This is a good story: http://thetimes-tribune.com/news/hos...#axzz19EDLw4gh

Ellen St. Ledger, R.N., heard the calling in 1998 as a beloved aunt faced the final days of her battle with a brain tumor.

Another nurse recommended hospice.

Although nursing was her profession, Ms. St. Ledger had never been in a hospice atmosphere. The experience was transformative.

"It was the first time I had seen her comfortable," said Ms. St. Ledger of the time her aunt spent at the VNA Hospice inpatient unit at Community Medical Center. "We only had two days here, but it was two beautiful days. Her pain was managed. The family was all around her. It was the best decision ever.

"That was the draw. When I saw that, I wanted to apply here. I felt like this is the kind of nursing I wanted to do."

In a world where dying is the ultimate fact of life, where the conclusion of one life opens a new chapter in the lives of those left behind, it often falls to hospice workers like Ms. St. Ledger to ease the pain of the passing for both patient and family.

It is work that requires compassion and patience, dedication and understanding, where the best possible clinical care for the patients is combined with emotional and spiritual support for their families. And it is a job that doesn't take a holiday.

Last week, as most people were planning their Christmas celebrations, the workers at VNA Hospice were painfully cognizant of the heightened emotions that surround the death of a loved one with an end-stage illness during what is supposed to be a time of comfort and joy.

In those circumstances, joy may be hard to come by, but certified nurse's aide Jim Polkowski said comfort is what they do.

"You are dealing with families whose emotions are raw," said Mr. Polkowski, who joined the unit two years ago. "For a lot of them, this is new ground. They are obviously distraught - someone they care dearly for, and who they would trade places with in a heartbeat, is leaving them. It's tough."

In December 2009, Paul Luers' wife of 46 years, Judith, was admitted to VNA Hospice shortly after being diagnosed with advanced cancer of the pancreas and liver. A devout Roman Catholic, she died nine days before Christmas.

In her final moments, Mr. Luers asked if he could lie in bed with her.

"She literally died in my arms," Mr. Luers, 75, recalled. "With my arms around her, I gave her a last kiss, that last, terrible kiss."

Before that experience, Mr. Luers said he thought hospice involved nothing more than "injecting painkillers into patients before they die." He never expected the level of genuine caring displayed by the hospice staff for both his wife and the family.

"Two words: comfort and dignity," he said.

Scranton resident Carol Triano, L.P.N., who like Ms. St. Ledger has been doing hospice work for 12 years, said she considers it a privilege to care for individuals at the end of their lives. The reward, she said, is knowing she provided "the utmost comfort and the best nursing care they probably will ever receive.

"A lot of times we get attached to the patients and to the families," she said. "They get to know us through the process they are going through. Even though it can be a short time, it happens."

Although it occupies part of the seventh floor at CMC, the VNA Hospice unit operates independent of the hospital.

There are nine beds in the unit, and lately most have been filled, Ms. St. Ledger said. Last Tuesday, seven beds were occupied; two of the patients were expected to go home, but two more were expected to arrive.

Whether patients transition home or remain in the unit, Ms. St. Ledger said the agency assumes responsibility for the medical side of their care, which takes pressure off family members.

"It gives the family a sense of relief," she said. "You can just be the wife, daughter, son or whatever, just be with them, be supportive in that way, sit by the bedside."

While they have a job to do, Ms. St. Ledger said hospice workers are also human, and their empathy is authentic. She admitted there are moments when her heart breaks, especially when caring for a terminally ill child or a parent with young children.

"I never want to become a stone. If I don't feel the passion, then I don't think I should be doing this," Ms. St. Ledger said.

"That is actually what keeps you doing it. You realize, in this world, we don't know what we'll be faced with, but we are all going to die, and whatever you can give to make it the best for the individual, for the family, that's what it's all about."

Each holiday season, VNA Hospice invites families of patients who have passed away to a memorial service, which it views as part of the healing process. But the unit also has an open-door policy, and family members are welcome to return at any time.

Mr. Luers has visited frequently in the past year. If the room where his wife died is occupied, he'll stand outside the door and say prayers for her.

"To me, it is a sacred place," he said.

Mr. Polkowski said everyone has coping mechanisms, even hospice workers. There are times, he said, when the work can be emotionally overwhelming, and he has to step away.

"It's like, OK, I have to step off the floor for a break - I need to do that," he said. "And you gather yourself. You take a deep breath and you dive back in."

As much as hospice care can be draining, Ms. St. Ledger said, it can also be fulfilling.

"You might have a day where you say, 'Oh, my goodness,' and then something beautiful will happen, and you're happy for where you are," she said.

"It's hard seeing sick people, but if you know you can do something to help that or alleviate some pain or maybe just talk to someone - help them out - I think that's a pretty good job, you know."