1. Peters, Andy RN, BA, BSN

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I recently had the opportunity to participate in the launch of an award honoring nurses in end-of-life care. I invited the executive director of the Cunniff-Dixon Foundation, Andy Peters, to share his perspectives on this award. - Betty Ferrell, PhD, FAAN, FPCN, CHPN JHPN Editor-in-chief



In January of 2005, Andy Baxter, founder of the Cunniff-Dixon Foundation, lost his wife Carley Cunniff to metastatic breast cancer. For 3 years, Andy and Carley were guided impeccably and compassionately by Dr Peter Dixon, a small town family doctor who did not necessarily consider himself to be a practitioner of "palliative medicine." Andy Baxter loved borrowing a phrase from the late Dr Rich Payne who used to say Dr Dixon just practiced "good doctoring."


As Andy Baxter reflected on the beautifully guided experience that Dr Dixon gave to him and his wife and began to share his story with friends and strangers, he quickly learned that his experience was not the norm. It was in this light that he created the Cunniff-Dixon Foundation (CDF) to enrich the provider-patient relationship near the end of life. With this mission, it was Andy's hope that more individuals and families would experience a version of the gift that Dr Dixon had given them.


I had the privilege of watching CDF begin and grow as I prepared to attend nursing school back in 2008. Working under the late Dr Robert Martensen, I did anything I could to help the foundation build its first websites, aggregate content, and support the beginning of what became the Hastings Center Cunniff-Dixon Physician Awards.


Now, as the executive director of the Cunniff-Dixon Foundation, it is a great privilege to share news of our inaugural Hastings Center Cunniff-Dixon Nursing Awards. I often asked Andy Baxter along the way, "Why aren't we recognizing nursing in the same light as the physicians?" Andy would smile confidently, "Because nurses already know how to do this well. They are good communicators and advocates by nature. Physicians are the ones who need to be better at this."


This past fall, as the pandemic continued to evolve, we at the Cunniff-Dixon Foundation sat down with The Hastings Center, our partner in these awards, and decided it was time. The pandemic had thrust nurses who were already "doing the work" every day into unimaginable situations. Nurses, like many providers these last 2 years, have been asked to work in unsafe environments, working inhumane hours while desperately trying to provide the quality care they know each person deserves. When I picked up the New York Times one day in the spring of 2020 and saw that one of my classmates at NYU had died from COVID-19 while working as a nurse at the bedside, I was heartbroken. My heart sank for every nurse that showed up each day facing their fears and the risk of death, often without proper safety precautions, in order to care for their fellow humans.


Important existential questions that I had already made a point to tackle in my life rippled back through me: What is required of us to be fully present with a fellow human being when challenges surround us? How do we work toward this personally and professionally? Having devoted a large part of my life to learning how to be present with myself through the practice of yoga and meditation, I often examined how the ability to be present with other human beings affects how we live, practice nursing, medicine, or caregiving in general.


How do we continue to do work and protect ourselves as we work and care for others? Perhaps being "present" allows for both to happen without push or pull. When present, we do not impose our fears-no matter how strong or unresolved they are. When present, we also receive wisdom from the patient before us who is experiencing some version of pain or life nearing its end. In this sense, the relationship between patient and provider becomes something unconditional. A special and rare space to be in and/or work toward.


It is such an honor to celebrate the inaugural Hastings Center Cunniff-Dixon Nursing Awards with three exceptional nurses who have and are working daily toward this masterful space: Barbara Reville, DNP, ANP-BC, ACHPN of Dana Farber Cancer Institute/Brigham and Women's Hospital in Boston, Massachusetts, and Juanita Georges, LVN and Erin Perez, DNP, APRN, ANP-C, AGNP-C, ACHPN of University Health System in San Antonio, Texas. These three nurses were chosen by a prestigious selection committee for their evidenced-based practice, personal ethics, integrity, compassion, empathy, teamwork, and collaboration, as well as application of diversity, equity and inclusion.


Much like the care that the recipients of these inaugural nursing awards have given to their patients and their families, these awards are unconditional. It is recognition for the exceptional work they have done-creating and validating a body of work that will hopefully shed light on their future and the team around them. These three recipients are giving the gift of "good nursing" to their patients and families day in and day out.


On February 21, 2022, the Cunniff-Dixon Foundation sadly lost its visionary founder and dear friend, Andy Baxter. He died peacefully at home surrounded by his loving sister and daughter. Once again, Dr Peter Dixon was by his side for months, reminding all of us why the Foundation exists. Dr Dixon's care for Andy has reinspired us to propel this work forward, and it is a privilege to do so by recognizing our three inaugural nurses.


Andy Baxter reminded us in his final few months: We do not have control over every aspect of our path and process, but we must be present for it. Through this presence, we can begin to create a framework and narrative that helps those close to us, including health care practitioners, act in accordance with our wishes and human values. He would be honored to know the three nurses selected in 2022 who show up fully present for their patients and families every day.


As a fellow nurse, I am so excited to see these awards come to fruition. What attracted me to nursing after a short career in education was that it was holistic by nature. Every day, I had to consider the entire well-being of a fellow human being-physically and spiritually, and I learned that no matter where I was in my technical education, I could still practice "good nursing." I feel very fortunate to have been introduced to the world of palliative care while working in home-care and skilled nursing facilities-caring for elders who had few or no advocates. This taught me so much about what I was capable of, regardless of my degree. By listening and being present, I could often pick up on emotional or physical subtleties that colleagues around me were missing. And in my personal life, with 50 years between myself and my husband, it is our ability to be present with each other that allows us to fully engage in life together each day, unconditionally.


I am grateful to be a nurse and to witness "good nursing" in my colleagues. It is our hope that through these awards, the Cunniff-Dixon Foundation will honor the work of nursing care at the end of life.



Andy Peters, RN, BA, BSN