The Starshine Team of nurses work and is on call 24/7 to provide quality care for our patients and families during their end-of-life journey.  Starshine nurses work with patients and families to honor wishes, create legacies, support quality of life without suffering, and help patients pass away with dignity and grace.  Death can be as beautiful as birth and that is the goal of Starshine.

Starshine has transitioned to team nursing care.  This level of care provides consistency, trust, and continuous quality care to our patients and families.  We are building stronger relationships with our families as well as with the medical providers on a daily basis.  It is very difficult for our families to have to tell their stories and journeys to so many people, so team nursing makes it easier for us to collaborate and provide the level of care families deserve.  Recently we had a 14yo that has been in the hospice program for almost six years pass away.  Emma was the nurse on call for the weekend in which this guy had a huge decline.  I have been a primary on this case since he started in Starshine.  I reached out to Emma to let her know I was around all weekend to help if he needed any visits, or she needed support.  Emma called me at 10 pm on a Saturday night stating that things weren't well.  I arrived to find him in a very ill state and was not going to recover.  Since Emma was not able to get in touch with me right away, she called our manager, Kim Foster, who supported her until I arrived.  The three of us sat quietly with Mom and eventually were able to talk about his medical status, wishes, and goals.  While the three of us were there, Michelle Spaulding was in touch with Emma and took the phones for her in case any other patient needed assistance.  Kim Foster supported this family by scheduling either Emma or myself daily visits to support Mom.  The request for Either Emma or myself was Mom's request as so much was changing, and he was declining more and more each day.  Emma and I were both able to be present for his death which was peaceful for the parents and patient. 

Another scenario where Starshine made a difference was a patient that went home from the hospital for End of life and was told they may not survive the trip home. Julia admitted her on a weekend and spent many hours there supporting the mom and dad.  They were from the UAE and mom and baby had never been home from the hospital for 6 months since being here in the United States.  Dad had been working from the apartment and mom spent every day and night with her baby.  Mom became ill after arriving home and needed to go the emergency room.  Julia didn't think twice about what she needed to do to support this family.  She went to their home and sat with the baby while Dad took Mom to get the care she needed.  

Starshine nurses care for families outside the box and meet them where they need it most.  We have no idea what we are walking into each visit as things change quickly every minute of the day.  As nurses, we were able to give this family two weeks at home with their daughter before she passed away.  It was time they were so grateful for.  We saw them daily, providing emotional, physical, and medical support.   Each of us saw and cared for this family every day, sometimes twice a day.  We would have teams meetings to talk about our visits and how to best support the family and ourselves.   Also, this mother wanted to know that her baby was dying from her disease, AML, and not anything else.  Mom wanted a blood test to show that the cancer was taking her daughter.  2 hours prior to her passing, Michelle Rudisell was able to get an order from the MD, draw the CBC, take it to the lab, and get the results back before she took her last breath.  This simple test was the only request mom had so that she knew it wasn't anything that she did or didn't do for her child.

There was a 10mo baby girl from Napal that had spent her entire life in the CICU.  It was the mother and father's wish to take her home to provide rituals to try and cure her of her cardiac illness as well as cancer.  I went to the CICU and met the mother and baby to ride home in the transport vehicle.  The baby was hooked up to monitors, machines, and oxygen.  She came home with only oxygen and was going to go right back after the rituals were performed.  We arrived at the home and collaborated with the MD, Chaplain, and social worker who were awaiting our arrival.  There were several family members present as well as the Napolean preacher.  There were so many candles lit that it was unsafe to take her in there with the oxygen. The mom was comfortable taking the oxygen off for a few moments since there was a nurse and a doctor in the room.  This was a blessing on their baby that they wanted to be performed not only in hopes to take away the illness but also to bless her if she was to not recover.  She was turning blue throughout the ceremony worrying all of us medical people that she was going to pass while off the oxygen.   We were able to stay there for the entire ceremony and return to the hospital, where she died the next day.  

Child life, music therapy, chaplain, social worker and holistic health are all a part of our team.  We do co-visits with them and provide support for each other. So many of our visits can be emotionally draining at times.   It is great to have a team of individuals that not only care for our patients and families but for us nurses as well.

Respect Everyone; We work with a very diverse group of patients and families.  We also recognize that each one of us nurses is unique and has special gifts that we bring to the group.  We are always learning about cultural diversity to meet and provide for our families the best we can.  It is important to take time to see and hear each individual story to provide optimal care.  

Tell the Truth;   Being honest with our families and our co-workers is best practice.  Our manager, Kim Foster, is an advocate of "putting it out there."  This is a great tactic that helps to avoid drama amongst the team and provides truth and transparency.  

Work as a Team;  As stated in the examples above. We can't do this job alone, it takes each and every one of us to Make a Difference.  We make a difference every day in our patients and families' lives.  Providing them with quality of life for as many days as possible.  We help each other make a difference by supporting each other in many different ways.  It's not a difficult job when you are supported by your co-workers and managers to do the best job you can.  Everyone on this team is a phone call away and you never feel alone.