1. Ferrell, Betty PhD, MA, FAAN, FPCN, CHPN

Article Content

This year of 2016 signifies an important point in time for many of us in hospice and palliative care. It was during the decade of the 1970s that hospice began in the United States and, on that foundation of hospice care, over the next 2 decades that palliative care began. One reality of this timeline is that many nurses who were the pioneers starting these programs now 40 years ago-yes, 40 years ago-are now at a point of retirement. Each year, I become more aware of nurses across the country who started the first hospice in their community, opened the first inpatient palliative care unit, served as the first president for their Hospice and Palliative Nurses Association chapter, or authored an article in the first issues of this journal who are now retiring.


In the hectic days of our work world and lives, I think that sometimes, we do not pause to recognize or honor these pioneering nurses whose handprints are left behind on every aspect of our field.


One such nurse in my community who is retiring this year after 40 years of nursing is Gay Walker, RN, CHPN, who started a pediatric hospice program in California, Trinity Kids. Gay has been at the bedside her entire career, and 15 years ago, while caring for adult hospice patients, she was called to create one of the first pediatric programs. I met Gay about this time, as she came often to meet with me to talk about starting pediatric hospice. Honestly, I had little knowledge to offer, but I think that what she needed most was a nurse colleague to listen, as she meticulously planned every detail of the program.


What I recalled then and have thought about this month, as Gay and I have discussed her retirement, is that every conversation we have ever had has focused on 1 thing-what will be best for the children.


I have witnessed Gay over the years as her initial program has blossomed to become a national model, expanding to care for a broad range of pediatric illnesses, forge partnerships with neonatal intensive care units, guide children's hospitals in creating palliative care programs, develop bereavement care, and constantly consider which children and families are most in need.


I have also watched this bedside nurse, Gay, drawn into the very foreign world of health policy, as she became a leading voice for the California legislation creating concurrent hospice and palliative care for children, which then became a national model and influenced national legislation. Gay eagerly returned to the bedside, so you will not see her in the national media, but I believe that the current advances in care would not have happened without Gay.


Gay is the definition of an unsung hero in nursing. She has mentored hundreds of clinicians across disciplines not through her words but through her caring. Not so long ago, Gay sat in a garage that served as a home for a poor, Latino family, holding a frail and frightened 4-year-old in the very last stages of a terrible course of leukemia. The only parent, the father, said that Gay became the mother-the eternal mother-for this motherless child in the hours leading to death. We know that although Gay is retiring, her face will remain in the hearts of literally thousands of family members who have been the recipients of her care. One bedside nurse. One career. Trinity Kids has now cared for more than 2000 children who, as Gay described, "died gently in our arms."


This time of seeing our pioneers retire poses many questions for our field of palliative nursing. Are we capturing their wisdom before they retire? Have we maximized efforts to ensure that they have mentored the next generation of nurses? And have we taken the time to thank them for changing cultures, breaking down walls, speaking for patients and families, giving up their sleep and their weekends, and carrying the grief of the many lives they have shepherded until the end.


Many of our retiring colleagues will continue to find ways to be involved professionally. Some are ready to fully hand over this precious work we call nursing. Gay is getting the best promotion of all-a full-time position as grandmother to her 2-year-old grandson and his new brother due to arrive soon. What lucky children!


Thank you, Gay. And thank you to all of our colleagues who have retired or soon will. As has often been said, we stand on the shoulders of giants in our field. For palliative nursing, I would say we rest in the arms of nurses-arms that have held dying patients and comforted their families and whose arms embrace the future of palliative nursing.


Betty Ferrell, PhD, MA, FAAN, FPCN, CHPN