Finding the magic amid the chaos

Last Modified: 3/11/2022

DIL hospice

This post was written by Emma Hetrick, digital copywriter, Parkview Health.

I’ve always enjoyed watching musicals. When I was younger, I couldn’t get enough of the original Mary Poppins, and now, as an adult, the sequel has stirred up all those familiar feelings and nostalgia. As I snuggle close with my own children and watch the actors dazzle on the screen, I take in the refreshed storyline from a newfound perspective. Though the characters are grown with their own families, the themes are still the same. A magical figure brings order to disarray both internally and externally. She helps those in need make the most of what they have in a single moment, showing them the light and positivity in even the toughest of situations while infusing their lives with hope and love.

After observing her practicing her calling, I see the same grace and affection in Tammy Lyons, RN, Parkview Home Health & Hospice. I couldn’t help but draw the comparison as I watched her work with the same spirit as my beloved whimsical heroine. There are some differences. Instead of a bottomless magic carpet bag or talking parrot head umbrella, Tammy travels with a car equipped with hospice supplies, a backpack filled with nursing essentials, and a heart bursting with compassion and support for her patients and their families. But like Mary Poppins, she encounters colorful characters full of life on her journeys. Fortunately, I had the privilege of shadowing her for an entire day, experiencing the unique and rewarding role of a hospice nurse.

First impressions

I arrived at the Home Health and Hospice office around 8 a.m. It was unseasonably warm that morning, which was a nice change from the recent snow and ice, but it presented the age-old question: coat or no coat? Knowing we’d be in and out all day, I decided to live life dangerously, so I left my jacket in the car, double-checked my bag and headed for the building. The gravel crackled and popped beneath my shoes as I made my way across the parking lot and closed in on the front door. I pressed the white weathered call button and waited patiently to get buzzed into the lobby. A few moments later, I was standing at the front desk, checking in with Nancy, the receptionist, and waiting patiently for my tour guide.

Tammy rounded the corner, a noticeable bounce in her step. She radiated that palpable pep of a person who truly loves what they do. She greeted me warmly, then apologized in the same breath, “Hi Emma! I’m so sorry, but we both need to do a COVID test before getting started today.” I reassured her that it was no problem. After all, we’re all pros at the double nose swab these days. After about 15 minutes and a negative test result, we were off.

I followed Tammy as we walked past co-workers and cubicles, weaving our way back to the supply room. Her day typically begins around 8:15 a.m. She starts by popping into the office to check the day’s schedule, collect and replenish supplies, and sign out medications for patients. As a Parkview hospice nurse, Tammy typically oversees 8-12 patients at any given time, visiting each home multiple times a week. However, if a patient’s condition worsens or they are close to passing, she will see them more frequently. “Each visit usually lasts 30-60 minutes, but if a patient or their family needs a little extra time that day, it’s okay,” she reassured. “We meet them where they are, walking alongside them offering comfort and support.”

hospice supplies

With our essentials in hand, we headed for Tammy’s car. As I slid into the front passenger seat and fastened my seatbelt, she gave me a quick rundown of the schedule, mentioning that we would be dropping in on five lovely characters throughout the day. 

Making the rounds

As we drove away from the office and ventured out on our first visit, I decided to dive right in and ask the question that had been weighing on my mind, “Tell me, Tammy, why did you become a hospice nurse?” She laughed and said, “Well, it might surprise you, but I wasn’t always a nurse. I spent the majority of my career in journalism, working at newspapers.” She went on to explain that she didn’t make the decision lightly, but after facing setbacks of her own, she had a moment of clarity about her life and how she wanted to live it.

“About 12 years ago, I experienced some health problems and had to go to the Cleveland Clinic for several surgeries and treatments. While I was there, I remember being so impressed with the nurses and aides,” she gushed. “Looking back, I don’t know that they did anything out of the ordinary, but in those moments when I felt so vulnerable, they were there comforting and supporting me. The entire experience got me thinking about my life and career. Plus, I saw the writing on the wall with the newspaper industry, and I thought I wouldn’t mind trying something within healthcare.”

With the wind at her back and determination in her heart, Tammy decided to go back to school and get her nursing degree. “It was definitely a challenge, especially because I had three school-aged children at the time,” Tammy recalled. “Honestly, going back to school after most of my professional career was in a different field was scary, but so worth it. I wouldn’t change a thing.”

Tammy has been a nurse for the past four years. “I worked for about a year in a hospital, as a bedside nurse within the heart failure unit,” she said. “I liked what I did, but I didn’t get to build relationships like I wanted to. There just wasn’t enough time.” Then, with a year of experience under her belt, she found her stride with Parkview’s Hospice team, which is where she’s been for the past three years.

Knowing that hospice can be emotionally taxing and requires a delicate touch, I wondered if Tammy’s interest in the field had always been there. Reading my mind, she continued, “It might be hard to believe, but I’ve always been interested in hospice. I loved the idea of getting to know my patients and their families. But, before I could jump in, I knew I needed more experience and would have to start in a hospital setting. But my end goal was always hospice.”

