A GIFT FOR THE DYING

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Curtis entered nursing school in 1976 after being encouraged by a friend who was going. She didnít want to at first. "No thanks, that sounds icky," she said. But after evaluating her career plans, she decided, "What the heck, Iíll apply." Initially turned down because she had no microbiology classes, the school then allowed her to enter the program if she took microbiology concurrently with the nursing courses. She figured if she didnít do it now, she never would. 

After graduation, while working as an orthopedic nurse, she began working in home health care part time to earn extra money. Curtis liked the one on one contact she had with the patients. "I really liked this home health stuff," she said. Eventually she left the hospital to do home health on a full time basis. One weekend a month she had to be on call as a charge nurse.

"It terrified me," she said. "What if I got a hospice patient and didnít know what to do?"

Her worst fears were realized when she got a call one Saturday. A patient had come from Reno to die with his family. Curtis saw him that weekend. "Wow, this is really cool," she said. "It wasnít so scary because I felt I made a difference." She enjoyed the hands on aspect of the visit: ordering the hospital bed and pain medicines for him and comforting the family.

The following Monday she asked her hospice manager if she could follow that one patient. "I think I can do this," she said. But the patient had died Sunday night. Curtis, impelled to continue working in hospice, gradually took on more patients. A few weeks later she officially made the switch to hospice care. "Now, I canít imagine doing anything different."

Walking into the bedroom of her breast cancer patient, Curtis approaches the hospital bed. "Good morning," she says quietly to the 83 year old woman who is lying coma-like, facing the wall. Slowly she turns her head, a flicker of recognition in her eyes when she sees Curtis, who leans in close to her ear. "I hear you talked to the other nurse yesterday, and you wonít talk to me!" she says, teasing her affably. As Curtis carefully begins to check vital signs, the patient stares intently at her face. She can not talk since the cancer has metastasized to her brain, but her face shows an awareness of Curtisí presence.

"Here comes the cold instrument. Iíll try to warm it up for ya," she says rubbing the stethoscope between her hands before placing it on the womanís chest. Curtis strokes her arm gently and asks her how she feels. The patient tries to speak but no words come out. Curtis encourages communication by showing genuine interest in her patient. "You had your hair washed today. How pretty you look!" she tells her. The patient smiles weakly, all the while keeping her eyes focused on Curtis.

Curtis goes into the kitchen to talk to the caregiver. Does the patient need any more medicine refilled? What about pain? She is professional and to the point, yet she never gives the impression that she is in a hurry to finish her business. After calling in the prescription renewals, Curtis returns to the bedroom to say good-bye. "Iíll be back on Thursday or Friday," she tells her patient reassuringly. 

Curtis next visits a 63 year old man with lung cancer, who has been on hospice only one week and is deteriorating rapidly. The bath nurse opens the door. "How is our patient today," Curtis asks cheerfully. The nurse tells her the patient is pretty good today, but the wife has been crying inconsolably. Curtis sits on the couch next to the wife who is slumped in an overstuffed chair. She turns her full attention on the wife.

"Having a bad day, huh?" Curtis asks compassionately. She looks over at a mattress in the living room next to the patientís hospital bed. "I have to sleep down here with him," the wife tells Curtis. The nights are very difficult. 

"Sometimes I just need to get out to the market or to get my hair done," she says. Curtis tells her that hospice can provide a male attendant to help with her husbandís care, someone who can stay with them at night as well. Letting out a sigh of relief, she thanks Curtis. After the visit, Curtis immediately calls her office from her car phone. "Please arrange to have a male attendant call her today," she tells the social worker. 

Curtis drives to the next patient, the 91 year old woman, who she calls "just precious." She has been on hospice eight months. "I never thought it would go this long," she says. The patient, curled up in her usual place on the corner of her couch, smiles brightly when Curtis enters the living room and sits next to her. Curtis seems in no hurry to get down to business, chatting with the woman a little while before asking the caregiver for vital information. Curtis suggests increasing the dosage of Sennakot-s to help with constipation. The caregiver leaves to mix up the concoction of the powder and applesauce.

Curtis begins her familiar banter with the patient who has pictures of her beloved cat all over the house. An obvious bond of affection exists between them as they argue good-naturedly about the merits of dogs versus cats. The woman struggles to speak, but her eyes twinkle when she talks with Curtis. The visit ends, and Curtis tells her patient she will be back on Friday with a doctor.

"I donít want a doctor," she says stubbornly, but Curtis explains how important it is to have the doctor evaluate her. "She only wants you," says the caregiver. "Donít worry; I will come with him," she reassures her patient. Curtis finishes the visit and promises to see her Friday.