My first book, Transitions: A Nurse’s Education About Life & Death, tells a larger story (of my education) from several short stories (of my patients) and how I learned patient after patient, more about Life and Death. There’s humor and inspiration and some heart wrenching sharing.

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I recently had the honor of giving two lectures to the St. Francis oncology nurses. It was such a joy to be there again. It was where my nursing career began in 1980 right out of nursing school! I was able to tour the in-patient unit, the out-patient infusion unit, the radiation oncology unit and roam some old familiar hallways!

With my background in primarily Oncology and Hospice and the gift of so much education from the patients and their families, significant others, and friends during my career, I wanted to share stories with these nurses and encouragement as well.
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Patients and their loved ones want to know right off the bat, “Do you know what you are doing?” They are concerned about everyone’s competence when they arrive at our doorstep, especially those with a fresh diagnosis that requires oncology or hospice! They will demonstrate some comfort when they feel certain we do know what we are doing! So I want to encourage formal education, continuing education, listening to ‘seasoned’ nurses and everyone who shows up in the arena of caregiving who can always teach us from their territory. I tried to make a point of getting to know the respiratory therapists, dieticians, chaplains, social service, psychology counselors, nurse techs, etc. Anyone who would be arriving in the space of my patients’ care plan…I wanted to know. I learned from all of them!

The next thing I quickly learned that these patients and those who are with them at the bedside was, “Do you see me? Do you hear me? Do you care?” Compassion!!

If you are the brightest nurse in the hospital, or outpatient setting or visiting in the home and you don’t have compassion, these patients recognize it and feel it. Believe me, I understand that there is so much to do in an 8 or 12 hour shift, and a great deal of it applying to numbers: weight, date of birth, lab values, room number, Medicare or insurance, abdominal girth, etc. But in the rush to get to everyone and meet every need, we can become insensitive and not even realize it.

Science and especially quantum physics teaches us that when we break everything down to the smallest entity of who we are, they found energy, Alive Energy! I like to call it Divine Energy! We are all connected!! We are able to feel another’s energy when they enter a room and while they are with us and when they leave the room every time we attend to them. What do people feel when you arrive? Anxiety? Anger? Kindness? Compassion? Joy? We choose what we bring to one another!

I also figured out in a hurry that I couldn’t do it all by myself. Cooperation with all the staff was key to giving the very best care we could give any patient. It is not a competition for who is the best nurse or best employee. It really does take a village to deliver excellent care. Welcome everyone who dances in this dance of caregiving! No one knows it all. I found that I learned something new every day. I still do in my retirement! It helps to have a healthy relationship with all involved to afford these patients the safest, healthiest, kindest experience in this particular path of their journey called Life!!

You can apply this to every career, every employment opportunity, and every relationship!! My precious dying (or as I like to say, ‘transitioning’) friends taught me that even if we live to be 110, it passes quickly. Embrace your day!!

When I got the call she wasn’t feeling well and that her blood pressure was dropping I headed to the ER to join her youngest son in the ‘discovery’ process that involved blood work, x-rays, etc.

She was cheerful, considering all that was happening. She was totally willing for the tests to be done and cooperative with the poking and jostling around, but she was frequently letting her requests be known. “I want to go home! I’m tired. I’m done. I just want to go on home.”

A kind employee said, “Well, it might be safer for you to be where you could have assistance with your care.”

My darling, precious ninety year old friend opened her eyes and replied with a dainty smile, “I want to go to my Heavenly Home, not my house.”

And with this she also began to speak of family members who were waiting for her. As her devoted son was attending to paperwork, I had the honor of listening. She shared with me about her childhood with such pride. She said she was her grandfather’s favorite grandchild because she was the one who would retrieve items for him.

She shared memories of their farmhouse, the water they had to draw from the well, the large garden’s bounty to be canned and stored in the cellar, the feisty chickens and gathering their eggs, how loving her Mother was, the huge concrete front porch. Then she matter-of-factly stated, “I’ve been visiting with my Dad and there are angels all around us.”

