Five nurses provide skilled care for Hospice of Luverne Community Hospital. They are (front row, from left) LPN Terri Steensma, RN Audrey DeBoer, (back) LPN Beth Duwenhoegger, RN Sara Lanoue and Hospice Clinical Director Linda Reisdorfer, RN.
By Lori Ehde
For terminally ill patients coming to terms with hopes and fears in their final days, hospice nurses are often more than the health care workers checking vital signs.
They become the patient's connection to an end-of-life system that includes doctors, social workers, chaplains, home health care aides and trained volunteers.
For these nurses, caring for hospice patients presents unique challenges and opportunities.
"I never thought I could do this," said LPN Terri Steensma. "I wondered, 'How could you do this - deal with dying people?"
Steensma, like the other four nurses involved with Hospice of Luverne Community Hospital, quickly learned the work has its rewards.
"I think we have a special place with our patients, their families and with our team," said RN Audrey DeBoer. "It's more than just nursing."
She said the rewards of endearing friendships balance the stresses of dealing with end-of-life issues.
"Do we shed tears? Yes we do," she said. "But you get a God-given grace to deal with that and get you through it."
Hospice nurses most commonly work with family members to help patients, but sometimes their work is solo.
"There have been times when we're the only ones there for them," said RN Sara Lanoue. "We're happy we can do it. We're happy to have the hospice concept that allows us to do that."
The nurses all know about each others' patients and work together to provide the care best suited for each patient.
The goal of hospice is to keep patients as pain-free as possible, with loved ones nearby, until death arrives.
During regular visits, hospice nurses assess patients' pain, as well as other symptoms, check vital signs, make necessary changes in medication or treatment, and communicate with the patients' doctors.
At the same time, hospice nurses work closely with the patients' families - especially primary care givers - to teach them how to care for patients at home and keep them updated on the patients' conditions and what to expect.
These skilled visits can be in patients' homes, nursing homes, hospitals or in the hospice Cottage. A hospice nurse is on call 24 hours a day for all hospice patients and their families.
In the process of caring for dying patients, nurses are often the ones who deal with patient concerns on all topics ' not just health-related.
Most commonly, hospice patients express fear of how severe their pain will be and if it will be manageable. Other concerns deal with becoming a burden to others, losing control, losing dignity and choice and finding meaning in their lives.
The hospice program provides spiritual counseling, helps work out arrangements for dependents, answers caregivers' questions and is available 24 hours a day, seven days a week.
Hospice nurses and team members get brief glimpses at the inner souls of their patients, and the result is often lifelong relationships with family members after the patient dies.
"You can go for years and the family will still recognize you," said Beth Duwenhoegger, who said she often receives Christmas cards from the families of her former patients. "That's rewarding."
Hospice of Luverne Community Hospital serves patients within a 30-mile radius of Luverne and made 706 skilled nursing visits.
Last year, 76 people were admitted to hospice and spent an average of 24 days in the program.
Forty-nine patients utilized the hospice Cottage in Luverne.
In Minnesota, the majority of hospice patients have cancer - more than 60 percent. Others commonly come to hospice with heart and lung problems, AIDS and Alzheimer's disease.
Although Medicare covers hospice care, reimbursement is often inadequate. The local hospice program is generously supported by the community through donations and volunteer labor.
For example, Sioux Valley Southwestern Electric recently donated $2,000 through its Operation Roundup program to the Cottage to install new carpet.
Also, the annual Hospice Banquet and Charity Auction typically brings in $15,000 to $20,000.