An Inside Look at Hospice RN Jobs:

Dying to Be There Introduction

This is the introduction to Dying to Be There and what is involved in Hospice RN Jobs. It will give you a taste of my writings, where it started and where it is now. It is more than just a fly on the wall look at hospice. It is packed with life lessons we can all benefit from. These lessons came from working with the most incredible people on the planet, those who had only a few days to share their wisdom. We hope you enjoy.

If you do, please give us a like /comment On our Dying to Be There Facebook page.

Reviews

"The Go To Book For Everything Hospice"

“Dying
One of Two Different Cover Concepts

Wow. 'Dying to Be There' is THE go-to book for everything health and hospice.

From the personal stories to the professional references and resources, Jonathan Steele, RN has crafted a text that is captivating, informational, and necessary for us to understand all things related to life and death. Not only did I enjoy learning from this book- I really appreciated how it made me take pause, reflect, and feel.

Bestselling Author of "Nursing from Within"

-Elizabeth Scala, MSN/MBA, RN Bestselling Author of 'Nursing from Within'

Read more reviews, scroll down to below the introduction.
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Questions?
Contact The Author


There are two versions of this book. One for the public, one for professionals. Both give a view of hospice. The second provides more of information on the RN hospice jobs.

Dying to Be There: 21 Life Lessons Version

Introduction

This is the public version. Scroll down for the Hospice Version (March 18th Revision)

This is written for all who want to improve their lives. It is hoped that the experiences in these pages here will touch all whom they are shared with. These lessons have changed the lives of those who they came from and those who used them. While there are 21 main life lessons, within these pages there is much more on how to be a better person and how to live life to the full. All of this comes from my life experience of working with those who were near the end of their lives.

During my healthcare career and then on entering the healthcare universe of hospice, it was possible to have an incredible education. The people and stories are real and come from my years of nursing in the hospital, private duty, educating and lecturing to doctors and nurses around the world and in hospice. The names and some situations have been changed to protect the privacy of those involved. The lessons do not follow the chapter. Like life, they sometime came at inopportune times.

Lesson #1: Be mindful of your life's priorities. We all get the same amount of time, use it wisely.

The following is perhaps one of the most important life lessons I've learned. One day while out and about, I crossed paths with a little lady who was enjoying a day of shopping with her father at Target.

At six, this little girl with big blue eyes taught all of us present that day, a very important lesson on the topic of what is most important in life. Perhaps she had wisdom beyond her years or maybe it was just her innocence that caused each and every one of us there that day to make a dramatic shift in the way we think.

The young girl and her dad were leaving the store with their spoils as were all of us just standing there. We were stopped there and held captive at the awning covering the patio in the front of the store. We were imprisoned by a tremendous downpour. This is the kind of rain that my Grandma would have called a goose-drowner. It was coming down with such fury, even a goose would have drowned in the rain.

There were several of us standing, watching and waiting, enjoying the downpour in all its power and glory. It was truly amazing to see the rain performing in this one-act play before our eyes.

Of those remaining, a few who were noticeably put off by the majestic display. In spite of the wonderful performance, the less appreciative there were like rain on our parade, or in this case, rain. Of course, this performance was an interruption of our busy lives at the most inopportune time. After all, we had things to do, jobs to get to and lives to live.

It was at this moment that we overheard the little girl speak loud enough so her dad could hear, “Why is it raining so hard?”

The father asked if she remembered going to the car wash and riding in the car when it was being cleaned, to which the little girl said yes.

“Well, this is like a giant car wash the Earth goes through. Sometimes it needs more of a wash than other times. I guess you could call it an Earth wash. Whenever the Earth gets too dirty, this is how God washes away all the dirt, grime and for a moment, even all of the problems on the Earth wash away, right down the drain.”

Then the little girl, tugging on her father's arm, started to drag her father out and get him to go with her into the rain. She said, “We have to go, it’s important.”

“But it is raining too hard, right now, we will get all wet” the dad replied.

“We have to get home,” the girl said, continuing to tug on her fathers arm,” It is really important.”

“We are going to get home as soon as it stops raining,” he replied, adding, “Just be patient.”

“But then it will be too late,” the little girl said, looking worried and expressing her impatience. She continued, “We need to get home and get Mommy out in the rain.”

“Why do we need to get Mommy out in the rain?” asked the dad.

“Well,” she replied, “if the rain makes the problems on the Earth go away, then maybe it can make Mommy’s cancer go away. But we can’t wait. We have to go because the rain will stop soon and it will be too late.”

In that moment, we had a profound change in our thinking. What’s most important in life? This little girl helped us to get our priorities in order. I don’t know about the others there but it made the Earth stand still for me. I doubt there was a single dry eye among those that received this gift of being able to hear those words.

Her impatience for helping her mom win the fight against cancer caused us to take pause of the importance of the most valuable thing we have in life, our relationships.

Perhaps those inconvenienced by the rain felt a bit of shame. After all, what was so important that they could not wait just a few minutes while the rain washed away the problems of the Earth.

When turning back to look at the little girl, both she and her dad started running toward their car. Only thing, the little girl waved her hands in the air, trying to catch as many of the drops as she could as they drenched her tiny body. As she started out she shouted, "Daddy, can we take some rain home with us for Mommy, just in case it stops before we get home?"

Whatever the worries, concerns or fears we may have, the next time it rains, stop, watch the rain and remember that little girl. Remember what is most important in life.

Whatever the problems we have, they will go away, if for only a brief moment, if you know what is most important.

As we near death, all the possessions we own, all we have in the way of material things will mean nothing. There is no time, no journey to take, place to be or job to be done when that time comes. Everything material we have will in that selfsame day become worthless to us. It will become the sum total of the final breath we take. It will become nothing more than an exhalation.

The one thing we can take with us to that very last breath are the moments in life that we have and keep in our hearts. We will have these moments to recall if we truly know what is most important.

Up until the last thought during our life, unlike the material possessions we have, there are two things that cannot be taken away from us. One (for those who have faith) is our precious relationship with our creator and the other, moments and memories we have of friends, family and our lover.

Be patient and if just for a moment, stop and let the rain wash away the problems of the world and of life, savor your memories and know what is most important in life.

One of those most important things has to do with how we will face our death. This book is designed to help you create a dialogue on the subject of death and dying. Talk about it with loved ones, with friends and family. Talk with yourself about it.