I never tell anyone that they are hallucinating when they tell me they are seeing relatives who have ‘transitioned’ or seeing angels! I pay respectful attention!

“It won’t be long now.” She said with simple faith and not a smidgen of fear.

The local wonderful ER doctor was efficient and kind as were the nurses and other hospital staff. They were gentle, respectful, and patient with her need to express any comments!

Later that day I arrived at her place of top quality care for Hospice and loving family and friends visits. I’ve had the great fortune of being with now eight of her family members in their ‘transitioning’ time over the past 25 years. This family knows how to escort dear ones to their Heavenly Home!!

Again I was impressed with the Hospice team and the Hospice team’s physician, nurses, and chaplain. Great folk!! They listened to her requests that she plainly stated early on. They honored her with expert care and compassion.

But above all I am so proud of how this family honored their Mother, grandmother, great-grandmother, sister, aunt, by their ‘being present’ and offerings of tender care.

Can there be a good death? That is a book in itself!! But with all I’ve witnessed over the years and all of us knowing we shall not escape this ourselves, we do hope for a good death.

These dear ones in these most recent days made sure someone was with her all the time, reassuring her that she was not alone. They so lovingly and expertly addressed her physical needs, shared stories of fond memories, thanked her for her love, praised her for being such a truly good Mother, grandmother, etc., painted her nails, warmed her blankets, sang her favorite hymns, prayed over her, stroked her clammy brow, reminded her of God’s great love for her.

Bless them!! As much as there possibly can be…it was a good death because of their Love!!

This month is a time of celebrating, thanking, and remembering nurses. I caught myself thinking of so many worthy nurses in my career. If I started naming all of them here I wouldn’t have enough space!!
One in particular was coming forward in my thoughts this morning. She died, or as I like to say ‘transitioned’, to her heavenly home a few years ago. But in my memory banks she is still alive.
When I first met her I thought she had more energy than all of us in the Home Health/Hospice agency I was working in with her. She was about 15 years older than me and put me to shame with passion for each day and each patient!
I would not have known all the extra she did in each home had it not been for the patients and/or their family members telling me when I also made a visit to them a day or so after Virginia had. Not only did she do a thorough assessment of her patient: appetite, weight, pain management, strength, wound care, vital signs, safety concerns, ambulatory status, skin integrity, and on and on….But she also checked their cabinets in the kitchen and the refrigerator and freezer to see if they had plenty to eat. Then she would counsel them on a healthy lifestyle and a healthy diet! AND if they did not have enough money to support a healthy menu, she would go to the store and buy fruits and vegetables, etc. for them!
She always offered to pray with them if they wanted prayer. She would visit some of them on her days off from work to just sit with them for a while and listen to their concerns.
I found out later from her husband that she also before working with us, took care of her Mother and her Mother-n-law in side by side hospital beds in her home when the two of them were needing full time care physically and was with them both when they died.
Ranks right up there with sainthood in my mind!
We all have our talents in the nursing profession. I so admire those who work in ER! And those who care for babies that weigh less than 4 pounds! Those who work in the burn unit! Those in labor and delivery! Well, I could go on and on. One of the best things about nursing is the diversity!
Same thing applies to any career, any life. We each have our God-given talents and our choices in education and where we want to spend our talents and how.
And we can choose to be more like my friend Virginia regardless of your chosen career. These patients continue to teach me over and over that we are One Human Family, that we really are all connected. We choose what kind of energy we want to bring into a hospital room, a judge’s chambers, a restaurant, a business, you name it!
How will you be remembered? What kind of footprints do you want to leave here on Earth? How will your grandchildren speak of you after you are gone? You are here with purpose for a very brief journey even if you live to be 110. Own it!! And give thanks for it!!

