Although she was born and raised in England, Moyra Molina, RN, was American at heart from childhood. She said, “My father was American and my mother British, but my father died when I was a baby. I had this obsession about the fact that I should have been raised in America. So I pestered my mom all of my childhood about this, and at the age of 17, she finally agreed to sign for me to join the U.S. Air Force.”
Molina served for 25 years. Along the way, she married and raised three sons. Also along the way, she realized a new obsession to launch a career as a nurse.
“My interest in nursing began when I had my first son. He was born premature and was placed in a neonatal unit for a month. During that time, I was amazed at how these nurses were not only taking such wonderful care of him, but also of me. They were so kind and compassionate. They understood how frightened I was without me saying a word about it. I remember thinking if I was a nurse, that’s how I’d be. The seed was planted. Life and more children came along, and it was 13 years later that I finally started nursing school.”
Molina believes the timing was perfect; she knew then that her primary interest would be working with older and seriously ill individuals nearing the end of life. After earning her degree and gaining valuable experience at the Intermediate Care Unit at Kent General, Molina was hired as a hospice nurse with Delaware Hospice in 2008.
One patient motivated her decision to contact Delaware Hospice. She said, “This patient was in and out of the hospital repeatedly. Clearly, his illness was not something that could be fixed. We were bringing him in, patching him up, to just go home for a few days and then return. No one was having the conversation with this patient or family about other options. That weighed on me. I also realized that I personally was having issues with how task-driven nursing had become in facilities. There was no time to actually be with a patient.”
Delivering care in the home isn’t always an easy change for nurses coming from the controlled environments of hospitals. Molina felt comfortable from the start. “As a hospice nurse, you never know what type of environment or situation you’re walking into. It’s always an adventure!”
A hospice nurse must be able to function in less-than-perfect conditions. Molina remembers a home where the patient smoked one cigarette after another. “That was one of his pleasures, and that’s what he did. He also had two little dogs. I don’t think I ever listened to his lungs or took his blood pressure when I didn’t have smoke in my face and both dogs on either my lap or his!”
She said some families collect things, which is always a great ice breaker. One might say, “I see you’re into ceramic dogs,” and then they’ll tell stories about their collection. When one provides care in the home, it’s easier to understand who the patient and family are and what’s important to them.
Finding homes in rural areas can be particularly challenging, and Molina remarked that if she had tried to do this before the era of GPS, it would not have been good!
On-call hospice nurses occasionally travel in the middle of the night to homes in rough neighborhoods or through blizzard conditions. Molina said, “What gets me through these uneasy feelings is to focus on the patient and family’s needs. For someone to call in the middle of the night, you know that they really need help. I feel compelled to get to them to relieve a symptom or simply to reassure them that they’re doing everything they need to do.”
In traditional nursing, there’s an emphasis on educating the patient and family about what to do and how to do it. “But in hospice,” Molina said, “You must do more listening. You must hear them first, because certain approaches won’t work with certain people. Patients and families coping with a serious illness are overwhelmed, upset, or even angry. You are the one who must adjust to where they are in order to find the best way to help this unique person and family.”
Molina feels hospice nursing is special because it transcends all things that make people different. “We have this thing in common - that I’m human and so are you. We have all experienced loss, and we will all face the end of life. We know that on this one level, we’re all similar, and this important connection allows us to be more helpful to them."
Molina visited patients occasionally at the Delaware Hospice Center and was struck by how calm and serene it was. "I offered to serve as a part-time nurse there, and found myself feeling very useful. I felt equipped and supportive for this inpatient level of care for patients with out-of-control symptoms,” she said. She transitioned from home care to the center, served for a year and a half as a team leader, and presently continues to serve patients and families there.
“People are so grateful for our care, but really, for me, I’m the grateful one," Molina said. "I believe that we are at our most content when we are giving of ourselves. Whatever I’ve been able to give to patients and their families has come back to me a hundredfold. It’s such a good feeling. Last night I spent half a shift with one family and a good portion of it with another patient who was by himself. We just talked and shared stories, and when I got home I thought, this job is so rewarding, it’s a wonder I get paid for it too!”
Molina concluded, “I feel so honored to be a Delaware Hospice nurse and to be entrusted with the care of these precious souls at this special time in their lives.”