In our society and culture, death is rarely spoken of unless in the form of black humor or horror movies. Yet we in our youth have said things like, ‘I am dying to…’ and fill in the blank about anything that we felt strongly about.

We have been dying to go to a particular concert, to the mall, dying to belong or even dying to spend the night with a friend.

Somehow when the mortality of life hits us, we stop using the expression, ‘dying to…” Yet, all of us are eventually dying to be there at that place where we have been totally fulfilled and have had a meaningful life.

As you go through the book, there will be interactive sections. These allow for you to create a conversation with others. Some make for water-cooler topics. Others could be used at a party or gathering as icebreakers.

All will start a discussion that will open the door to speaking on the topic of death and dying, or more importantly, living.

Most people think of hospice as being synonymous with death. However, it is not so much about dying as it is about helping people live the last days of their life.

Unfortunately, many do not get admitted to hospice until it is too late. They suffer for months to finally get relief for only a few days then die. Yet, if admitted early enough, hospice can enhance the final days of life to be much better than the suffering that many go through. This improvement in the quality of life is so profound that rarely some improve so much, that they have been discharged from hospice to live their life a bit longer.

Rather than trying to cure someone in a hopeless state, hospice helps them live the best quality life they can have during the final days of their life. Even before hospice was available in the area I lived and worked, one of my experiences is a testimony of how important this is.

Three More Days To Live

The following experience again reminds us of the importance of priorities. What is most important in life, especially when that life is about to end?

One day, in my first hospital nursing job, my assignment was a woman who was in kidney failure and nothing could be done. This meant that she had no more than 3 days before she was going to die. Entering her room, two of three daughters and her granddaughters were present. Rather than comforting their mother, they were all weeping, mourning her loss even though she had not yet passed.

Asking them to leave so as to provide her assessment, they went out and quietly waited in the hall. She was in a hospital room with two beds, out of consideration for her terminal condition the first left empty to allow more room for the family.

Once the room was quiet and we were alone, she said in her Irish accent, “This is so depressing, I wish it would just be over with.” After asking questions of her background and completing the care, her daughters were asked back in the room, all except for one.

On asking to speak to the oldest daughter, in the hall we discussed her mom, the life she lived and how special she was. I suggested that the family would have the rest of their life to mourn their mother's death and the idea was planted to make the remaining two days a celebration of her life. There should be time for one-on-one visits with her on and off throughout the day as well as time for everyone to be together.

Where there might be a tendency to speak to each other, I encouraged her to always include mom in the conversation and make her the focus of the remaining days. Even if when not talking to her, make sure she was a part of the conversations if she wanted to be.

Later, that sister asked me to share with her younger sister what I had told her.

The mood changed considerably the rest of that day. Suggesting that mom might like someone reading Bobby Burns, they looked at me as if to say they were not familiar. Then when quoting the well-known words from, ‘“To a Mouse, “The best laid schemes o' mice an' men / gang aft a-gley,”…they knew who he was. It turned out we just happened to have one of his books in the hospital library which they were able to borrow and read, much to her delight.

The next day, on taking my supplies to provide her a bath, I was met by the three daughters at the door. Telling me that my services would no longer be needed, they took the basin and towels and gave their mom her AM bath and care. When it came time to assess her, they left the room. Remember my suggestion that everyone get their one-on-one time? Well, they suggested that I should have the honor of having my own one-on-one time too.

Mom thanked me, explaining that my speaking to her daughters provided her with one of the most wonderful gifts that she had ever received in her life, that of being able to enjoy the last few days of her life with the ones she loved. Towards the late afternoon of day three, I was paged to her room. The family asked me to come into the room. They wanted me to be the first to know that she had passed. I then called the doctor who came to pronounce her.

They waited outside as the nurses aide helped me with the final preparations. When exiting the room, the family was lined up along the hall. One by one, each of the daughters and granddaughters gave me a hug, thanking me for allowing them to enjoy her last few days of life.

This happened before hospice was available in the area. Few even knew what hospice was or even did back then.

It was a tremendous privilege to be able to give this gift at the end of life to families. This is what hospice does so well. This is what hospice can do for you and yours. If you considering a hospice career move or if you want to volunteer, it will do even more, much more for you.

Please enjoy what you will discover here, start a dialogue and make hospice a part of your estate planning and encourage it for those you love.

Also, although this sounds like it is addressing those in healthcare, the information is about life skills all of us can develop. Even if you are not a nurse, at some point in your life you may be called to nurse someone. This applies to men and women around this world. Contrary to popular culture think, the world’s oldest profession is actually that of the Male Nurse.

In the Bible at Numbers 11: 12, it says, ‘carry them in your bosom just as the male nurse carries the suckling.’ This was written between 1512 and 1473 BCE.

Think of what the word 'profession' means. It is an occupation that involves prolonged training and qualifications. It can be a career, calling, occupation, vocation line of work or business. In ancient times, if a man was too small of stature or frame to be a farmer, metalworker, mason, carpenter or soldier as most men were, what could he possibly do? Thus the profession of being a Male Nurse came to be.

So even men could be called upon to be a nurse to loved ones in the final part of their life.

Some will find an even greater calling and get the schooling to become professional nurses, eventually perhaps becoming a hospice nurse or a palliative nurse.

Whatever you read herein, it is designed to get you to think. Think about living and helping others live, whatever field of work, whatever your vocation or avocation, what ever your station or situation is in life. We can best help our loved ones when we are together. If there is abuse or if you are in danger, then you need to seek help on how to deal with your situation. But for those who still have the potential to salvage their relationships, now is the best time to pursue peace and for everyone to get together.

Ultimately, it is hoped this will help all to understand these life skills learned from those who were dying and, as a result, have a greater appreciation for life and the relationships we have.

If you grew up as part of the Star Trek generation, you often heard the mantra, 'Live long and prosper.' There is a more important mantra to have. It is 'Live well and prosper.' We can always die but we cannot always live. To live a life abundant with love and goodness is worth more than a long life with material prosperity and misery.

Enjoy your trek through my life experience and these lessons I have learned and now share with you.

Ever,

Jonathan Steele, RN








"The Benefits of This Book"

Jonathan Steele's “Dying to Be There” is very much needed. The benefits of this book can be realized by the medical community, lay people who may either be in need of or have a loved one who needs hospice care, and those interested in the profession of hospice care.

