Hospice Nurse Reflects on Many Years of Providing Comfort, Compassion & Education  

Kristina DatheFor the past 15 years, Kristina Dathe has provided education, comfort and compassion to her patients as a nurse with Hospice of the Red River Valley. In this time, she’s cared for hundreds of patients in our communities. She explained that she has learned so much from those she’s cared for throughout the years.

“Working at Hospice of the Red River Valley has made me value the little things in life. You meet so many people who have such a great perspective. Many of my patients have lived long lives, much longer than I have. They have a lot more knowledge than I do,” Kristina shared. “It has made me appreciate life’s lessons more. Working here has made me enjoy what I have, while I have it.”

Kristina shares more about her background and passion for working in hospice care:

Tell us about your background and what brought you to hospice care.
I started working as a medical assistant at a podiatry office. I had no health care background and they said they would train me. I decided I liked health care and went back to school. I first became a licensed practical nurse (LPN) and worked for a year and then became a registered nurse (RN).

When I was in nursing school, someone spoke to us about hospice care. I found myself very drawn to it after listening to her. I was older when I was in school, in my 30s. As a new nurse, I felt I needed some experience to work at Hospice so I worked as an LPN for a year while I completed my RN education. After getting my RN, my husband was going to be deployed overseas and would be gone for 1-2 years. One day, I was watching my son at a game in town and someone who worked at Hospice of the Red River Valley was sitting next to me and we got to talking. I told them I was interested, and I applied. My husband got on the bus to go to training before being deployed, and I started with Hospice of the Red River Valley the following Monday. My kids grew up with me being a hospice nurse. I’ve now been here for about 15 years.

How does working here change your perspective on life?
I have learned so much about living from our hospice patients and their families. I recall one patient I cared for was a gentleman who was in his late 60s. He and his wife were talking about how they never took vacations during their working years because they had this grand plan of what they were going to do after retirement—go south for winters and travel to other places. He was diagnosed around the time he retired, so instead of vacationing and traveling they bought a modified van to fit a wheelchair, but by the time they got that they couldn’t use it. They didn’t get to do any of the things they had planned. They told me, ‘Don’t wait until tomorrow. You don’t know what tomorrow brings and nothing is guaranteed.’ My husband is a “some day” guy and I’m a “do it now” kind of person.

I tell my patients if you are having your best day and I’m scheduled to come see you, I hope you call and cancel my visit so you can spend it doing what you love or spending it with your family. I want them to enjoy the days and months they have left the best way possible. Don’t spend your best day waiting for me.

When you are sick, you get into habits—go to doctor appointments, do more tests and lab work, eat this and don’t eat that, take these pills, get more exercise, etc. After awhile and when you are at the end stages of a chronic illness, you have so many people helping you make decisions that it can seem like people forget to ask you, what do you want? How do you want to spend your time? If those tests and doctor appointments really aren’t helping anymore, then what do you want out of your time you have left?

How do you help patients prioritize all of the things that they want to do?
First, I try to provide education. Your doctor is there to cure or fix whatever problem you may have, and sometimes it’s really difficult for them to step back and say they can no longer fix the problem. It’s not easy to tell people that their illness can’t be fixed and share other options. But it’s so important to tell people what the options are and what the results of each option might look like. Which options will result in more tests, hospital stays, side effects, etc. Will the options enhance the quality of your life?

I had a conversation with a lady I was caring for who lived in a facility and I was talking to her about hospice care and what it can do and what does it mean. The entire time, the only question she asked me was if she could have some of the good water out of the faucet. She was on thickened liquids because of aspirating, and she was wheelchair bound. She hated the thickened liquids. Water from the faucet was all she wanted. I talked to the family about it and explained that she was still at risk of aspirating and developing pneumonia but obviously this was the most important thing to her because she hated the thickened liquids and wasn’t drinking. The family decided to take the risk and that lady was so happy. I honestly think she lived longer because she was happier and drinking more and taking in more nutrition. After she passed the family sent me a really nice letter stating how something so simple was missed, and they didn’t think to ask.

You often hear there is nothing more that can be done, but that doesn’t mean there isn’t more to do. Education is a big part of what I do as a hospice nurse.

Secondly, I ask my patients questions. What do you want? Then I advocate for patients and families because sometimes you are their voice. They deserve to have the things that they want no matter how simple. I tell patients, ‘You are the boss. I will tell you what I know and what your options are, but you are the boss. Nobody has to do anything. You decide what you want to give up or gain. By doing nothing, sometimes you gain more.’ A statistic from some years back compared those patients on hospice care versus those not on hospice and the hospice patients lived 11 days longer than individuals not on hospice. Research continues to show that people tend to live longer on hospice. Often, the interventions do more harm than good so people on hospice can potentially have extra time that is more comfortable, peaceful and meaningful. They can do the things they want to do.

