In hospice, we often frame the end of life as a “journey,” a microcosmic narrative with recurring characters, ups and downs, days both good and bad, that ultimately declines into a final silence.
This framing helps patients and families better conceptualize the vagueness of the period before death and understand that, whether it’s traversed quickly or slowly, a path is laid out to an unavoidable destination—but it’s one that has been walked before, and it doesn’t need to be faced with terror or anguish. In fact, I’ve seen how these final months, weeks and days can be among the most powerful in the lives of both patients and loved ones.
For the nurses and other care providers on a hospice team, the job itself is another kind of journey. What starts with a spark of passion leads to the pursuit of education, then practice, then eventually integrating the end-of-life journeys of countless others into one’s own, larger mission of care.
For 35 years, my journey has been dedicated to the goal of changing the way the world lives and dies. While I initially carried out this personal mission as a nurse at a mom-and-pop hospice in South Florida, today I’m the executive vice president of the same hospice: VITAS Healthcare, now celebrating its 40th anniversary and solidly staked as the nation’s leading hospice provider, with 12,000 employees caring for nearly 18,000 patients in 47 hospice programs spread across 14 states and the District of Columbia.
My nursing journey with VITAS was spurred by end-of-life experiences that shaped my understanding of death and the impact that compassion can have on those nearing it.
My father died when I was seven years old, leaving behind my mother, my eight siblings and me. This was my first formative experience with death and grief, but it wasn’t the one that illuminated my calling for nursing. That notion blossomed after caring for my dying mother as a young adult. Leaving behind the business and banking career that I had pursued after high school, I attended Broward Community College, where I attained an associate degree in nursing and first learned about hospice.
In 1983, I joined the still-young VITAS as a nurse. On my first day on the job, I was faced with the reality that all hospice workers eventually confront: the death of my patient. I found myself staying late to comfort three generations of a grieving family, calling in a chaplain to offer whatever comfort was possible for the bereaved.
Since that first day, I’ve been enamored with and honored to be part of a system that guides patients and families through some of their most vulnerable, turbulent moments to better achieve a sense of peace and comfort at the end of life. I soon found that the impact of my care could extend beyond individual patients and their families, however.
In a few years, I was a member of VITAS clinical leadership, a role that enabled me to provide impactful care to disadvantaged communities on a broader scale, as well as influence the direction of the organization.
I helped create Vx, VITAS’ proprietary electronic medical records program. I encouraged the membership of the National Black Nurses Association to participate in the End-of-Life Nursing Education Consortium while challenging them to explore their career potential beyond the bedside. I also spearheaded an effort to address the unique concerns and health challenges that veterans face at the end of life, an initiative that continues to flourish today.
Being present is central to my personal philosophy, which means staying involved with my community at work and beyond. Today, I continue to remain active on a variety of boards and committees, including the National Alliance for Grieving Children, Community Health Accreditation Partner, and the Florida Hospice and Palliative Care Association.
No matter what I’m doing or to whom I’m speaking, my leadership is values-based. “Always make the ethical decision, and business will follow,” I told a new VITAS GM nearly 30 years ago. In 1993, I incorporated my personal creed—“patients and families come first”—into VITAS’ guiding values.
I’m blessed to be on a journey alongside a team that believes in the cause of hospice—and VITAS specifically—as thoroughly as I do. After walking this path for 35 years, I’m no less excited to find new and more effective ways to provide compassionate care for patients and families at the end of life than I was on the morning of my very first day of work.
