Woo-hooo! School’s finally out for the summer! I just finished my five-week summer course this morning (one of two — the other one wrapped two weeks ago), and just in time for the official arrival of summer. Now I feel like I can really give everything I’ve got to my summer externship! I can’t believe that a year from now — with a little luck — I will be prepping for the NCLEX!

I am loving my summer externship. Loving. It. Like giddy one minute, emotional with tears welling up in my eyes the next. I’m at a mid-sized hospital on an ICU and I’m seeing and experiencing things that are blowing my mind. I’m only four shifts in, and I’m wondering if maybe this was a “meant to be” sort of a thing. I’ve gotta say, I’m feeling a sort of pull in the direction of hospice care! And to think I was upset that I got placed on an ICU instead of MCH or the NICU like I wanted. (I got over that pretty fast — as a wise elder family member reminded me, there’s no reason ICU can’t later translate to a Peds ICU or NICU.)

Strangely enough, most of my most memorable and moving experiences thus far have dealt with death in several ways. In the first two shifts I worked, three different families made the noble decision to bring their terminally ill relatives home to die with dignity under the loving care of hospice nurses. I asked the nurses on the unit if this was the norm. It seemed like a lot to me. I worked on this unit in another capacity before the externship and couldn’t remember ever seeing one single family make this decision. Usually, they all want everything to be done for their loved one, often ignoring the wishes of the patient.

Anyway, one of these three cases was “my” patient (not really mine since I can’t sign RN yet, but you get the idea). He was a 70 year old man with end stage renal disease among a whole host of other problems (morbid obesity, diabetes, etc.) We were told that he was admitted because he’d gotten an infection in dialysis. His condition was grave when he was admitted to the unit. His lovely wife was enraged and kept saying, “I blame the dialysis for this!”

His wife and daughters were beautiful souls, forced with making the agonizing decision as to what to do with the rest of this man’s life. The wife was adamant that he would not be going back to dialysis. He told her so before he slipped into a semi-comatose state. We explained that we totally respected their decision, but wanted to make sure they understood that he would not live without dialysis. My preceptor was so awesome talking to this family, despite the language barrier.

The wife and daughters waffled. They had a lot of questions about what he would feel if they allowed him to pass peacefully. They wanted to know if he could stay in our unit with us. When we explained the differences between an ICU and hospice unit, they understood. We talked about placement at an inpatient hospice, or sending him home with ’round the clock care.

In the end, after many tears and a lot of soul searching, they decided to bring this man home to die. They wanted him home for Father’s Day (this was the day before Father’s Day). I’ll never forget them. That Saturday while we made hospice arrangements, and while the family waited for a bed and supplies to be delivered to the home, lots and lots and lots of family came to be with the patient and his family. And the only word I can fathom to describe that entire day was beautiful. It was simply beautiful.

Devoutly religious, much of the day was spent around this man’s bedside, 5 to 10 people at any given time. They held hands and recited prayers in Spanish. They chanted. They placed a rosary across his body. The women wailed. And they sang. These beautiful, hauntingly peaceful hymns, also in Spanish. At one point, a male family member arrived. He hesitated outside the door while they were singing inside. I’d parked myself at a computer terminal right outside the room so I could hear the beautiful songs and chants. He looked at me and said, “I’m afraid to go in there,” (you could hear women crying softly, and some crying not so softly.) I said, “I can certainly understand that, but it’s kind of beautiful in a way, don’t you think?” And a peaceful look came over his face and he said simply, “Thank you,” and went into the room.

Around 4:30 that afternoon, the ambulance arrived to transport the man home. I wanted to go with them. The wife and daughters cried and hugged us and thanked us, and at the end of my shift that evening, I went home with a heavy, but happy, heart.

Thus began my internal exploration of a career in hospice nursing. It’s not a glamorous, intense, fast-paced, adrenaline-generating specialty, to be sure. But in my eyes, it’s a wholly worthy one. Definitely worth some further investigation.