I have had the honor of being with so many as they ‘transition’ to the other side. Many have been of the movie scenario quality with loved ones around the bed sharing stories, singing favorite songs, lovingly giving permission for their Mother/Father/child/spouse/dear one to go.

It doesn’t always happen that way. Sometimes that dear one is mad, bitter, hostile, hateful in moments, blasting tired relatives and friends with cursing, and daring a minister to step inside.

One acquaintance called me one day. “What in the Sam hill am I supposed to do with Daddy? He is cussing at my siblings and my poor tired Mom and acts like he might fist fight with the nurses. This isn’t him. Will he stay mad until the end? Because if you think he will, I’m outta here! And I’m taking Mama with me!”

When I do an assessment of ‘the big picture’ there are hints along the way for this behavior. Sometimes it has to do with a change in brain chemistry due to metastatic disease, drugs to help with pain or anxiety, or they are just plain angry. Why? Especially with men I’ve heard them tell me they don’t like losing their independence. They do not always do well with someone strange entering their private home and suggesting they consider a hospital bed or cutting back on their salt intake, or trying to give their pain meds the consideration of routine dosing around the clock to keep the blood level even to avoid playing ‘çatch up’ if doses are missed. It comes down to thinking they have lost control of their lives. They feel like they are no longer in charage. Who are they going to yell at? Often it’s the ones closest to them: spouse, child, parent, partner, doctor, nurse, dog…

When the weary family members try to take it all in stride along with their physical stress, prepatory grieving process, lack of sleep, they are tempted to walk out the front door and not return. It is tempting!!

Loss of a loved one is hard enough when everyone is supporting one another and the patient is comfortable, at peace with the process, and tenderly expressing thanks for each one there. BUT the reality of life is there are times when we call in the Hospice team and say, “Can you help me out here? Can you look with fresh eyes at this and point me to where and how I sit with this anger and not take it personally? Do you have a volunteer who can objectively sit here while I walk around the block or drive a few miles south of town to a park?”

And that is a great idea! Move away from the scene for a while if at all possible. Breathe and then remind yourself you may not be able to ‘make it all ok’ no matter what you say or do. It is what it is. Sit with your grief, your heartache, your sadness and honor those feelings. Then give yourself permission to return with full understanding that Mom might move into a different space before this is all done and wrap her arms around you. Or Mom may go into a coma and you will sit in peace and quiet a few hours or a few days before her vital organs stop. Or Mom could very well be angry to the bitter end.

These are questions in many hearts of patients that often aren’t voiced. “Can you sit with me in my pain? In my anger? In my fear?”
“Will you see past my outburst? Will you forgive me? Will you still love me?”

One sibling pulled me into an empty hallway while his Dad was ranting and raving. His sister refused to leave Dad alone. She ignored his ‘spells’ and would hum or do needlepoint or rock in the padded bedside rocker seemingly untouched.

Paul was wringing his hands, “I can’t sit in there. Does that make me the ‘bad’ child? I don’t know what to say. I can’t ignore him when he is saying those horrible things. My sister acts like she can’t hear it. They are both making me nuts!!”

Be honest with where you are. One sibling may stay in the kitchen fixing supper for evreyone. One sibling may do outside yard work or care for livestock. One may work on financial and insurance papers. And one may sit at the bedside. No one is more worthy. All are worthy! Don’t judge where you are or where they are. Thank one another for whatever they are doing and don’t try to make them fit a mold they don’t fit into.

Unconditional love, genuine forgiveness, and respect go a long way. Talk to your priests, your minister, your best friend, your grief group, your counselor, or your pet, and especially your God….or write about it. No one escapes this. One day it will be us.

From the moment she arrived off the hallway’s elevator, Claire’s energy was felt. She refused assistance to walk from her wheelchair to the restroom. With determined slow steps all 94 pounds of her crossed the now crowded chemo waiting room.
Her powder blue terrycloth scarf covering her head matched her warm-up suit, both blue and both too big. Sympathetic eyes met hers with only a cold glare returned. She dared anyone to speak a kind word. Her full, round face (due to steroids) was such a contrast to her otherwise bony features.