I cared for a lady in her late 80s who lived in her apartment by herself and functioned on her own. Her family wanted her to move to a facility, but she liked where she was and didn’t want to leave. She didn’t want anyone cramping her style. Her family was scared about her falling. She was not and was willing to take the risk to stay in her home.

I always tell people that the sooner someone starts on hospice the sooner we can find out what their goals are and start working to help them reach the goals. We help honor their wishes.

What’s the best part about your job?
The best part of my job is making someone’s life better. That’s the very best. The lady who wanted to have the good water from the faucet probably would not have gotten it had we not been there. It made her life so much better and happier. It was so simple, but it made her feel so much better, and it helped the family to see her feel better. I always tell my kids if I’m living my last year, months, weeks or days, let me eat and drink what I want. The damage is done. Let me do what I want to do.

Talk to us about the role as a hospice nurse and as a community relations specialist and how these roles work together.
The role of the nurse is so many things. Our patients see their assigned staff nurse every week for a  full assessment, to monitor symptoms and make sure patients’ needs are met to their satisfaction. We assure comfort, order medications, supplies, equipment, and anything else the patient needs. On-call nurses are there for the patient any time of the day or night to help the patient and help the family take care of the patient.

Community relations is newer to me. Education has always been a part of my job, but now as I work in community relations, I educate not only my patients but also our communities, hospitals and nursing homes as requested or desired. I talk to providers and the general public. I make sure we are collaborating with primary care physicians, so we are all kept in the loop and providing good continuity of care for our shared patients. In community relations, we get the word out about Hospice of the Red River Valley and hospice care. A lot of the people who need our services don’t know how we can help or what we can do.

Why do you think people are hesitant to contact Hospice for support, or wait until the last days?
I think when people sign up for hospice, they believe they are signing up for death and that is not the case. You are signing up to live your life the best you can during those last stages.

I’ve had some interesting personal experiences with hospice care recently. My grandma was on hospice care, my father-in-law recently passed away on hospice around Thanksgiving, and my mother-in-law is now on hospice. She’s had chronic health issues for quite some time. Last summer she had some health changes and became eligible to use her hospice benefit. Being the daughter-in-law, I didn’t want to be pushy.

My husband asked about it. I told him and his sister that she is eligible and talked through it said that we have this benefit that could provide a lot of support for everyone right now. Whether we choose to use it or not, the end result is going to be the same so why wouldn’t we use it? Hospice care has been a Godsend for her. She has aides coming in to do some restorative exercises, help her with showers and help her with meals. She has a hospital bed that she can raise and lower to her needs. Without that, she would not be able to get in and out of bed by herself. Her goal is to get well enough to go off hospice care someday, and maybe she will.

My father-in-law started on hospice last April. He had a lot going on with his health and he was able to stay on the farm all summer and still mow the grass, which he loved to do. He was living his best life. He cared about his lawn and had been taking care of it for many years. He really enjoyed being on the mower. They moved to an assisted living in October and with hospice, he was able to stay there until he passed; we didn’t have to move him again. With hospice, we were allowed us to come in and stay in the apartment with him. They allowed all of us to be with him.

Complete this sentence – Hospice is…
Hospice is a lot of things. Hospice is love. Hospice is allowing people to live their life in the way they want to, right up until the end. Hospice is a lot of moments. Hospice is honoring people’s wishes by allowing them to live their life the way they want to. People’s goals change over time. When you are at the end of your life sometimes your goals are simpler—spending time with kids or grandkids, meeting a new great grandchild, renewing your vows, etc. We’ve had patients go fishing one last time or get their whole family together again. These are meaningful moments and hospice helps them enjoy those moments.

Why do you choose to work with Hospice of the Red River Valley?
There’s been a lot of changes in the past 15 years, but one thing has never changed. When I’m not sure what to do, the answer to most of my questions has always been: take care of the patient. I’ve always taken care of the patient first. As long as that is the theme at Hospice of the Red River Valley, then I’m in the right place. It’s what is most important to me, our patients.

About Hospice of the Red River Valley
In 1981, Hospice of the Red River Valley was founded on the fundamental belief that everyone deserves access to high-quality end-of-life care. We fulfill our nonprofit mission by providing medical, emotional, personal and spiritual care, as well as grief support to our patients, their families and caregivers during a tender time in life. Our staff helps those we serve experience more meaningful moments through exceptional hospice care, 24 hours a day, 365 days a year, wherever a patient calls home. Spread across more than 40,000 square miles in North Dakota and Minnesota, Hospice of the Red River Valley offers round-the-clock availability via phone, prompt response times and same-day admissions, including evenings, weekends and holidays. Contact us anytime at 800-237-4629 or hrrv.org.

 

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