by Gillian Beck van Heemstra, RN
One day when I was in nursing school at OHSU, I was working with just one patient. He had been cooped up for weeks after a serious injury and wanted to get out of his room. I got permission to take him in his wheelchair on an adventure through the hospital. We took the elevator to the staff cafeteria deep in the bowels of the hospital, visited the skybridge to the VA hospital, and found the best spot to see Mount Hood. I felt delighted, and so did he. After we got back to his room, I talked with my preceptor about it. I asked if I would ever get to do that kind of thing once I was an actual nurse. She said no—when you’re working on a hospital floor, you can’t leave, and when you are caring for four or five patients at once, you would never have time to do something special like that for one patient.
Lucky for me, hospital nursing isn’t the only option for RNs. At Housecall Providers, both in hospice and in-home primary care, I have lots of leeway to do something special for my patients. I’ve found many opportunities to do this—helping someone who couldn’t leave his bed get a virtual reality experience, arranging for a man in his 90s who loved cars to visit a classic car shop and take a ride, getting funds for family members to take a road trip to see a loved one on hospice, bringing a patient a plate of her favorite barbecue. Often these things are free, but we also have a patient assistance fund to help with cost. Being part of these experiences makes me feel like I’m in the right place.
I found out about Housecall Providers from two nurses who trained me, Ruth Sehm and Zoe Moskovitz. They told me that Housecall Providers was a great place to work, and I would have a great boss, Housecall Providers Hospice founder Rebecca Ashling. It was true—and all three of us are still working at Housecall Providers 10+ years later. Working at Housecall Providers aligns with my personal values. It’s a mission-driven nonprofit that respects its patients, values its employees, and there’s great teamwork. The sabbatical program is one of the most special things about working for Housecall Providers (and our parent company CareOregon), because work-life balance is huge for me. I think this is true for everyone who has worked in hospice—we know that you have to do what brings you joy as you go along, every day, every year, because you never know what’s coming next.
What dream could you fulfill with three months of paid time off? I’ve already taken my five-year sabbatical (it was great) and am now eligible for my ten-year one too. I’m dreaming big. I love seeing what my co-workers do with their sabbaticals too.
I started out working for Housecall Providers Hospice. It was meaningful to me to be present with people in their homes at those difficult, emotional, intimate, and sometimes beautiful moments. I usually felt that my presence, understanding of the dying process, and symptom management skills helped my patients and their families and caregivers. I couldn’t change the fact that someone was dying, but together with my team of a CNA, social worker, chaplain, and doctor, I could make it go better for that person, for their loved ones and caregivers, and that made me happy. People think working in hospice is sad, and sometimes it is, but for the first nine years, it brought me a lot of joy.
During the first year of the Covid-19 pandemic, I witnessed many people dying without family and friends by their side, family caregivers isolated and unable to get support, and the heightened grief of people who couldn’t be with their loved ones at the end of life due to travel and visiting restrictions. This made me so sad that I wanted to do something different for a while, but I didn’t want to leave Housecall Providers.
Just then, my nurse friend KT left Housecall Providers Primary Care to become a mental health nurse practitioner and invited me to apply for her job. Two years later, I’m very happy to be a Housecall Providers Primary Care RN. I have excellent co-workers, I never have to work weekends or be on call, and I still get to do the kind of nursing I always wanted to do. I still get to visit patients in their homes and get to know my patients well through long-term patient-provider relationships.
What’s next for me? I’m planning for my 10-year sabbatical! I’ve been doing guest lectures at OHSU School of Nursing along with Housecall Providers Hospice RN Zoe Moskovitz about hospice and end-of-life care, and I love that. I’ve also been precepting nursing students and will continue doing that. I’m in the CareOregon Aspiring Leaders program, and I started a Housecall Providers Employee Resource Group called Big Rainbow Umbrella this year – while expanding my skills as a primary care nurse. My aim is to support the three PCPs I work with, prevent errors during transitions in and out of the hospital, help patients feel supported, and work with my patients to identify and follow through on their health goals. I must be doing well because my team won a national award this year!