Caring for someone with cancer takes an enormous amount of patience and compassion, traits that phlebotomist Elizabeth Atwell has learned to master over her 29 years of working in the medical field.
Atwell has seen her fair share of pain, worry and despondence in both cancer patients and their families, so she aims to make her work at the Promise House hospice in Santa Cruz as meaningful as possible.
“My day at the hospice can sometimes be challenging because every case is different. But because of how beautiful and well-equipped it is, I think it’s somewhere where somebody would always want to rest in peace,” Atwell told Guardian Media.
Nestled in the lush, peaceful valley, Promise House houses a paediatric cancer care facility, an adult cancer hospice, and a home for the aged, all on the same compound. Both cancer care facilities are free to anyone in need of the services, and residents at the home for the aged pay a subsidised fee.
The NGO’s chairperson Dr Jaqueline Sabga describes the facility as “an ecosystem of love”.
The hospice can house a maximum of five patients and Atwell explained that unlike a regular medical facility, there is no hectic inflow of patients on a daily basis. But, she said, staff has to be continually attentive because a patient’s status can change in mere seconds. That’s why her 12-hour shifts always begin with a careful assessment of the needs of the patient, which guides how she treats them.
“So, for example, a non-oxygen dependent patient could slip into oxygen dependent mode within a very short space of time, and I would have to quickly make the switch. Or they may be moving around on their own, and in a couple of minutes they may need assistance to move around. We always have to be very vigilant.”
A top priority, she said, is to keep patients as comfortable as possible, and that could frequently mean sitting and talking with them, reading to them, or hugging them so they could feel the warmth of another human touch.
“We let them know that we feel whatever they are feeling.”
Another priority, she outlined, is making sure each staff member is very familiar with each case so that handovers can be smooth.
“All of us work together with one goal in mind: to help the patient’s last days to be as comfortable as possible.”
Atwell said she has done palliative care on a one-on-one basis, but although her work at Promise House is on a larger scale, she feels right at home doing it because she has the experience and the fundamental elements remain the same.
“To me the only thing that is different is that working on a broader scale like this, I am using a lot more modern equipment. But otherwise, it’s like a normal day for me.”
And just as the patients put their trust in their caregivers at the hospice, their families too place their trust in the capabilities of the doctors and nurses who work there.
“So our loyalties as caregivers lie with both the patients and their families.”
That time is usually a confusing time for families, and Atwell said sometimes they even expect the hospice staff to think for them.
“We are always happy to guide and assist them as much as we can. I usually have long conversations with the family; explaining to them what they should expect. You know, trying to make things very easy for them.”
And when families come to visit the patients, they are given their space to connect in whatever way they need to.
“At the end of the day, we have to make sure that they have ample time with their families. But of course sometimes we have to also let them know, ‘okay, the person would want to take a rest now.’ Sometimes their biggest fear is that the person might want to rest eternally.”
Atwell said while that is a difficult conversation to have, family members have to be made aware that their loved ones are at the hospice for end-of-life care, a fact that they have to accept at some point.
“These are some of the things we as caregivers have to talk about. We try to keep them assured that everything is going to be all right with their loved one; that when they go, it will be in a peaceful manner…The atmosphere here is very calming; like a dream come true. It’s a place where you come in, get comfortable, and rest to die. That’s the intention.”
