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Easing the Pain

Hospice Nurse Finds Positive Side to Working With the Terminally Ill


Carol McCormick spends her days with the dying. She listens to their complaints and fears, eases their pain and watches them die.

Occasionally she cries, but mostly McCormick finds the experience a testament to human nobility. She is a hospice nurse.

"You just see so many courageous things that people do, [and] I get to see people doing really good things for people," she said. "To me, it's not depressing at all."

She remembers the woman who left her home in Mexico to care for her dying sister. And the husband who helped his dying wife hold their 5-month-old twins in her weak arms. And the 69-year-old woman who endured great pain so she could keep painting until her final days.

Patients of the Livingston Memorial Visiting Nurse Assn. program, the Ventura hospice where McCormick works, have six months or less to live and have stopped seeking treatment for their diseases. This makes the role of the nurses particularly challenging, said Director Anne Moore.

"Most people become nurses because they want to help people. In hospice, we help people, but the difference is they don't get better. They die. You're always dealing with loss," Moore said.

Some people associate hospice care with giving up hope, but McCormick doesn't see it that way. It's just another chapter in life when it's particularly important to be comfortable, retain your dignity and continue doing what you enjoy, she said.

"[We're] not focusing on the dying. [We're] focusing on making this part of their living the best," said McCormick, who learned to accept death in a positive way after losing her father and sister 20 years ago and her mother six years ago.

McCormick, 50, of Ojai has been a nurse for 17 years, but began working in hospice care five years ago. After 12 years as a manager in a hospital, McCormick said, she became frustrated by the focus on making money that limited the time she could spend with patients. She decided to work instead for a nonprofit agency and applied at Livingston.

Livingston was founded in 1947 to provide in-home care to the sick and frail in Ventura County. It now provides numerous services, ranging from physical therapy for rehabilitation patients to support groups for children facing the loss of a family member. The hospice program, which became Medicare-certified in 1987, provides physical, emotional and spiritual help for about 500 terminally ill patients and their families through a team of nurses, home health aides, volunteers and a chaplain.

McCormick, the mother of four and grandmother of four, said the emphasis at Livingston--where patients pay on a sliding scale based on what they can afford--is not on money, but on patient care. She earns $40,000 a year working a reduced schedule of four days a week and serves eight to 10 patients at a time. She can give them all the attention, medication and equipment she feels they need, whether they live in a trailer or a mansion, she said.

One recent morning, McCormick drove to the homey Ventura beach cottage of Patricia Tavernelli, whom she has been visiting since May. It was too hot for McCormick to wear her regulation white coat over a blue sweater and white pants. She pulled a backpack loaded with medical supplies and a briefcase filled with papers from her trunk.

She found Tavernelli, 69, painting small wooden birds at a table in the craft room at the front of her house.

Cancer had spread throughout Tavernelli's body, leaving painful tumors everywhere. She sat in a wheelchair, having lost one leg to the disease. Breathing was a struggle and tubes carried oxygen to her nose.

Tavernelli was willing to tolerate more pain than many patients so she can be alert enough to continue her crafts, which had been selling. On a scale of 1 to 5, with 5 being the worst, Tavernelli can withstand what she considers level 2 or 3 pain, McCormick said. She refused pain killers that would diminish her ability to paint.

"Everybody has to go through this in their own way, and I'm there to support them in it," McCormick said.

The veteran nurse is particularly skilled at this part of her job, Moore said.

"She accepts patients for who and how they are, and she doesn't judge them, but helps them go where they want to go within their abilities," Moore said.

McCormick sat down and discussed Tavernelli's breathing, fatigue level and new sores. Then she took her patient's blood pressure.

With the medical portion of the visit out of the way, McCormick leaned her tanned face close to Tavernelli's and the two talked softly about Tavernelli's crafts and how much better Tavernelli feels when she can get out of bed and work on them.

McCormick picked up a quilt hanging over a rocking chair and asked about it. Tavernelli explained that each of the women in her quilting group made her a square when she had her leg amputated and she sewed them together.

McCormick considers listening to such stories as important as any of her medical duties. Listening is the aspect of the job she enjoys most.

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