She had been forced to come in today by her insisting mother for routine blood tests, weight check and exam. She was sick of all of it: the tests, the dietary counseling, the scales, the waiting room stares, the drugs, the hair loss, the endless expense and yes, all of us.

Another young woman her age, LaShondra, and only a few pounds heavier, perhaps owning a few more hairs and maybe a little more strength, silently witnessed our weary patient. She opened her inexpensive, worn purse and pulled out a folded, slightly wrinkled piece of paper. Carefully she slowly rose from her chair and boldly approached Claire.

“Excuse me Miss. I was just wondering if while you were waiting to see the doctor if you would read this?” She questioned while holding out the paper.
LaShondra, while slowly backing away, explained, “It’s just that there have been times it has been beneficial to me.” She explained and began the journey back to her waiting chair.

I could see she was having some difficulty getting across the room. I hopped up and took her arm as she whispered to me, “That poor girl is hurting in her spirit as much as she is in her flesh. I’ve been there. Sometimes we are just plain tired and mad. That doesn’t mean we are bad patients or bad people. That just means sometimes we can’t hide what we are feeling anymore. That little prayer was written by another one like us who knew.”

Everyone in the room turned their eyes again toward Claire. She had not taken her eyes off LaShondra. Then she slowly opened the folded paper. She appeared to be reading the poem. Her facial expression did not change. No indication was made that it was helpful or appreciated.

As I escorted LaShondra to her exam room to see the doctor she whispered again, “Becki we never know the full condition of the soil of another soul’s heart. Maybe it is hard on top, but maybe it has a crack or two where a seed of hope and love might just fall into and take root. We aren’t to judge any of it. We are called to just sow seeds where we can.”

What a great time visiting with Al Cole on People of Distinction about my book and what the dying can teach us about life!!

http://www.live365.com/stations/alcoleradio?play=1

So thrilled with the review by Rhetta Akamatsu of BlogCritics of my book Transitions: A Nurse’s Education about Life and Death!!

Thank You Rhetta!!

http://blogcritics.org/books/article/book-review-transitions-a-nurses-education/

Sunday, January 20th, 2013, I was featured on the website, Inspire Me Today. I was asked to share in 500 words or so what I’ve learned so far in life, something I would want to pass along.

Here is my rough draft. You can read the final one on the website: www.InspireMeToday.com

One of my favorite adults to spend time with as a child was my grandfather. I followed him downhill to the barn, across the pasture, into the garden, inside the chicken house. He talked and I listened.

One of the life lessons I learned from him is that even if you live to be 110 years old, it’s brief!! This is becoming truer to me as I have now reached my 60′s and remember him and his words. What kind of footprints do I want to leave here on Earth?

Those who are critically, chronically, or terminally ill teach me so much about life and death. The trick is whether or not I am listening to them. I have to train myself to ‘be present’ to hear them, really hear them, and honor the wisdom their suffering is teaching me.

I can become so caught up in my day-to-day survival mode that I miss golden opportunities to make a difference to someone else in my path. When I stop and make the time to be still and listen to my heart, my soul, speak to me in prayer and meditation as I seek to hear The Spirit, I find I am more aware of my purpose in being here.

It’s not all about my accumulations, for the dying teach me that I can take none of the material goods with me when I die.

It’s not about how big a house is, but do I care about the homeless?

It’s not about how expensive the restaurant is where one makes a reservation, but do I care about those who are hungry?

It’s not about how perfect a lawn looks, but did we play ball with family out there, have a picnic, play chase with the dog?

It’s not about how toned and beautiful we want our bodies to be, but have we compassion for those in the nursing home, now weak and fragile, often forgotten, or those in pain as broken bones mend, or those weaker from disease?

The only thing we take with us, if you will, is the LOVE woven into the DNA of our souls of how we have treated one another.