We eventually arrived at the medical facility where Tammy’s first patient was staying. The beautiful brick building was filled with natural sunlight. We signed in and underwent a quick temperature check. Once we were both cleared, we secured our stick-on visitor name tags to our shirts and made our way to the patient’s room. Tammy stopped to coordinate with the facility nurse, comparing notes, checking medications, and sharing any pertinent information about the patient’s current condition.

hospice chatting with nurse

As she finished her conversation, with her ever-present calm and easygoing demeanor, we arrived at the patient’s door. As we stepped into the bright room filled with the patient’s original artwork, I wondered about the life this person must have led. I imagined all the beautiful things they saw, the fantastic places they must have traveled, and the experiences they had to elicit such extraordinary creations. As my mind wandered and I reflected on my own story in comparison, Tammy didn’t hesitate to pick the conversation up right where they’d left off from the last visit. They joked, laughed and discussed their favorite treats from Trader Joe’s. That’s when I chimed in, professing my adoration for the chocolate almond biscotti. Tammy concurred and continued conversing while moving about the room effortlessly. She asked, “How are you feeling today?” while simultaneously checking the patient’s vitals, asking them to rate their pain level, changing bandages and dressings, and assessing their overall well-being. After a few more minutes of reminiscent talk of loved ones and favorite tv shows, it was time to leave.

We checked out at the front desk and returned to Tammy’s car. That’s when she turned to me with apologetic eyes and humorously stated, “Okay, this is the boring part. I usually take a few minutes to chart when I get back into the car following a visit.” I laughed, then informed her that no part of her job seemed dull. But I knew what she meant and granted her some well-deserved silence to collect her thoughts and document her tasks.

When she finished charting, and we began our trek toward the next patient’s home, I asked her what she liked most about her job. She smiled and took a moment to think. “I enjoy the people I work with and couldn’t ask for a better team. As far as going into a patient’s home, I love getting to know them and their families. Every patient has a story, and I love finding out what that story is.”

In a matter of minutes, we found ourselves in front of the next patient’s home. Tammy briefed me on the situation as we walked up the driveway. When I stepped inside, I was transported back to my grandparents’ house. From the crystal bowl on the side table cradling jewel-toned candies to the game shows playing on the television in the background. It was uncanny. I couldn’t help but remember the summers I spent with my grandmother before she passed, baking cookies and talking about the places we would visit when I got older.

The crinkling of paper on Tammy’s spiral-bound notepad brought me back to the present. I looked on as she quietly sat next to the patient, intently listening as they described how they were feeling and the side effects of a recent medication. Tammy jotted down what was working and what wasn’t, discussing the changes they could make in the meantime as long as it was what the patient wanted. Before we left, the patient’s nephew insisted on sharing one of their favorite recipes with us, swearing it was a must-try for dinner that night. This, I thought, is such a true illustration of the warm and welcome sharing that comes from being in a family’s home. Yes, Tammy was providing medical care in a comfortable setting, but she was also being incorporated into their routines, their relationships, their conversations. And sometimes that means swapping recipes.

hospice nurse car

As I climbed back into Tammy’s mobile office, it occurred to me that I’d heard her ask her patients the same question multiple times that morning. “What would you like to do?” The longer I thought about it, I realized I needed to shift my way of thinking toward Tammy’s patients. As a reasonably healthy individual, I’m used to finding the answer to my ailments with the help of my healthcare professionals. I make an appointment to discuss the issue, they prescribe a medication, therapy or treatment, and eventually, I’m back to my old self. But that’s not the case for individuals under Tammy’s care. The difference in hospice care, she shared, is that “it’s important for patients to understand that they are in control. Many are dealing with scenarios and situations that are so far from orderly; they need to know that they have a say and a way to bring order to their personal chaos.” That’s why Tammy and the hospice team are so important. They take the time to treat the whole person, providing relief from their symptoms while ensuring a comfortable and improved quality of life. It’s about supporting the patient where they are on their journey and showing them the beauty in the time they have left.

We had a little time before our last visit, so we opted for a quick bite to eat. Knowing we’ve all been through so much over the past two years, it only seemed fitting to ask Tammy how COVID has impacted the work they do. She shrugged and explained, “Yes, in some capacities, the pandemic has made our jobs a little more difficult. For example, because our work is relational and so much of what we do is conveyed through facial expression, wearing masks has complicated and slightly hindered that bonding process. It can be challenging for a patient when they can’t see our faces or that we are smiling or speaking to them.” But she was quick to add that they can still find ways to communicate with all patients despite the extra precautions.

With food in our bellies, Tammy had one more check-in to round out the day. As the wind picked up and the afternoon sun moved behind the clouds, we made our way up the front porch steps to the final patient on the schedule. As Tammy began her assessment, I observed, yet again, a shift in her demeanor. With all her patients, she tailors her approach to meet their individual needs and makes an effort to provide them with the mental, physical and emotional support they require.

With the final visit of our day together complete, I decided to pose one last question to Tammy, “What would you say to the family members currently walking alongside a loved one going through hospice?” Without hesitation, Tammy said, “Hospice can be heart-wrenching. It’s an emotionally charged and overwhelming time for patients and families, but as hard as it may seem in that moment when they look back, they will never regret the time they spent with their loved one.” It was so true. It’s human nature to get caught up in the moment and focus on how hectic things are, but the silver lining of impending loss is that it forces people to slow down and embrace the time their loved one has left.

hospice nurse walking

Saying goodbye

As we approached the parking lot where we’d part ways, I thought of Mary Poppins and how she said goodbye to the Banks family. She didn’t give a formal farewell. Instead, she looked on from afar, lovingly watching from a distance as the Banks family headed to the park to fly their kites and spend time together, which in the end they all realized, as did the viewers, is what’s most important.

Like the fictional character, or the warmth of the sun that day, Tammy and her fellow hospice team members’ time with a family is often brief, but beautiful. The gifts they can bring to a fragile time are magical in their own way. They devote their lives to helping people come to terms with a transition that feels unimaginable. They remind us that while sadness and heartache are a part of the hospice journey, so too are hope, love and joy.

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