On my way home from work this evening, a white tailed deer ran across the road. Luckily, we didn’t collide. This beauty was just close enough for me to notice her in the dusk. According to “Animal Spirit Guides” by Steven D. Farmer, white tailed deer are about the rocky path behind you. “You’re entering into a time of plenty, but the path to get there has not been without sacrifices.” 

One year ago today, I had completed one week of orientation as a hospice nurse case manager at my new job. It has been a year of being cracked open, whipped around and cracked open some more. I have dived deep into my emotional self and learned that I am not crazy. I have been introduced to the notion that we are all entitled to our feelings no matter what they are and even if we can not identify them. I have taught some of my patients about that. What delicious relief when it sinks in.  

I have been pushed to be my best and have appreciated that in hindsight. When I took the job, I told my old friends that I was going to have to “step up my game.” I am grateful that I had the right kind of guidance to learn to meet those challenges. I won an award last month for showing extraordinary compassion to my patients and coworkers. It felt good to be recognized by people who do such amazing work themselves.

Last summer, I couldn’t wait until I understood more of the layers of hospice nursing. Learning about eligibility and what is covered by whom is a tangled mess for the new hospice nurse. Which medications are on our formulary and what does that have to do with coverage and relationship to primary diagnosis? The RN case manager has a major role in identifying eligibility and coverage.  

I even envied my mentors for simple things like knowing everyone in the agency by name and how to buzz up the back stairs in our affiliate hospital without reading all the signs. (I can almost always find my patient rooms on the first try now for the GIP hospice patients.)

I will soon get an opportunity to mentor a likeness of my former self. Our agency has hired a new nurse and I remember perfectly the things that were helpful to me. I can not wait to show her the strategies I have learned and been given along the way this year. Some are for patient care and many for self care. I remember exactly the points at which I was grateful that I stuck with it and the places I learned to rely on the team. Then and now, there are many, many times that I recognize the immense privilege of being part of a hospice team that works at our level and provides an experience to patients and families that preserves comfort and dignity at the end of this life.    

The deer also means that I am “…poised for an enticing adventure, one that will take you down many different paths and lead to many important insights.”

It’s been that already, of course, and it’s only been one year. This is an adventure that is new again and again. The many different paths are those to each patient’s home or that of his or her trajectory as well as my own winding path through the continuum of understanding.