Crystal Downs, RN, began her hospice career a little over a year ago, working nights at the HopeHealth Hulitar Hospice Center. Today, she’s an RN case manager in Massachusetts, caring for patients in long-term care communities and supporting the families who love them.
She reflects on the moments that stay with her, and why other healthcare professionals should consider a career with HopeHealth.
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Was there a moment when you knew HopeHealth was the right place for you?
A few years ago, my father was on hospice care with terminal lung cancer. Seeing the care he was provided — and the support that was provided to us as his daughters — was really moving. I wanted to be able to offer that support to someone going through their own end-of-life journey, along with their loved ones.
I was impressed that HopeHealth’s doctors are available 24/7 for our patients. I knew that would make such a difference in providing responsive care to my patients. I was also impressed that HopeHealth has an inpatient unit, the Hulitar Hospice Center, which is invaluable — it means that our patients’ symptoms can be managed no matter how severe. As a clinician, I like knowing we have that level of support and resources to provide great care.
> Related: In the halls of Hulitar: An inpatient hospice nurse opens up
What does a typical day look like for you?
I’m part of a team that cares for Massachusetts patients who reside in facilities. As the RN case manager, I collaborate with the in-house nurses to make sure we are providing the best care for patients, with an emphasis on symptom management.
My job is all about knowing who my patients are, what matters to them, and making adjustments to their care along the way to make sure they’re comfortable and their wishes are honored.
What’s something you love about your job?
I love spending time with my patients and connecting with their loved ones, and tailoring care based on what matters most to them. It’s about keeping them comfortable so they can have meaningful experiences, such as participating in activities, having their hair done, or eating with others.
I also love how hospice emphasizes each person’s dignity. Dignity comes through in small acts, such as asking a patient’s permission before beginning an assessment, asking what you can do for them before saying goodbye, and providing privacy and choice.
These small acts help a person hold onto their identity as themselves, and not as a patient.
Is there a patient or family who stays with you?
I’ll always remember my patient who was cared for at home by his long-term girlfriend, both of whom were in their 80s. Their love for and commitment to one another was palpable at every visit.
Weeks before his passing, they held a private ceremony in their apartment to become legally wed — and I was invited. I was so honored to be part of such a big day for the two of them.
I think about the smaller moments too. I remember one of my patients at the Hulitar Hospice Center who was thirsty and wanted a popsicle. I’ll never forget his smile and genuine happiness as I helped him eat.
> Read: “What a privilege”: Reflections of a hospice nurse
What would you say to another RN considering a career with HopeHealth and hospice?
This work has had a great impact on me personally. I try to be more present and appreciative of what the day has to offer — something that’s easier said than done when the stressors of life pull at you. It has given me more perspective and gratitude for health and time together with loved ones.
What do you wish more patients and families knew about hospice?
We will walk with you and see you through until your next journey, whatever that may mean to you. We will bear witness to your joys and sorrows and work to make your days as comfortable as possible, physically and emotionally.