Monday, January 28, 2008

Of Hospice and Free Agency

Life as a (per diem) hospice nurse has certainly altered what (some of) my workdays can be like. Instead of answering to the unending demands of more than eighty needy patients as a care manager, I now answer to the rather predictable needs of no more than six residential patients.

What is unusual about my hospice work is that, during any given shift, one nurse and one home health aide must not only provide direct care to six patients in varying states of illness, including medications, bathing, treatments, dressings, and toileting. We are also responsible for preparing meals, cleaning up after meals, feeding patients who need to be fed, doing laundry, answering phones, taking out trash and recycling, and doing general housekeeping. If it sounds like a lot, it is, and I often feel that I am torn in a dozen directions at once.

Just today, in the midst of tending to a patient's lacerations from an early morning fall and calling the medical director about orders, we were toileting patients, passing medications, answering call bells, preparing breakfast, and thinking about how to begin preparing for lunch as we cleaned up from the maelstrom of breakfast. Phew! With several patients who are at risk for falls, and several who may be entering the final stages of life, meal preparation can sometimes seem like the last thing one wants to think about. But it must be done, nonetheless.

Still, as a workplace wherein I come and go, it is still a relief to simply do just that---come and go. The benefits of not being full-time anywhere are still making themselves known. For now, I revel in the fact that there is nowhere I report to day in and day out. And that free agency is a blessing beyond measure.
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