Kyllie Chang, RN and Deborah Jones, BSN, RN, SCRN

Nurse Educators

Houston Hospice

Houston, TX

What inspired you to become a nurse?

Kyllie: I watched my mom struggle and fight breast cancer when I was growing up, and I have always had an interest in the healthcare field since then.

Deborah: I was inspired by my mother, an LVN for 30 years, to pursue nursing. Her compassion, consideration of her patients, and unlimited kindness is something I aspire to emulate for my patients and colleagues every day.

How did you come to work in hospice specifically?

Kyllie: Both of my parents passed away when I was young, so I have been exposed to death ever since a young age. After working as a bedside nurse during the COVID pandemic, I saw a lot of patient deaths all around me, and became interested in the hospice field.

Deborah: Having the opportunity and privilege to have worked previously with my co-educator, Kyllie Chang, RN, I took the immediate opportunity to work again with her when an educator role became available at Houston Hospice. We work very well as a team.

What has been your favorite or proudest moment as a nurse?

Kyllie: My favorite moments as a nurse are watching the young and new nurses that I trained succeed in their role.

Deborah: As an educator, I don’t often get the opportunity to care for patients directly day to day, but recently I attended a patient visit with one of our RN Case Managers. This family expressed concerns in using a select medication, especially after reading information online.  I took the opportunity to educate the family on the many uses of the drug, explain why the use of such drug would be beneficial, and explained my experiences when this drug was used in similar situations. I also explained my background as a Stroke Certified Nurse, which helped the patients understand how I came to know this medication.   After offering to get a substitute drug if they so wanted, the family expressed their immediate comfortability with the information and therefore no longer had any concerns in using the originally prescribed medication.  In fact, we continued to chat throughout the rest of the visit and the family invited me to come by any time I was in the area. I strive to positively impact our families during their very difficult times while on hospice.

In what ways (if any) is nursing different from what you expected when you first started?

Kyllie: Nursing has become a lot faster paced due to higher acuity patients, as well as advancements in technology that have become increasingly more integrated with the nursing role. I moved into the education role to help bridge the gap between nursing and technology.

Deborah: I never expected to experience a world-wide pandemic. This is something no one can ever prepare for in advance. The on-the-job training, rapid advances in nursing process and practice, as well as the expanded skills set that I learned drove my ability to nurse more efficiently and effectively while providing patient centered care.

Do you have any advice for someone considering a career in hospice?

Kyllie: Hospice is probably one of the toughest but also one of the most rewarding fields of nursing. As a nurse, you will be the primary source of support for your patients and families; you have to be in a good place mentally and emotionally.

Deborah: Hospice is a calling. Truly one must be solid in their nursing knowledge, a good communicator, have self-confidence, and demonstrate strong problem solving skills. It’s a difficult career path but one that is rewarding both to the individual, the patient you serve, and the family you will console.

How do you keep from getting overwhelmed in your busy day-to-day?

Kyllie: Take a moment (or several) during the day to take a breather and get organized.

Deborah: Organization, compartmentalizing, and focus. It’s a must in my role as I wear many “hats” within our organization and this role requires a vast ability to troubleshoot and educate.

Have there been any patients or families that have been particularly memorable? How so?

Kyllie: I once had a patient who had just switched to hospice services, and the physician had discontinued tube feedings for him. I remember the patient’s family member came up to me afterwards and were worried the patient was going to starve. After explaining how end of life mechanics worked, the family’s anxiety about feedings were assuaged. I remember thinking that situations like these are the one of the reasons why hospice nursing was so rewarding.

Deborah: When you can impact a family when they are experiencing panic about a situation, it feels good to be there to help. I was walking through our inpatient unit back to my office one day and I saw 3 family members that appeared to be stressed.  I stopped to ask, ‘how may I help you?’ One lady expressed her loved one was choking.  I began looking for the nurses on the unit, but all were in rooms with other patients.  I immediately threw on a gown and gloves to assess the patient for myself.  She was not choking but needed suctioning.  I did so and the family was so grateful.  Her spouse immediately asked my name and thanked me for stepping in.  I never pass on a nursing responsibility regardless of my patient or not.  I am here to help everyone.

Has your work influenced how you think about death? In what ways?

Kyllie: I think there will always be a little bit of fear in regard to death and the unknown, but death should be a celebration of life and all the good memories that have been made.

Deborah: Yes. Death can be a peaceful, comfortable experience if one decides to seek hospice care. I have experienced a great deal of death in my lifetime and I feel that as a nurse, it has changed my role. I am a supporter, comforter, and active listener for families experiencing such grief. I have learned to become an empathetic individual to loved ones and find ways to console them in their time of greatest need. It just takes a kind word, gentle touch, or empathetic look to positively impact that experience.