Steele uses his personal experiences as well as everything he learned about hospice through the interview process to write a book that covers just about every aspect you can think of when it comes to hospice care.

With his years as a nurse he weaves true life stories into educating us as to what hospice care is and isn’t (names are changed for confidentiality purposes). Many of these stories will touch your heart as we learn how the last days of patients and/or loved ones can be enriched and celebrated through the caregivers, as well as the very patient care itself.

This is an important book for anyone to read. Many of us really have no idea what hospice care is or does and there is a lot of misinformation out there, even in the medical community. It is important to educate ourselves with the facts so that if or when that time comes to find care for our loved ones during their last days, we can move forward swiftly to make sure our loved ones can leave this earth with love and dignity.

Rev. Dr. Karen L. Langford

Chapter 1 Chapter 1: My Introduction to Hospice .....or
Why would anyone ask the job interview question, "How do you want to die?

Chapter 2: Hospice Social Workers

Beyond Dying to Be There Introduction: Go To The Steel Yard:




This section covers the hospice RN jobs and hospice jobs in general. While there are numerous RN hospice jobs, this looks mostly at the case manager.

Dying to Be There: What Hospice Is and Does Version

Introduction / March 8th Edit

This revision of the introduction reduced the size and redundancy. The original follows this.

“Dying
First Cover Concept

While this is written for three particular groups of people, there will be many more it will resonate with, both the older and younger who are charged with caring for the health of a loved one as they near the end of life.

Doctors Who Don’t or Won’t Admit to Hospice

If you are a doctor and you don’t routinely admit terminal patients to hospice, this will hopefully give you a fly-on-the-wall view of what hospice is and what hospice can do for your patients.

Nurses Thinking of Becoming a Part of Hospice

If you are a nurse and thinking of making a change, while hospice may not be for everyone, here you will find a glimpse of what hospice is. The stories here are my observations as I entered the world of hospice. It was a massive paradigm shift, to say the least for me. Daily I learned lessons that made me wonder why these things were not taught by my family, in school or even on the job. Why did it take coming to hospice to learn such varied aspects of life, emotional intelligence and how to live, let alone how to help someone maintain dignity through the end of life?

Beyond the life-sustaining care you may have given in a hospital or nursing home, hospice and palliative care is drastically different than what you have been taught. When and if you learn and embrace it, you will be entering a world very different than the healthcare system you know. As you read about my experience, you will see why this can be said with all authority.

Those Who Don’t Know What Hospice Is

If you are reading this and you or someone you know does not know what hospice is or does and if your life is busy and full and you are facing the loss of a loved one, you need to know there is a team of people that can help you with the process. The lessons I learned in hospice and share here are only a glimmer of the experience they will provide for you and your loved one.

My hospice experience was limited to just a few agencies. To compile this information and as I continued to meet more and more people from various hospices around the country, amazingly, they all seem to have a commonality. Most hospices seem to defy the traditional health care system in function and form. It is not that hospice is better, rather, it may be a better option for the needs of you and your loved one. Hospice is extremely effective in helping those dealing with the challenge of living and enjoying the last days of life rather than experiencing the death of our spirit and waiting for our body to catch up.

What’s Most Important in your life?

The following is perhaps one of the most important life lessons I have learned. One day while I was out and about, I crossed paths with a little lady who was enjoying a day of shopping with her father at Target.

At six, this little girl with big blue eyes taught all of us present that day, a very important lesson on the topic of what is most important in life. Perhaps she had wisdom beyond her years or maybe it was just her innocence that caused each and every one of us there that day to make a dramatic shift in the way we think.

The young girl and her dad were leaving the store with their spoils as were all of us just standing there. We were stopped there and held captive at the awning covering the patio in the front of the store. We were imprisoned by a tremendous downpour. This is the kind of rain that my Grandma would have called a goose-drowner. It was coming down with such fury, even a goose would have drowned in the rain.

There were several of us standing, watching and waiting, enjoying the downpour in all its power and glory. It was truly amazing to see the rain performing in this one-act play before our eyes.

Of the remaining ones, there were a few who were noticeably put off by the majestic display. In spite of the wonderful performance, the less appreciative there were like rain on our parade, or in this case, rain. Of course, this performance was an interruption of our busy lives at the most inopportune time. After all, we had things to do, jobs to get to and lives to live.

It was at this moment that we overheard the little girl speak loud enough so her dad could hear, “Why is it raining so hard?”

The father asked if she remembered going to the car wash and riding in the car when it was being cleaned, to which the little girl said yes.

“Well, this is like a giant car wash the Earth goes through. Sometimes it needs more of a wash than other times. I guess you could call it an Earth wash. Whenever the Earth gets too dirty, this is how God washes away all the dirt, grime and for a moment, even all of the problems on the Earth wash away, right down the drain.”

Then the little girl, tugging on her father's arm, started to drag her father out and get him to go with her into the rain. She said, “We have to go, it’s important.”

“But it is raining too hard, right now, we will get all wet” the dad replied.

“We have to get home,” the girl said, continuing to tug on her fathers arm,” It is really important.”

“We are going to get home as soon as it stops raining,” the father replied, adding, “Just be patient.”

“But then it will be too late,” the little girl said, looking worried and expressing her impatience. She continued, “We need to get home and get Mommy out in the rain.”

“Why do we need to get Mommy out in the rain?” asked the dad.

“Well,” she replied, “if the rain makes the problems on the Earth go away, then maybe it can make Mommy’s cancer go away. But we can’t wait. We have to go because the rain will stop soon and it will be too late.”

In that moment, we had a profound change in our thinking. What’s most important in life? This little girl helped us to get our priorities in order. I don’t know about the others there but it made the Earth stand still for me. I doubt there was a single dry eye among those that received this gift of being able to hear those words.

Her impatience for helping her mom win the fight against cancer caused us to take pause of the importance of the most valuable thing we have in life, our relationships.

Perhaps those inconvenienced by the rain felt a bit of shame. After all, what was so important that they could not wait just a few minutes while the rain washed away the problems of the Earth.

When turning back to look at the little girl, both she and her dad started running toward their car. Only thing, the little girl waved her hands in the air, trying to catch as many of the drops as she could as they drenched her tiny body. As she started out she shouted, "Daddy, can we take some rain home with us for Mommy, just in case it stops before we get home?"

Whatever the worries, concerns or fears we may have, the next time it rains, stop, watch the rain and remember that little girl. Remember what is most important in life.

