Join us as we shine the spotlight on distinguished hospice and palliative care nurses!
Words of Wisdom
"I think the most common misconception about hospice is that people go there to die. The perception I would like people to have about hospice is that people come there to live their best life to the end".
- Debi Davin, BSN, RN, CHPN
with Julie Kesterson, MSN, RN, CHPN
Welcome to the first in a series of conversations with Bay Area distinguished hospice and palliative care nurses!
Our first guest is Debi Davin, founding member of San Francisco Bay Area Hospice & Palliative Nursing Association and inaugural recipient of our Champion of Nursing Award.
Debi began her career as a nurse in the US Army in Germany. After being discharged as a Major, she found success in medical sales, home health, case management, and hospice nursing. Since becoming certified in 2003, Debi has challenged status quo in hospice nursing and championed the integration of evidence-based practice. Through her company, Care At Life’s End, Debi successfully helped more than 1000 nurses prepare for hospice and palliative nursing certification. In 2011 she was HPNA’s Certified Hospice & Palliative Nurse of the year. In addition to clinical advocacy, Debi has been a prolific volunteer including nine medical mission trips abroad. Most recently she has been bringing joy and happiness to the eldery through song and dance with her husband, music therapist, Eddie Davin.
The conversation that follows has been edited for clarity and length.
J: You have quite the resume! What inspired you to become a nurse and how did you find your passion in hospice?
D: Growing up in the 1950s, my options were to be a secretary, nurse, or mother. My cousin, who lived next door, was a nurse and so from the age of seven, I knew I was going to be a nurse. When it came time for college, I had the option to do a two, three, or four year degree. Though the program was only three or four years old, I decided to go to Penn
State for my bachelor’s degree because I wanted to start from the top. After being approached by a recruiter on campus, my boyfriend and I decided to join the Army Student Nurse Program, which paid for our last two years of college in exchange for three years of service.
Being an Army Nurse changed my life. After only three months in Germany, the Director of Nursing saw potential in me and made me head nurse of two units, Male Medical and Hepatitis. That is how I became a nurse leader. After that, I said yes to every opportunity and let them place me wherever I was needed including an intensive care unit with multiple patients on ventilators. After the Army, my career continued to progress including several successful years in medical sales and then home health.
I found hospice while working in home health. My mother died in a car crash and not long after, I saw an article in the newspaper about bereavement classes at Hospice of Petaluma. At the time, I didn’t even know what the word bereavement meant but when I read the article I thought, “holy heck that’s me” and signed up for the classes. I became a hospice volunteer and at the same time, the agency I worked for started taking hospice patients and that's how I found my calling.
J: You’re a champion for hospice and palliative nursing certification, how did certification impact you?
D: Not long after my mother’s accident, I moved to Ohio and took a job for a small hospice that only had eight patients at a time. The case managers required that everyone be certified so I took the test in 2003. My life was never the same once I started studying for certification because I realized that in order to do my job best, I needed to know everything in the book. I realized that when you only do on-the-job training, you only learn from the people you’re with. If you never learn national standards, you won’t know if your practice is current or appropriate. I became passionate about getting others certified because I could immediately see how it helped me improve my practice. As just one example, we used to nebulize oral morphine if you can believe that!
J: Why do you think it's important for other nurses to become certified?
D: When you put this effort into your profession, you’re choosing to make national guidelines the pillars of your practice. HPNA’s job is to determine best practices based on evidence and to make their guidelines accessible to nurses across the nation.
J: Beyond certification, what else should nurses do to maintain up-to-date practice standards?
D: Though great, conferences and things like that can be very expensive when you add up registration fees, time off, travel costs, and accommodations. For that reason, I recommend starting with local chapter membership. We founded the chapter to make current education accessible and affordable. For us that means, helping nursing get certified and disseminating relevant information from HPNA. We provide a year’s worth of education for only $25, it’s a bargain. The other easy thing nurses can do to maintain current practice is read The Journal of Hospice & Palliative Nursing.
J: How do you recommend nurses take care of themselves to avoid compassion fatigue and burnout?
D: Have things you’re passionate about besides your work. Find something to look forward to and put effort and time into planning it so that what you’re doing for work doesn’t take over your life. You need something to turn your attention to when you get home from work so you don’t have time to think about things like, “did I counsel them enough or give enough morphine?” For me this means taking vacation and traveling. When I can’t go away, I focus on crafts.
Now you can’t always just turn it all off so it’s also important to have people you can debrief with. I always had hospice and palliative nurse friends to talk to and springboard ideas off of. You need someone to go to when you need to process or figure something out.
These things are important because you can’t help others if you’re burnt out.
My heart is with all of the nurses who’ve been working full-time this last year and I’ve been hoping they’ve taken time to care for themselves. I can’t imagine hospice nursing through all the layers of PPE and without an ability to touch.
J: Palliative care and hospice have garnered a lot of attention in recent years. Recently I’ve heard from several new graduates who are interested in hospice. Do you have any advice for them?
D: This is great because we want to be inclusive of all nurses. I would say that anyone interested in hospice should plan to work somewhere else first so they can gain experience. In hospice, nurses are the eyes and ears for physicians and they’re often working with a patient alone. You need to know how to recognize and respond to things like respiratory distress. I think a new graduate could make this transition after as little as one year working in a skilled nursing facility.
J: Before we wrap up, I’m going to end with a question inspired by the hosts of The Oncology Nursing Podcast. What is something more people knew about hospice nursing?
D: I think the most common misconception about hospice is that people go there to die. The perception I would like people to have about hospice is that people come there to live their best life to the end.