photo by James Coburn, staff writer
CAREERS IN NURSING.
It’s amazing how medicine has advanced to help people. But sometimes the body signals that life will end in a matter of time.
Traditions Home Health and Hospice can make that journey more comfortable, said Johna Paul, RN.
“They’re strong nurses and hard workers,” she said. “We have some really hard-working people here. They go above and beyond.”
Nursing in general is a great occupation for women, she said. Different aspects of care and opportunities offer a lot for personal growth. (story continues below)
Paul began her career as a medical surgical nurse, followed by critical care work before venturing into public health and a post coronary care unit. Paul earned her degree at OSU/OKC more than 20 years ago and has dedicated her career to hospice work for nearly three years. She always knew the time would come when she would be a hospice nurse.
“You get that gratification that sometimes you do not get in another setting,” said Paul at the Oklahoma City office of Traditions Home Health and Hospice. Traditions Home Health and Hospice provides hospice care, home health and palliative care in Oklahoma. And Paul feels enriched by providing a holistic mission of care that patients and families value.
She has worked in admissions and as a case manager. Her initial visits with patients and their families are not always easy. Some things need to be explained to families during the admissions process. Patients are not necessarily ready to absorb all the information after a physician has recently explained they face a terminal illness.
“You just have to be gentle about things, but I also have to let them know,” Paul continued. “Even though it’s difficult, people do want to know the truth.”
Hospice nurses have a great deal of compassion for people. Hospice is an environment where nurses shine with kindness because they care about families, Paul said.
A patient’s survival rate comes with a six-month prognosis knowing there are people who will survive beyond or less than that time frame. Hospice improves the comfort levels of patients but does not intervene when death is inevitable.
“So, I try to get that across really well to make sure they understand we will work to make you comfortable,” Paul said.
Whether the task involves equipment, supplies, or nursing aides providing a bath, a nurse’s assessment is indispensable in understanding the need for care in declining health.
She meets with the interdisciplinary team every two weeks to discuss the needs of a patient and their loved ones. The team involves social workers, chaplains, medical directors, and supervisors. This interdisciplinary team is essential in making sure the patient is meeting standards that qualify for services.
“That’s why I say a nurse’s assessments are very important, so when a patient declines further, we can increase our visits,” Paul explained. “It’s nice to be able to start providing more care and see them more often. As they have more needs arise, that requires more attention and medications. Maybe we start introducing the comfort meds to be with them throughout this entire process to the end. I emphasize we will be the ones here — we want to be here — it’s our job to take care of everything. That’s what’s nice. We do all of that to make sure they get what they need.”
Nobody is alone. Death brings sadness. And nurses get the emotional support they need as well.
“I think you’re going to have to be able to handle being in a room with someone who is dying, and that can be hard,” Paul said. “You have got to be ready to take over that situation and help that patient and help the family. So that sounds easy because you’re caring for people, but honestly it’s a stressful situation.”
Chaplains do a great job in letting nurses know they can meet with them whenever there is a need, Paul said.
One of her patients was a woman struggling with anxiety due to lung cancer. Paul was invited to speak at her funeral service. A video showed photos of when the woman was younger, so beautiful and full of life.
“And then they showed pictures of when we were taking care of her,” said Paul, who will never forget. She still stays in touch with the woman’s mother.
Recently she was helping to assess another patient’s cognitive level. It touched Paul’s heart when seeing the look in the woman’s eyes.
“I’ve got to be honest. I think I’m pretty tough, but when you have quite a few of them pass, and that does happen, it is a bit of a struggle,” she said. “I would lean on them for sure. We have our social workers as well. I think they are all there for us.”
Families respond by letting Paul know the care she provides does make a difference in a difficult situation.
Families express gratitude even when their feelings of grief leave them feeling vulnerable.
“At least we’re there for them,” Paul said. “And they really come to appreciate it.”
Families are not left alone after the death of their loved one. They know they can continue to contact a chaplain or social worker whenever there is a need.
“We have chaplains that do services to help with that for some people,” said Paul, a mother of five children.
Nurses must also care for themselves and gets a lot of love from her family.
“I get some down time. I’ve kind of learned to look for little things. If I get to sit on the back porch for a while by myself, I feel I’m doing pretty good.”
She and her husband took their boat to the lake recently.
“We had the kids with us, but I did take some time to make sure I just chilled for a little bit,” she said.
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