Whatever the problems we have, they will go away, if for only a brief moment, if you know what is most important.

As we near death, all the possessions we own, all we have in the way of material things will mean nothing. There is no time, no journey to take, place to be or job to be done when that time comes. Everything material we have will in that self-same day become worthless to us. It will become the sum total of the final breath we take. It will become nothing more than an exhalation.

The one thing we can take with us to that very last breath are the moments in life that we have and keep in our hearts. We will have these moments to recall if we truly know what is most important.

Up until the last thought during our life, unlike the material possessions we have, there are two things that cannot be taken away from us. One (for those who have faith) is our precious relationship with our creator and the other, moments and memories we have of friends, family and our lover.

Be patient and if just for a moment, stop and let the rain wash away the problems of the world and of life, savor your memories and know what is most important in life.

One of those most important things has to do with how we will face our death. This book is designed to help you create a dialogue on the subject of death and dying. Talk about it with loved ones, with friends and family. Talk with yourself about it.

In our society and culture, death is rarely spoken of unless in the form of black humor or horror movies. Yet we in our youth have said things like, ‘I am dying to…’ and fill in the blank about anything that we felt strongly about.

We have been dying to go to a particular concert, to the mall, dying to belong or even dying to spend the night with a friend.

Somehow when the mortality of life hits us, we stop using the expression, ‘dying to…” Yet, all of us are eventually dying to be there at that place where we have been totally fulfilled and have had a meaningful life.

As you go through the book, there will be interactive sections. These allow for you to create a conversation with others. Some make for water-cooler topics. Others could be used at a party or gathering as ice-breakers.

All will start a discussion that will open the door to speaking on the topic of death and dying, or more importantly, living.

Most people think of hospice as being synonymous with death. However, it is not so much about dying as it is about helping people live the last days of their life.

Unfortunately, many do not get admitted to hospice until it is too late. They suffer for months to finally get relief for only a few days then die. Yet, if admitted early enough, hospice can enhance the final days of life to be much better than the suffering that many go through. This improvement in the quality of life is so profound that rarely some improve so much, that they have been discharged from hospice to live their life a bit longer.

Rather than trying to cure someone in a hopeless state, hospice helps them live the best quality life they can have during the final days of their life. Even before hospice was available in the area I lived and worked, one of my experiences is a testimony of how important this is.

Three More Days To Live

One day, in my first hospital nursing job, my assignment was a woman who was in kidney failure. This meant that she had no more than 3 days before she was going to die. Entering her room, two of three daughters and some granddaughters were present. Rather than comforting their mother, they were all weeping, mourning her loss even though she had not yet passed.

Asking them to leave so as to provide her assessment, on cue they quietly waited in the hall. She was in a two bed hospital room with the first bed left empty to allow more room for the family and out of consideration for her terminal condition.

Once the room was quiet and we were alone, she said, in her Irish accent, “Wow, this room is so depressing, I wish it would just be over with.” After asking her a little about her background and on completing the care, her daughters were invited back in the room, all except for one.

On asking to speak to the oldest daughter, in the hall, we discussed her mom, the life she lived and how special she was. Then, suggesting that the family would have the rest of their life to mourn mom’s death, the idea was planted to make the remaining two days a celebration of her life. There should be time for one-on-one visits with mom, on and off throughout the day and evening as well as time for everyone being together.

Where there will be a tendency to speak to each other, make sure to always include mom in the conversation. Make her the focus of the remaining days. Even if you are not talking to her, make sure she is part of the conversations if she wants to be.

Later, that sister asked me to share with her younger sister what I had told her.

The mood changed considerably the rest of the day. Suggesting that mom might like someone reading Bobby Burns, they looked at me as if to say they were not familiar. Then when quoting the well-known words from, ‘“To a Mouse, “The best laid schemes o' mice an' men / gang aft a-gley,”…they knew who he was. It turned out we just happened to have one of his books in the hospital library which they were able to borrow and read, much to her delight.

The next day, on taking my supplies to provide her a bath, I was met by the three daughters at the door. Telling me that my services would no longer be needed, they took the basin and towels and gave their mom her AM bath and care. When it came time to assess her, they left the room. Remember my suggestion that everyone get their one-on-one time? Well, they suggested that I should have the honor of having my own one-on-one time too.

Mom thanked me, explaining that my speaking to her daughters provided her with one of the most wonderful gifts that she had ever received in her life, that of being able to enjoy the last few days of her life with the ones she loved.

Towards the late afternoon of day three, I was paged to her room. The family asked me to come into the room. They wanted me to be the first to know that she had passed. I then called the doctor who came to pronounce her.

They waited outside as the nurses aide helped me with the final preparations. When exiting the room, the family was lined up along the hall. One by one, each of the daughters and granddaughters gave me a hug, thanking me for allowing them to enjoy her last few days of life.

This happened before hospice was available in the area. Few even knew what hospice was or even did back then.

It was a tremendous privilege to be able to give this gift at the end of life to the family. This is what hospice does so well. This is what hospice can do for you and yours. If you are making a career move into hospice or if you are going to volunteer, it will do even more, much more for you.

Please enjoy what you will discover here, start a dialogue and make hospice a part of your estate planning and encourage it for those you love.

Also, although this sounds like it is addressing those in healthcare, the information is about life skills we all can develop. Even if you are not a nurse, at some point in your life you may be called to nurse someone.

This applies to men and women around this world. Contrary to popular culture think, the world’s oldest profession is actually that of the Male Nurse.

In the Bible at Numbers 11: 12, it says, ‘carry them in your bosom just as the male nurse carries the suckling.’ This was written between 1512 and 1473 BCE.

Think of what the word ‘profession’ means. It is an occupation that involves prolonged training and qualifications. It can be a career, calling, occupation, vocation line of work or business. In ancient times, if a man was too small of stature or frame to be a farmer, metal-worker, mason, carpenter or soldier as most men were, what could he possibly do? Thus the profession of being a Male Nurse came to be.

So yes, even you men could be called upon to be a nurse to those you love in the final part of their life.

Some will find an even greater calling and get the schooling to become professional nurses, eventually perhaps becoming a hospice nurse or a palliative nurse.

Whatever you read herein, it is designed to get you to think. Think about living and helping others live, whatever field of work, whatever your vocation or avocation, what ever your station or situation is in life.

