ones. The family expressed gratitude for everything that the VA did to facilitate his transfer to the VA and his peaceful death. Stephanie was the pivot on which the whole process revolved. If it had not been for her determination to make this happen, he might have died in the ICU at another facility.
Stephanie is always compassionate, attentive, responsive, intelligent, and nice. And she regularly goes above and beyond. But that day she went way beyond any expectation to help this special Veteran and his family.