My Path to Palliative CareLoren Steinfeldt, MSPC May 17, 2022
“Life can only be understood backwards; but it must be lived forwards.” –Soren Kierkegard
One fateful day on my very first clinical, I was assigned to a young woman with breast cancer that had turned into leukemia post-treatment. She was very weak, and her husband and two young girls were going to visit that day. I helped her bathe, and it was one of those seminal moments where I really began to understand the truth of care-giving. My expertise in meds, complex care, and pathophysiology didn’t matter; in that moment, what mattered was that I helped her with what mattered most to her. So began my career in oncology.
I thought I would spend my entire career in oncology, but I had so many interests-hospice, infection, public health, and quality of care. I have always had a life that was unexpected, and I’ve learned to be open to the things that come along rather than sticking to a 5 or 10-year plan. This has led to travel nursing in many areas of hospital work, becoming a state surveyor in nursing homes, quality assurance in hospitals and then in nursing homes, pain management and interventional pain, quality assurance in home health, and nursing education. However, I have always had the idea that there was more. My career was not meant to be about doing the thing that would make the most money, or that would get me the next promotion. I wanted always to find the path that would allow me to use my own set of skills to do the most good.
When I decided to go back to school, I couldn’t decide what to specialize in, because that’s what a Master’s degree is about, right? I was chatting with a friend about how I wished one could get a Masters in hospice. She found the UC Denver program on palliative care, and a light went off in my head. This was it! I remembered a palliative care nurse in my last hospital job. We didn’t call her that. It wasn’t her title; but that’s exactly what it was. We went through patients each day and discussed goals of care and needs. When we identified patients who had a change in prognosis or a new diagnosis with which they were not coping well, she was the one we went to, to organize a meeting with the physician and family or whoever the patient wanted present, as well as the oncology RN coordinator. I thought that was noble and needed work that I would like to learn to do. Enter the MSPC program. Halfway through the program, as I put in applications in Missouri- where I was preparing to move after 20 years in California-and not receiving any responses, only rejections, I became distressed. What was I doing? I knew this was my passion, what I loved. But what if I couldn’t even get a job doing it?! I’d been doing quality assurance, not bedside or direct care. What if nobody cared that I was in school for palliative care?
Cut to today as I prepare to finish my work at the home health agency for a job as a Palliative Care RN Coordinator for an ambulatory clinic at the nearby university hospital. And I finally understand. It took me 10 years to decide on a master’s degree because the palliative care program Dr. Amos Bailey started didn’t exist yet. It took me four years to get a job in palliative care because this position didn’t exist yet. I will get to do exactly what the MSPC program was designed to do. I will help build a palliative care program with a team dedicated to expanding care into other serious and life-limiting illnesses beside cancer, such as ILD, ESRD, and neurology, both in direct patient care and in coordination with other clinics, to introduce the concept of palliative care to other clinics and how we can help their patients. It’s so exciting, I have to pinch myself! And I will be surrounded by others with the same passion.
Life can only be understood backwards, it’s true. I am in this position because I followed my passion and was lucky enough to find leaders of the MSPC program who also had this passion and could teach me about it. Teach me how to master it and use it to help in the best way possible, which is all I’ve ever wanted to do. My other experiences and the skills I learned, going where the path led-even when I didn’t know where it would end-also helped. If you aren’t sure, I would just say follow your passion and be open to opportunity, even when you aren’t sure where it will go. The rest will follow, and in hindsight, it will all make sense. Just keep moving forward.
“Faith is the substance of things hoped for, the evidence of thing not seen,” Hebrews 11:1-2.