Ultimately, it is hoped you will better understand death and dying and, as a result, have a greater appreciation for life.

If you grew up as part of the Star Trek generation, you often heard the mantra, ‘Live long and prosper.' There is a more important mantra to have. It is ‘Live well and prosper.’ We can always die but we cannot always live. To live a life abundant with love and goodness is worth more than a long life with material prosperity and misery.

Ever,

Jonathan Steele, RN




ΩΩΩΩΩΩΩΩΩΩΩΩΩ

Dying to Be There Introduction
Feb 26 Edit

This revision of the introduction reduced the size and redundancy. The original follows this.

Have questions? Then Contact Dying to Be There Author



Introduction

While this is written for three particular groups of people, there will be many more it will resonate with, both the older and younger who are charged with caring for the health of a love one as they near the end of life.

Doctors Who Don’t or Won’t Admit to Hospice

If you are a doctor and you don’t routinely admit terminal patients to hospice, this will hopefully give you a fly on the wall view of what hospice is and what hospice can do for your patients.

Nurses Thinking of Becoming a Part of Hospice

If you are a nurse and thinking of making a change, while hospice may not be for everyone, here you will find a glimpse of what hospice is. The stories here are my observations as I entered the world of hospice. It was a massive paradigm shift, to say the least for me. Daily I learned lessons that made me wonder why these things were not taught by my family, in school or even on the job. Why did it take coming to hospice to learn such varied aspects of life, emotional intelligence and how to live, let alone how to help someone maintain dignity through the end of life?

Beyond the life sustaining care you may have given in a hospital or nursing home, hospice and palliative care is drastically different than what you have been taught. When and if you learn and embrace it, you will be entering a world very different than the health care system you know. As you read about my experience, you will see why this can be said with all authority.

Those Who Don’t Know What Hospice Is

If you are reading this and you or someone you know does not know what hospice is or does and if your life is busy and full and you are facing the loss of a loved one, you need to know there is a team of people that can help you with the process. The lessons I learned in hospice and share here are only a glimmer of the experience they will provide for you and your loved one.

My hospice experience was limited to just a few agencies. To compile this information and as I continued to meet more and more people from various hospices around the country, amazingly, they all seem to have a commonality. Most hospices seem to defy the traditional health care system in function and form. It is not that hospice is better, rather, it may be a better option for the needs of you and your loved one. Hospice is extremely effective in helping those dealing with the challenge of living and enjoying the last days of life rather than experiencing the death of our spirit and waiting for our body to catch up.

What’s Most Important in your life?

This is perhaps one of the most important life lessons I have learned. One day while I was out and about, I crossed paths with a little lady who was enjoying a day of shopping with her father at Target.

At six, this little girl with big blue eyes taught all of us present that day, a very important lesson on the topic of what is most important in life. Perhaps she had wisdom beyond her years or maybe it was just her innocence that caused each and every one of us there that day to make a dramatic shift in the way we think.

The young girl and her dad were leaving the store with their spoils as were all of us just standing there. We were not moving because of being held captive at the awning covering the patio in the front of the store. We were imprisoned by a tremendous downpour. This is the kind of rain that my Grandma would have called a goose-drowner. It was coming down with such fury, even a goose would have drowned in the rain.

There were several of us standing, watching and waiting, enjoying the downpour in all its power and glory. It was truly amazing to see the rain performing in this one act play before our eyes.

Of the remaining ones, there were a few who were noticeably put off by the majestic display. In spite of the wonderful performance, the less appreciative there were like rain on our parade, or in this case, rain. Of course, this performance was an interruption of our busy lives at the most inopportune time. After all, we had things to do, jobs to get to and lives to live.

It was at this moment that we overheard the little girl speak loud enough so her dad could hear, "Why is it raining so hard?"

The father asked if she remembered going to the car wash and riding in the car when it was being cleaned, to which the little girl said yes.

"Well, this is like a giant car wash the Earth goes through. Sometimes it needs more of a wash than other times. I guess you could call it an Earth wash. Whenever the Earth gets too dirty, this is how God washes away all the dirt, grime and for a moment, even all of the problems on the Earth wash away, right down the drain."

Then the little girl, tugging on her father's arm, started to drag her father out and get him to go with her into the rain. She said, “We have to go, it’s important.”

"But it is raining too hard, right now, we will get all wet" the dad replied.

"We have to get home,” the girl said, continuing to tug on her fathers arm," It is really important.”

"We are going to get home, as soon as it stops raining,” the father replied, adding, “Just be patient."

"But then it will be too late," the little girl said, starting to look worried and expressing her impatience. She continued, "We need to get home and get Mommy out in the rain."

“Why do we need to get Mommy out in the rain?” asked the dad.

"Well," she replied, "if the rain makes the problems on the Earth go away, then maybe it can make Mommy’s cancer go away. But we can’t wait. We have to go because the rain will stop soon and it will be too late."

In that moment, we had a profound change in our thinking. What's most important in life? This little girl helped us to get our priorities in order. I don’t know about the others there but it made the Earth stand still for me. I doubt there was a single dry eye among those that received this gift of being able to hear those words.

Her impatience for helping her mom win the fight against cancer caused us to take pause of the importance of the most valuable thing we have in life, our relationships.

Perhaps those inconvenienced by the rain felt a bit of shame. After all, what was so important that they could not wait just a few minutes while the rain washed away the problems of the Earth.

When turning back to look at the little girl, both she and her dad started running toward their car. Only thing, the little girl waved her hands in the air, trying to catch as many of the drops as she could as they drenched her tiny body. As she started out she shouted, "Daddy, can we take some rain home with us for Mommy, just in case it stops before we get home?"

What ever the worries, concerns or fears we may have, the next time it rains, stop, watch the rain and remember that little girl. Remember what is most important in life.

What ever the problems we have, they will go away, if for only a brief moment, if you know what is most important.

As we near death, all the possessions we own, all we have in the way of material things will mean nothing. There is no time, no journey to take, place to be or job to be done when that time comes. Everything material we have will in that self same day become worthless to us. It will become the sum total of the final breath we take. It will become nothing more than an exhalation.

The one thing we can take with us to that very last breath are the moments in life that we have and keep in our hearts. We will have these moments to recall if we truly know what is most important.

Up until the last thought during our life, unlike the material possessions we have, there are two things that cannot be taken away from us. One (for those who have faith) is our precious relationship with our creator and the other, moments and memories we have of friends, family and our lover.

