CLINTON — When five nurses meet every Wednesday at Mercy Medical Center South, the conversations don't center on the usual daily medical jargon.
Sure, the meeting features discussions on their patients' needs and how they can best do their job. When the Mercy Hospice nurses gather, it's a time for support, too.
Mercy's Hospice care workers don't see a miracle cure in the final stages of life. They see death. And with an average of 45 people on hospice through the system at Mercy a day and 150 to 200 admissions per year, they see it more often in a weekly basis than many experience in a lifetime.
That creates challenges, Mercy nurse Heidi Harlock said.
"During those meetings, we talk about patients, but we also come together as a team to be a support system for each other," Harlock said. "Some people you get so close with, you love that person. And when they die, it's hard."
While many associate hospice care with death, it's not that simple. Some will inevitably "graduate" from hospice care, nurse Michelle Malli said, only to come back at a later date.
It's not just about defying the odds for another few months or even a few years.
Hospice care is about quality of life, Tim Shinbori, director of Mercy Medical Center's Home Care and Hospice, said.
"I came from outside of healthcare into healthcare," Shinbori said. "The biggest misconception about hospice is that it equals death. The biggest thing the public needs to know is that it's not death. I've had a sister-in-law go into hospice and three friends who died of pancreatic cancer. Hospice is not death. It's for the family."
That connection with the family starts right away in a person's journey through hospice care. Initial referrals to receiving hospice care can be made by anyone associated with the patient. Once that referral is made, the hospice staff will tackle several of the tasks of setting up care and then will conduct an assessment. Once the assessment is complete, the hospice team members will be pulled in to discuss the options available for families.
"The patient really gets to choose how many of the services they want versus how many they don't want," Clinical Manager Wendi Lippens said. "There's a lot of different areas that we can kind of pull from to meet the needs of the patient."
In addition to the nursing aspect, patients can receive social work assistance, spiritual care, music therapy and more. Nurses are on call 24 hours a day, seven days a week, and the hospice unit currently has 15 volunteers on their roster. A social worker and chaplain also are on staff.
"This is a different path you're choosing," Mercy hospice nurse Heidi Leavy said. "We want to make sure it's right for you. We try to give you the best days."
That focus on quality of life begins with a book given to families right away, discussing what will transpire in the coming days, weeks and months. The transition to hospice can elicit several varying circumstances, including a perceived boost to health.
"The significance between hospice and other care, is that you stop seeking curative treatment," Shinbori said. "It's no longer about fixing what's wrong. You're going to live with and mediate it, treating the symptoms and controlling the pain. Once we take people off the meds, they a lot of times get better. The family may freak out and think they made the wrong decision. What's going on? The book and talking to the nurses helps them get a better understanding of the process."
The process is different for everyone. The average length of stay on hospice is 49 to 50 days. If the diagnosis doesn't progress the way the doctor believes, then people can exit hospice. And people who are on hospice aren't immediately bed-ridden riding out their final days. Hospice is appropriate in cases where doctors certify that a patient has a life limiting illness of six months or less, meaning some patients are able to still function and maintain a regular lifestyle.
"We're not going to kick you out because you don't die fast enough," Harlock said. "We've had cancer patients where we discharged them and they went on for one or two more years. Eventually we get them back. But they get that quality of life to spend with their family."
It's that quality of life that the Mercy hospice care nurses strive to give to the families in their care.
"When I was working in the hospital, you go from one patient to another," Harlock said. "Here, you get to build relationships with these people and families. It's rewarding. We're not just pushing drugs. We're actually doing something that matters. They appreciate you and they want you there."
Being there for the family may be even more important than for the patient. Right away, nurses work with the families to prepare them for the end of their loved one's life. They teach them how to give medications and how to provide care for bed-bound individuals. And even when they're off shift, it doesn't mean their patients are far from their minds.
"I always have patients I worry about every night," hospice nurse Leta Wilson said. "I still spend time with my family and shut off my work phone, but I still worry."
Most of the patients admitted to hospice at Mercy are not on a daily regiment of care. However, when the diagnosis progresses and days remain, patients are put on a daily schedule of monitoring by the nurses. Last week during the conversation with the nurses, four people were being cared for on a daily basis.
With days remaining in their life, oftentimes the patient withdraws, meaning that relationship with the family becomes even more important.
"Sometimes we take care of families more than the patients," Wilson said.
When the patient's day comes, it's emotional for the family and for the nurses.
"You become close with so many of the family members," Malli said. "When they pass, you're there for their support and help them through it. It's not unusual for me to cry with them. I say prayers with them, give hugs and reassurance."
Coping with the grief is another aspect of the job. For the families, social worker Sarah Eberhart offers support during the months after the death. Remembrance ceremonies are held during the year, with a ceremony coming up Sunday at the Bickelhaupt Arboretum.
Another ceremony is in April. Quilts also are made by hospice volunteers, etching the families' loved ones in the comforter. For the nurses, some attend the funeral, while others may even continue friendships with some family members. At the end of the day, the nurses keep moving on to offer support to area families dealing with some of the most difficult days of their lives.
"A lot of us had no hospice experience before we started," Lippens said. "But because of a certain experience that we probably all had in our personal or professional lives was drawn to the hospice work. Not everybody can sit at a bed side when somebody is dying and hold the hand and have those quiet visits. And some people are very OK with that. It is just kind of a calling I think for all of us that we ended up in hospice."
Whether in the home or another facility, the five nurses tasked with hospice care through Mercy Medical Center are keeping up with that calling one family at a time.