Have I been strong enough to forgive those who wounded me and too, forgiven myself for holding onto that memory or for me wounding another? Shall I remember the healing comes in forgiving and releasing and moving forward?

The hope is that we all do not strive to be remembered for all we donated in dollars to a well-deserved recipient and a bronze plaque in our honor nailed to a wall. But let us be remembered for how we have unselfishly, quietly, humbly, served one another AND our precious Earth and all upon it.

Let us be very bold and live our authentic lives fearlessly!! Don’t try to be someone else! Be you!! I’ll be me!!

Let us not wait thinking that someday we will be better. Let us choose ‘better’ today! Choose to remember how precious and dear each day’s gift to us is! Embrace your God-given talents and your dreams and live sharing your gifts with all around you!!

Never doubt that you are so beloved by God!!

http://www.ajayan.com/10-29-12-mind-matters-with-becki-hawkins/

I’d been working on the oncology floor about four months when I met them. I was still such a new and inexperienced nurse, but loved my work and could not believe I was being paid for it. That phase wore off!!
They, this darling pair, were in their 20′s, madly in love and scared out of their wits. She had leukemia with a poor prognosis and with this admission to our unit; she was fighting infections as well.
We were administering high powered antibiotics through her veins. The medicine was so potent, we were ordered to give pre-medications to help reduce the ‘chilling’ side effects, chills like I’d never witnessed before or since.
Julie watched me as I prepared to start the evening dose. I’d adready given her the premeds and she was frowning a little less now, but still had the furrowed brow.
“If it just works, then it will be worth it. I hate those damn chills! Worse than chills if you ask me!” In fact my charge nurse called them rigors.

“Did you bring warm blankets yet? Where’s Steve? I want him in here.” She anxiously continued as I finished preparing the drugs and equipment settings.
Her skin color wasn’t anywhere near normal. I couldn’t describe it effectively when I charted. She was sort of pale, sort of gray, speckled with smalll purplish hemorrhagic spots. Charting wasn’t what troubled me the most, though. It was all she’d say. It wasn’t like you could hurry in and out of her room.

There were ’round the clock’ medications, intravenous fluids, hyper alimentation, (like liquid food in an IV), vital signs to monitor, blood to give, etc. She wouldn’t keep quiet like many others. She had the need to express the anger, the prepartory grief, the unfairness, and so many losses.

Steve took a leave of absence from work. He listened, he held her tiny hands, he gently bathed her, massaged her cold feet, fixed her favorite snacks when she would try to take a bite, carried her with all the tubes to the bathroom when she refused the bedpan. But he was the one who said very little.

One evening he crept out of their room after she fell asleep and walked up and down the hallway sipping coffee. I asked him one of the stupidest questions a person can ask, “Steve, are you okay?”

“Nope, I’m not okay. And there is not a thing I can do about it. The doctors are doing all they can. All of you here in this unit are doing all you can. I feel like she’s leaving me all too soon, like down a giant whirlpool, and I can’t save her.”

“There’s no counselor, no clergy, no one, Becki, who can make this better. It’s just the way it is. I can’t blame anyone. It’s life. Sometimes you get a cure and sometimes you do not. It is unfair, but where pray tell did anyone ever say this journey here on Earth would be fair. You see, I grasp all of that, but it does absolutely nothing for this giant hole growing in my heart right now. You can’t make it better. But….you can get me some fresh coffee. This from the waiting room taste like it could tar a roof!”

I didn’t have enough life experience, nursing experience, or common sense to know how to respond. I just stood there and listened. I went to the nurse’s lounge and retrieved some fresh coffee trying not to let my tears drip into his cup. Slowly I walked back to their room trying to get a grip on my emotions.

There they lay, cuddled, best as possible with all her tubing, clinging to one another in her hospital bed. I sat the cup down gently and backed out slowly praying that somewhere, somehow, someday, Someone would help Steve find the hope he needed. This, however, was not the moment to say a word.