HOSPICE NURSE SPENDS DAYS EASING PAIN OF TERMINALLY ILL.

Byline: Ted Bell The Sacramento Bee

As a nurse in hospice care, Amanda McDowell takes on a task every day that many people would rather never think about - caring and comforting those who know they are at the end of their lives.

It is a daunting vocation. How can anyone, day after day, provide solace to the dying? How can someone continually refill the well of caring?

``Some really wonderful things come from it,'' McDowell explains. ``Families come together and (the patient) reaches an acceptance of the final stage of life by getting rid of the denial and the anger.''

On any given day, McDowell, 24, and her colleagues with the UC Davis and Mercy home hospice programs visit and care for about five people. They are terminally ill and have chosen to live their final days in their homes, surrounded by memories rather than institutional technology.

Her visits to patients' homes focus on monitoring their medical conditions and how pain and bodily functions are being managed. But often she does ``whatever can be done'' to make her patient comfortable, going beyond her job description to give a bath or cook a meal.

And then there's the listening, smiling, laughing, prodding and hand-holding.

``It takes special ears and special listening,'' McDowell acknowledges.

Away from the surroundings of her profession, McDowell is an uninhibited, energetic young woman - someone without makeup or pretense.

But she looks at others directly with a comfortable, nonthreatening manner and listens to them as though their words are the most important ever uttered.

She rarely answers without pausing to measure each of her words.

``In general, the qualities I find in hospice nurses is they are incredibly empathetic,'' says Robin Rositani, who is the hospice team coordinator for Kaiser's Sacramento and south Sacramento facilities.

``They can walk in cold and talk about a very intimate issue. People love to talk about sex, but no one wants to talk about death. They have a good ability to understand what people are going through and then identify very quickly what is needed.

``And that isn't something you find in a novice nurse. . . . It has to be an expert nurse with years of experience under her belt,'' Rositani said.

McDowell has that experience, gleaned from her work with participants in the Special Olympics.

``She had a willingness,'' her track coach, Ray Kondracki, recalled. ``I always look for the kids on my team to help with Special Olympics. Some just look down when I bring it up, but with her there was an eagerness and compassion in her eyes.

``When she was thinking about college and a career, she'd ask me where I thought her talents lay. I told her to follow her heart, not the money. The end result is what you do for others, not what you do for yourself.''

McDowell ultimately chose nursing, getting a degree from State University of New York, Plattsburgh.

A People magazine story about Paul Newman's ``Hole in the Wall'' camp in Ashford, Conn., for children with life-threatening illnesses caught her attention.

At 17, she volunteered for what would be the first of five summers working at Hole in the Wall. It was then she found she had what she says is a gift.

``A young girl had had a tantrum in our cabin,'' McDowell recalls. ``She kept asking, over and over, what was going to happen to her. She had watched her mom die, then her dad die. They had AIDS. She knew there was something wrong because she was having to take a lot of medication.

``I took her to the top bunk and held her and rocked her and told her that things would be OK. I knew then that I could be around and help people like her.''

At the Newman camp, she met another staffer with a remarkably similar personality named Jim Carnes, from Sacramento. Last year she joined him here, where he is an elementary school teacher. They will be married next month.

According to the leaders of hospice teams in Sacramento, the nurses and social workers assigned to people with six months or less to live usually have something to fall back on. The pressures, the emotions, could dry up the well of empathy quickly.

``It's emotionally draining,'' says McDowell. ``It's not a 9-to-5 job. I'm on call and I can work 50, 60, 70 hours a week. I can't close the door, so I do think about my patients at home.''

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Photo

Photo: Amanda McDowell, right, a UC Davis home hospice program nurse, checks Charlotte Thornhill, 82, who suffers from lung cancer.

Associated Press