Be patient and if just for a moment, stop and let the rain wash away the problems of the world and of your life, savor your memories and know what is most important in life.

Another of those most important things has to do with how we will face our own death. This book is designed to help you create a dialogue on the subject of death and dying. Talk about it with loved ones, with friends and family. Talk with your self about it.

In our society and culture, death is rarely spoken of unless in the form of black humor or horror movies. Yet we, in our youth have said things like, 'I am dying to…' and fill in the blank about anything that we felt strongly about.

We have been dying to go to a particular concert, to the mall, dying to belong or even dying to spend the night with a friend.

Somehow when the mortality of life hits us, we stop using the expression, 'dying to…' Yet, all of us are eventually dying to be there at that place where we have been totally fulfilled and have had a meaningful life.

As you go through the book, there will be interactive sections. These allow for you to create a conversation with others. Some make for water cooler topics. Others could be used at a party or gathering as ice breakers.

All will start a discussion that will open the door to speaking on the topic of death and dying, or more importantly, living.

Most people think of hospice as being synonymous with death. However, it is not so much about dying as it is about helping people live the last days of their life.

Unfortunately, many do not get admitted to hospice until it is too late. The suffer for months to finally get relief for only a few days then die. Yet, If admitted early enough, hospice can enhance the final days of life to be much better than the suffering that many go through. This improvement in the quality of life is so profound that rarely some improve so much, that they have been discharged from hospice to live their life a bit longer.

Rather than trying to cure someone in a hopeless state, hospice helps them live the best quality life they can have during the final days of their life. Even before hospice was available in the area I lived and worked, one of my experiences is a testimony of how important this is.

Three More Days To Live

One day, In my first hospital nursing job, my assignment was a woman who was in kidney failure. This meant that she had no more than 3 days before she was going to die. Entering her room, two of three daughters and some granddaughters were present. Rather than comforting their mother, they were all weeping, mourning her loss even though she had not yet passed.

Asking them to leave so as to provide her assessment, on cue they quietly waited in the hall. She was in a two bed room with the fist bed left empty to allow more room for the family and out of consideration for her terminal condition.

Once the room was quiet and we were alone, she said, in her Irish accent, "Wow, this room is so depressing, I wish it would just be over with." After asking her a little about her background and on completing the care, her daughters were invited back in the room, all except for one.

On asking to speak to the oldest daughter in the hall, we discussed a bit about mom, the life she lived and how special she was. Then, suggesting that the sisters would have the rest of their life to mourn mom’s death, the idea was planted to make the remaining two days a celebration of her life. There should be time for one on one visits with mom, on and off throughout the day and evening as well as time for everyone being together.

Where there will be a tendency to speak to each other, make sure to always include mom in the conversation. Make there the focus of her remaining days. Even if you are not talking to her, make sure she is part of the conversations if she wants to be.

Later, the older sister asked me to share with her middle sister the what I had told her.

The mood change considerably the rest of the day. Suggesting that mom might like someone reading Bobby Burns, they looked at me as if to say they were not familiar. Then when quoting the well known words from, 'To a Mouse, "The best laid schemes o' mice an' men / Gang aft a-gley."'…..they knew who he was. It turned out we just happened to have one of his books in the hospital library which they were able to borrow and read to her, much to her delight.

The next day, on taking my supplies to provide her a bath, I was met by the three daughters at the door. Telling me that my services would no longer be needed, they took the basin and towels and gave their mom her AM bath and care. When it came time to assess her, they left the room. Remember my suggested that everyone get their one on one time? Well, they suggested that I should have the honor of having my own one on one time too.

Mom thanked me, explaining that my speaking to her daughters provided her with one of the most wonderful gifts that she had ever received in her life, that of being able to enjoy the last few days of her life with the ones she loved.

Towards the late afternoon of day three, I was paged to her room. The family asked me to come into the room. They wanted me to be the first to know that she had passed. I then called the doctor who came to pronounce her.

They waited outside as the nurses aide helped me with the final preparations. When exiting the room, the family was lined up along the hall. One by one, each of the daughters and grand daughters gave me a hug, thanking me for allowing them to enjoy her last few days of life.

This happened before hospice was available in the area. Few even knew what hospice was or even did back then.

It was a tremendous privilege to be able to give this gift at the end of life to the family. This is what hospice does so well. This is what hospice can do for you and yours. If you are making a career move into hospice or if you are going to volunteer, it will do even more, much more for you.

Please enjoy what you will discover here, start a dialogue and make hospice a part of your estate planning and encourage it for those you love.

Also, although this sounds like it is addressing those in health care, the information is about life skills we all can develop. Even if you are not a nurse, at some point in your life, you may be called to nurse someone.

This applies to men and women of this world. Contrary to popular culture think, the worlds oldest profession is actually that of the Male Nurse.

In the Bible at Numbers 11: 12, it says, 'carry them in your bosom just as the male nurse carries the suckling.' This was written between 1512 and 1473 BCE.

Think of what the word profession means. It is an occupation that involves prolonged training and qualifications. It can be a career, calling, occupation, vocation line of work or business. In ancient times, if a man was too small of stature or frame to be a farmer, metal worker, mason, carpenter or soldier as most men were, what could he possibly do? Thus the profession of being a Male Nurse was created.

So yes, even you men could be called upon to be a nurse to those you love in the final part of their life.

Some will find an even greater calling and get the schooling to become professional nurses, eventually perhaps becoming a hospice nurse or a palliative nurse.

What ever you read herein, it is designed to get you to think. Think about living and helping others live, what ever field of work, what ever your vocation or avocation, what ever your station or situation is in life.

Ultimately, it is hoped you will better understand death and dying and as a result, have a greater appreciation for life.

If you grew up as part of the Star Trek generation, you often heard the mantra, 'Live long and prosper.' There is a more important mantra to have in life. It is 'Live well and prosper.' We can always die, you cannot always live. To live a life abundant with love and goodness is worth more than a long life with material prosperity and misery.



Want More? Chapter 1: My Introduction to Hospice .....or
Why in the world would anyone ask the job interview question, "How do you want to die?







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The Following is the February 5 version.

While this is written for three particular groups of people, there will be many more it will resonate with, both the older and younger who are charged with caring for the health of a love one as they near the end of life.

