Hospice of the Red River Valley has fulfilled a vital need for dignified, compassionate end-of-life care since its inception 30 years ago. Today, Hospice continues to fulfill the mission to provide comfort at the end of life’s journey.

Several staff members have served the organization since its earliest years. Together, Wanda Poehls, Mary Lou Dahms, Joan Routson, June Anderson and Rebecca Holte reflect on the changes along the way and the memories they’ve shared as Hospice of the Red River Valley established a reputation for excellence.

“When I started 25 years ago, Hospice was located in the basement of Lutheran Social Services of Fargo,” Wanda says. Now, as director of administrative services, Wanda recalls she did a bit of everything when she started as an office assistant, including billing, medical records, newsletter and even public speaking.

In those days, desks were a luxury. “We shared desks; we just found one that was unoccupied when we were in the office,” June recalls. June began working at Hospice as a concentrated care nurse and eventually moved into a staff nurse position when our patient numbers increased.

Mary Lou, director of marketing and public relations, shares similar recollections; she remembers when she started as the development assistant and her first office was a closet space that housed other office equipment. June adds, “We didn’t even have our own phones. Today, we each have our own laptops and cell phones with us at all times!” Hospice of the Red River Valley is now in its third building location in Fargo, since its location at Lutheran Social Services.

As Hospice began in the Fargo area, marketing, building maintenance, human resources and patient care were all part of one department. Today, these disciplines are their own departments. Similarly, staff members often held many responsibilities. Rebecca, who started as an accountant and is now Hospice’s controller, remembers, “We really had to do a variety of jobs; we just had to figure out how to do things as they came along, no matter our area of expertise because we didn’t always have staff available.” As Hospice grew, so did the job focus and levels of sophistication.

All agree, technology has driven the greatest change in the organization. Joan and June remember when all patient documentation and charting were hand-written and stored in one binder. Staff schedules were posted on a board in the office; if someone needed to reach a nurse, they would have to call the patients’ homes to track staff down.

Now, staff members chart on laptops. “As part of the personal care staff, I used to document all my information from a patient visit on a single sheet that was turned in at the end of the week. If my patient was in a nursing home, I would just let the nurse know about my visit when I was done. Now, nursing homes have access to all of our visit records for their residents,” Joan shares.

Technology has also changed the way we educate the public and share information. “We no longer rely on public service announcements on television, radio or brochures to get the word out about hospice care. Today, we are in our fourth version of our website. People can seek out information day or night through our website, Facebook, Twitter and our blog.” Mary Lou says.

In the early years, we served only five counties. Now, our service area spans 29 counties in North Dakota and Minnesota. The use of technology has enhanced communication and connectedness between the organization’s seven locations. Phone and videoconferencing enables staff to join in meetings and discussions wherever they are physically located.

Originally, Hospice of the Red River Valley cared for very few patients in nursing homes. Today, Hospice provides services in nearly 115 nursing homes and assisted living facilities. This territory is huge and the number of staff needed is tremendous.

As the organization evolved, more and more people benefitted from hospice services, specifically in rural areas. However, the years have also brought new challenges. Rules and regulations have tightened their grip, and cost of operations has continued to increase.

Amid tremendous growth and change, Hospice of the Red River Valley remains committed to its mission and recognizes there is still work to be done. “Often, we find people still don’t really have a grasp on the mission of Hospice, despite our 30-year history,” Rebecca says.

Wanda agrees, “We would like to see patients much sooner than when they are close to death, in order to also help families and loved ones. There is still need for some improvement in education.”

Mary Lou is optimistic, “I think far more people know about hospice, but still believe our mission is very limited. At least we are more open about death and dying as a part of the life process.”

When Joan and June started their careers at Hospice, they remember many physicians would only refer patients to hospice at the very end of life, in the last hours. They both agree it has taken immense teaching to get patients admitted sooner, allowing Hospice to better manage symptoms and improve quality of life for patients. “We have also worked hard to educate people that we serve more than just cancer patients,” says Joan. “We see a lot of people in nursing homes now with many different diagnoses.”

Throughout the years, all have developed fond memories; specifically, all spoke of the camaraderie among staff. “We have an ‘I love my job’ attitude which fosters great teamwork,” Wanda shares.

“It’s nice to know you are not alone in helping the patient. There is a team of people, including social workers, CNAs, chaplains, nurses, physicians and grief specialists, all working together to offer better support to patients and families,” June says.

Often, staff members are approached by people who assume working in hospice care must be depressing, sad or morbid. People just don’t want to think about dying as part of daily work and life. “I tell them, hospice care gives its own rewards. To see that I have helped someone who is dying be comfortable and in the place he or she wants to be is truly special,” June adds.

“My pastor once told me I would never have a more rewarding job,” Mary Lou shares. “He was right. Families will tell me Hospice helped during such a precious time in their lives and they could not have done it without our help.”

Joan explains, “We try to make life the best it can be at the end, and sometimes it’s the little things we do that help the most. I always look for the smile or the one little sound from a dementia patient and that makes it worth it. We welcome babies into this world with open arms, why shouldn’t we also be there in the end?”