SOURCE: The Post and Courier
AUTHOR: Jerrel Floyd
MUSC Unit Nurse Manager Carrie Moore, (left) and Registered Nurse Amanda Sawicki in MUSC Ashely River Tower waiting room. The two nurses were a part of the unit that organized a commitment ceremony for patient Eric Mason and his girlfriend, Justice Dunlap. MUSC/provided
Kaitlin Hall had only a few hours to get a special cake for a lymphoma patient’s commitment ceremony. Thankfully for her, a Publix worker named Joy was able to finish it in four hours.
“It was crazy how it came together,” said Hall, a registered nurse with the Medical University of South Carolina.
Work like this isn’t something that is taught in nursing school. There aren’t classes on organizing a baptism for a patient or final moments with a pet dog. And planning a commitment ceremony for a 19-year-old patient and his girlfriend isn’t taught, or paid for.
“It’s things we do every day,” said Carrie Moore, the unit nurse manager of the Hematologic Oncologic Protective Environment at MUSC.
Roper St. Francis Hospital Oncology Nurse Linda Moeller said, “Most people think that we just pass out medication.”
Making it real
A few weeks ago, some MUSC oncology nurses and staff put together a special commitment ceremony for Eric Mason and his 18-year-old girlfriend Justice Dunlap.
At the time, Mason was battling aggressive lymphoma. Prior to the event, he and Dunlap had already been talking about the chance of doing something like a commitment ceremony.
The couple had been together more than two years. Last summer, they talked about officially doing a ceremony. When Mason knew he didn’t have long to live, the nursing staff put together a ceremony in 24 hours.
“I think if you talk to any oncology nurse, they’re gonna have stories like this,” Moore said.
In 2014, the South Carolina Area Health Education Consortium reported that there were nearly 40,000 registered nurses in South Carolina. With oncology there is also an expected increase in need. A study by the National Cancer institute predicts an over 50 percent increase in U.S. cancer patients between 2005 and 2020.
With that population increase also comes the increased need for trained cancer staff. This includes registered nurses.
“These nurses have a specialized expertise,” Moore said.
Traditionally, nurses are the glue between doctors and patients so they are incredibly knowledgeable, she said.
But on the cancer floor, most nurses have accepted the harsh reality of routinely seeing patients on their deathbeds. This requires them to not only have the medical knowledge but also a high level of compassion and resilience.
Whether its administering transfusions or chemotherapy, the position doesn’t lend itself to seeing patients and families at their best.
“It’s not for everyone,” said Chelsea Richardson, a clinical practice nurse expert at MUSC.
In her experience, most nurses know immediately if they can handle the emotional intensity that comes with the job.
Moeller said for her, the hardest time is usually when they lose younger patients at Roper. It can be hard to speak with a family after losing a young life, she said.
“We actually kind of take care of the family members, too,” she said.
Dr. Margaret MacDowell, a radiation oncologist at Trident Medical Center said, “It is unlike any other nursing specialty and requires a unique individual who clinically and intuitively anticipates the needs of their patient.”
At MUSC, Moore explained that the staff sees themselves as a family. And they try to invite patients into that family when the come into their unit. So when some of the patients don’t make it, it can sometimes feel like a personal death.
“I don’t think you’ll ever forget your first patient loss,” Moore said.
“We do hard things here, but we can do hard things because we’re a family.”
In this year alone, there have been more than 10,000 estimated cancer deaths in South Carolina according to the American Cancer Society. The society estimates more than 300 deaths were from non-Hodgkin lymphoma.
The ceremony
Moore and her unit focus significantly on conditions related to blood, including lymphoma. For them, they see a lot of patients who come in for bone-marrow transplants. One of those patients was Mason.
He had spent a year with the staff treating his lymphoma. After relapsing following a stem cell transplant, his time grew short.
Though there are some successes, there are the losses. For those losses that are particularly challenging, Moore said, they try to come together as a staff to talk. For most nurses, the coping mechanisms are individualized. But there are some things they all connect on.
“We often focus on our memories,” said Jessica Shaw, registered nurse and clinical staff leader at MUSC.
Though Mason lost his health battle three days after the ceremony, the staff remembers his excitement for the event. The night before, Mason apparently stayed up all night.
“Eric had already invited everyone,” Moore said. “I’m Googling wedding essential playlists.”
The nurses were able to get a bouquet of flowers from the MUSC Urban farm as well as provide decorations and a cake for the young couple. The ceremony took place in the lobby overlooking the harbor.
Mason and Dunlap’s favorite song, “Slow Dancing in a Burning Room” by John Mayer, was played during the ceremony.
“It was amazing how much they did,” Dunlap said.
Of the ceremony, Dunlap said she remembers all the nurses who came to the event. There were even some that came on their day off to support the couple.
“To hear Justice say it was perfect, that’s all I need,” Moore said.
Hannah Coyne, a chaplain with MUSC’s palliative care program, was amazed to see what the staff had put together.
“Give nurses their kudos,” she said. “They are the frontline of health care.”
Nurses explain that their job requires not only a lot of compassion but intelligence as well. Throughout their shifts they are communicating with both patients and doctors.
The nurses help give their patients the information they need to make informed choices about their care, said Patrick Downes, CEO of East Cooper Medical Center in a statement.
The Department of Health and Human Services predicts that South Carolina will see a heavy shortage of nurses by 2030 . Even with the shortage, nurses still plan events like birthday celebrations and transplant anniversaries.
Besides Mason’s commitment ceremony, the staff has done full wedding ceremonies as well. They do this all while fulfilling their primary goal of being a health provider.
“We try to do little things,” Moore said.
Reach Jerrel Floyd at 843-937-5558. Follow him on Twitter @jfloyd134.