Doctors Who Don't or Won’t Admit to Hospice

If you are a doctor and you don’t routinely admit terminal patients to hospice, this will hopefully give you a fly on the wall view of what hospice is and what hospice can do for your patients.

Nurses Thinking of Becoming a Part of Hospice

If you are a nurse and thinking of making a change, while hospice may not be for everyone, here you will find a glimpse of what hospice is. The stories here are my observations as I entered the world of hospice. It was a massive paradigm shift, to say the least for me. Daily I learned lessons that made me wonder why these things were not taught by my family, in school or even on the job. Why did it take coming to hospice to learn such varied aspects of life, emotional intelligence and how to live, let alone how to help someone maintain dignity through the end of life?

Beyond the life sustaining care you may have given in a hospital or nursing home, hospice and palliative care is drastically different than what you have been taught. When and if you learn and embrace it, you will be entering a world very different than the health care system you know. As you read about my experience, you will see why this can be said with all authority.

Those Who Don’t Know What Hospice Is

If you are reading this and you or someone you know does not know what hospice is or does and if your life is busy and full and you are facing the loss of a loved one, you need to know there is a team of people that can help you with the process. The lessons I learned in hospice and share here are only a glimmer of the experience they will provide for you and your loved one.

My hospice experience was limited to just a few agencies. To compile this information and as I continued to meet more and more people from various hospices around the country, amazingly, they all seem to have a commonality. Most hospices seem to defy the traditional health care system in function and form. It is not that hospice is better, rather, it may be a better option for the needs of you and your loved one. Hospice is extremely effective in helping those dealing with the challenge of living and enjoying the last days of life rather than experiencing the death of our spirit and waiting for our body to catch up.

What's Most Important in your life?

This is perhaps one of the most important life lessons I have learned. One day while I was out and about, I crossed paths with a little lady who was enjoying a day of shopping with her father at Target.

At six, going on 16, this little girl with big blue eyes taught all of us present that day, a very important lesson on the topic of what is most important in life. Perhaps she had wisdom beyond her years or maybe it was just her innocence that caused each and every one of us there that day to make a dramatic shift in the way we think.

The young girl and her dad were leaving the store with their spoils as were all of us just standing there. We were not moving because of being held captive at the awning covering the patio in the front of the store. We were imprisoned by a tremendous downpour. This is the kind of rain that my Grandma would have called a goose-drownder. It was coming down with such fury, even a goose would have drowned in the rain.

There were several of us standing, watching and waiting, enjoying the downpour in all its power and glory. It was truly amazing to see the rain performing in this one act play before our eyes.

For others, it brought everything to a standstill. It was as if show was over, we were lined up to exit the theater but we had to wait on the slowly moving line to get out of the theater. The play, in their case was their shopping experience.

Of the remaining ones, there were a few who were noticeably put off by the majestic display. The grumbling complaints were loud enough to be heard over the drone of the falling rain. In spite of the wonderful performance, the less appreciative there were like rain on our parade, or in this case, rain. Of course, this performance from our creator was an interruption of our busy lives at the most inopportune time. After all, we had things to do, jobs to get to and lives to live.

It was at this moment that we overheard the little girl speak loud enough so her dad could hear. Everyone there heard her ask her father, "Why is it raining so hard?"

The father asked if she remembered going to the car wash and riding in the car when it was being cleaned, to which the little girl said yes.

"Well, this is like a giant car wash the Earth goes through. Sometimes it needs more of a wash than other times. I guess you could call it an Earth wash. Whenever the Earth gets too dirty, this is how God washes away all the dirt, grime and for a moment, even all of the problems on the Earth wash away, right down the drain."

Whether silently or audibly, right then and there, everyone chuckled. Because of the sound of the rain, maybe you would not have heard it but we were all amused and even touched by the young lady, her question and the response.

Then the little girl, tugging on her father's arm, started to drag her father out and get him to go with her into the rain. She said, "We have to go, it’s important."

"But it is raining too hard, right now, we will get all wet," the dad replied.

"We have to get home," the girl said, continuing to tug on her fathers arm," It is really important."

"We are going to get home, as soon as it stops raining,” the father replied, adding, "Just be patient."

"But then it will be too late,” the little girl said, starting to look worried and expressing her impatience. She continued, “We need to get home and get Mommy out in the rain."

"Why do we need to get Mommy out in the rain?" asked the dad.

“Well,” she replied, "if the rain makes the problems on the Earth go away, then maybe it can make Mommy’s cancer go away. But we can’t wait. We have to go because the rain will stop soon and it will be too late."

In that moment, all of us standing there had a profound change in our thinking of what is most important in life and what kind of things we need not worry about, like a rain storm that interrupts our lives for a moment in time.

Here some were impatiently waiting rather than enjoying the rain, if even for just a the few minutes the down pour lasted. For the duration of the down pour, in reality, nothing else mattered. It was as if the rain had washed away all the problems we had, if for just a moment.

We also had a profound paradigm shift. It was a self searching moment when we reconsidered what is most important in life.

We reconsidered what patience means. What exactly should be urgent and what can wait? This little girl helped us for the moment to get our priorities in order. I don’t know about the others there but it made the Earth stand still for me. I doubt there was a single dry eye among those that received this gift of being able to hear those words.

The precocious little girls impatience for helping her mom win the fight against cancer caused us to take pause of the importance of the more valuable things we have in life, of which, one is our relationship with our loved ones.

Perhaps those who complained at being inconvenienced by the rain felt a bit of shame. After all, what was so important that they could not wait just a few minutes while the rain washed away the problems of the Earth.

When turning back to look at the little girl, both she and her dad started running toward their car. Only thing, the little girl waved her hands in the air, trying to catch as many of the drops as she could as they drenched her tiny body. As she started out she shouted, "Daddy, can we take some rain home with us for Mommy, just in case it stops before we get home?"

What ever the worries, concerns or fears we may have, the next time it rains, stop, watch the rain and remember that little girl. Remember what is most important in life.

What ever the problems we have, they will go away, if for only a brief moment, if you know what is most important.

As we near death, all the possessions we own, all we have in the way of material things will mean nothing. There is no time, no journey to take, place to be or job to be done when that time comes. Everything material we have will in that self same day become worthless to us. It will become the sum total of the final breath we take. It will become nothing more than an exhalation.

The one thing we can take with us to that very last breath are the moments in life that we have and keep in our hearts.

