Giving the biggest gift of all

Lourdes Guerra-Lines

Annmarie Duggan

In 2009, Lourdes was introduced to a new patient of ours through social worker Annmarie Duggan. The young woman, who was in her early 30’s, was in one of our inpatient care centers. She had been diagnosed with a terminal cancer. She had been in an area hospital for 100 days before she was admitted to our hospice program. As Lourdes met with her, she learned about her illness, her wishes and her family. Turns out, her family was in Mexico and the patient’s one wish was to get home to Mexico to be with her family. With no money and her current immigration status, it was not going to be easy. Lourdes and Annmarie, wanting to do all they could to make this wish come true, began working out a plan. They enlisted the help of many other Hospice of Palm Beach County staff members, a local church, the Mexican Embassy and Hospice of Palm Beach County Foundation. With all of the support, they finalized details of her plan to get home. They had nurses working to help her gain her strength, a Mexican hospital to care for her when she arrived, transportation to the hospital, medication to last for two weeks and her father to accompany her home. On the day the patient was scheduled to leave, her nurses ensured her bandages – from the previous surgeries she had – were changed and secured for the trip, changed her into loose fitting scrubs, and provided her with the equipment and supplies she would need. They explained to her father, in Spanish, the only language he spoke, how to change her dressings and administer her medications while Lourdes was arranging an ambulance transport to the airport. The patient landed in Mexico later that afternoon, 18 days after she began our hospice program, and was able to spend time in her country, with her family before she passed away.

Beleaguered Nurses Need Empowerment

As a nursing leader at a large health care organization, I feel the way to change the trend of Florida losing nurses to other states or other industries is to help nurses, whether at the bedside or in a management position, feel empowered to get involved in solving problems and creating solutions.

To combat the shortage and hold on to our nurses, we at Hospice of Palm Beach County have created ways to delegate the workload so it is even across the care team. Staff workgroups conduct SWOT (Strengths-Weaknesses-Opportunities-Threats) analysis and address problems identified by clinicians and patients. This has encourages our nurses to act and truly become leaders, which is especially important in a hospice setting where the role of the interdisciplinary team is essential to providing quality patient care. This "shared care" philosophy has maximized quality care and reduced work stress.

Our teams have embraced this new philosophy and it is making an incredible difference in promoting nurse and staff retention in the hospice industry. While factors such as competitive pay and manageable case loads are important, they are not the sole decision-makers for engaged nurses committed to providing quality patient care. We need to recognize the other factors and do what we can to hold on to these valuable professionals.

Jacqueline Lopez-Devine
Registered Nurse and Vice President of Patient Services
Hospice of Palm Beach County