We will have these moments to recall if we truly know what is most important.

Up until the last thought during our life, unlike the material possessions we have, there are two things that cannot be taken away from us. One (for those who have faith) is our precious relationship with our creator and the other, moments and memories we have of friends, family and our lover.

Be patient and if just for a moment, stop and let the rain wash away the problems of the world and of your life, savor your memories and know what is most important in life.

One of those most important things has to do with how we will face our own death. This book is designed to help you create a dialogue on the subject of death and dying. Talk about it with loved ones, with friends and family. Talk with your self about it.

In our society and culture, death is rarely spoken of unless in the form of black humor or horror movies. Yet we, in our youth have said things like, ‘I am dying to…’ and fill in the blank about anything that we felt strongly about.

We have been dying to go to a particular concert, to the mall, dying to belong or even dying to spend the night with a friend.

Somehow when the mortality of life hits us, we stop using the expression, ‘dying to…” Yet, all of us are eventually dying to be there at that place where we have been totally fulfilled and have had a meaningful life.

As you go through the book, there will be interactive sections. These allow for you to create a conversation with others. Some make for water cooler topics. Others could be used at a party or gathering as ice breakers.

All will start a discussion that will open the door to speaking on the topic of death and dying, or more importantly, living.

Most people think of hospice as being synonymous with death. However, it is not so much about dying as it is about helping people live the last days of their life.

Unfortunately, many do not get admitted to hospice until it is too late. The suffer for months to finally get relief for only a few days then die. Yet, If admitted early enough, hospice can enhance the final days of life to be much better than the suffering that many go through. This improvement in the quality of life is so profound that rarely some improve so much, that they have been discharged from hospice to live their life a bit longer.

Rather than trying to cure someone in a hopeless state, hospice helps them live the best quality life they can have during the final days of their life. Even before hospice was available in the area I lived and worked, one of my experiences is a testimony of how important this is.

Three More Days To Live

One day, In my first hospital nursing job, my assignment was a woman who was in kidney failure. This meant that she had no more than 3 days before she was going to die. Entering her room, two of three daughters and some granddaughters were present. Rather than comforting their mother, they were all weeping, mourning her loss even though she had not yet passed.

Asking them to leave so as to provide her assessment, on cue they quietly waited in the hall. She was in a two bed room with the fist bed left empty to allow more room for the family and out of consideration for her terminal condition.

Once the room was quiet and we were alone, she said, in her Irish accent, "Wow, this room is so depressing, I wish it would just be over with." After asking her a little about her background and on completing the care, her daughters were invited back in the room, all except for one.

On asking to speak to the oldest daughter in the hall, we discussed a bit about mom, the life she lived and how special she was. Then, suggesting that the sisters would have the rest of their life to mourn mom’s death, the idea was planted to make the remaining two days a celebration of her life. There should be time for one on one visits with mom, on and off throughout the day and evening as well as time for everyone being together.

Where there will be a tendency to speak to each other, make sure to always include mom in the conversation. Make there the focus of her remaining days. Even if you are not talking to her, make sure she is part of the conversations if she wants to be.

Later, the older sister asked me to share with her middle sister the what I had told her.

The mood change considerably the rest of the day. Suggesting that mom might like someone reading Bobby Burns, they looked at me as if to say they were not familiar. Then when quoting the well known words from, '"To a Mouse, "The best laid schemes o' mice an' men / Gang aft a-gley."...they knew who he was. It turned out we just happened to have one of his books in the hospital library which they were able to borrow and read to her, much to her delight.

The next day, on taking my supplies to provide her a bath, I was met by the three daughters at the door. Telling me that my services would no longer be needed, they took the basin and towels and gave their mom her AM bath and care. When it came time to assess her, they left the room. Remember my suggested that everyone get their one on one time? Well, they suggested that I should have the honor of having my own one on one time too.

Mom thanked me, explaining that my speaking to her daughters provided her with one of the most wonderful gifts that she had ever received in her life, that of being able to enjoy the last few days of her life with the ones she loved.

Towards the late afternoon of day three, I was paged to her room. The family asked me to come into the room. They wanted me to be the first to know that she had passed. I then called the doctor who came to pronounce her.

They waited outside as the nurses aide helped me with the final preparations. When exiting the room, the family was lined up along the hall. One by one, each of the daughters and grand daughters gave me a hug, thanking me for allowing them to enjoy her last few days of life.

This happened before hospice was available in the area. Few even knew what hospice was or even did back then.

It was a tremendous privilege to be able to give this gift at the end of life to the family. This is what hospice does so well. This is what hospice can do for you and yours. If you are making a career move into hospice or if you are going to volunteer, it will do even more, much more for you.

Please enjoy what you will discover here, start a dialogue and make hospice a part of your estate planning and encourage it for those you love.

Also, although this sounds like it is addressing those in health care, the information is about life skills we all can develop. Even if you are not a nurse, at some point in your life, you may be called to nurse someone.

This applies to men and women of this world. Contrary to popular culture think, the worlds oldest profession is actually that of the Male Nurse.

In the Bible at Numbers 11: 12, it says, 'carry them in your bosom just as the male nurse carries the suckling.' This was written between 1512 and 1473 BCE.

Think of what the word profession means. It is an occupation that involves prolonged training and qualifications. It can be a career, calling, occupation, vocation line of work or business. In ancient times, if a man was too small of stature or frame to be a farmer, metal worker, mason, carpenter or soldier as most men were, what could he possibly do? Thus the profession of being a Male Nurse was created.

So yes, even you men could be called upon to be a nurse to those you love in the final part of their life.

“Dying

Some will find an even greater calling and get the schooling to become professional nurses, eventually perhaps becoming a hospice nurse or a palliative nurse.

What ever you read herein, it is designed to get you to think. Think about living and helping others live, what ever field of work, what ever your vocation or avocation, what ever your station or situation is in life.

Ultimately, it is hoped you will better understand death and dying and as a result, have a greater appreciation for life.

If you grew up as part of the Star Trek generation, you often heard the mantra, 'Live long and prosper.' There is a more important mantra to have in life. It is 'Live well and prosper.' We can always die, you cannot always live. To live a life abundant with love and goodness is worth more than a long life with material prosperity and misery.

I certainly hope you enjoyed reading this as much as I did writing and in some parts, remembering it.

Ever,

Jonathan Steele, RN

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