As a hospice nurse for over 25 years, Karen Crosby has experienced a great deal of death. But she doesn’t find that sad. “When I’m with somebody that is dying, it is a complete honor. And I feel like it’s the same thing as when labor and delivery nurses are with a birth. To be there at that time is just incredible.” She shares stories about being there at the end of life and what lessons that has taught her.
Click here to listen to Episode 3 of Season 2 of Grief from the Other Side. “Karen’s Story: It’s an honor to be there at the end.”
Narrator:
Grief From the Other Side. Where the bereavement experts at Chesapeake Life Center talk about living with loss, sharing stories of hope and resilience.
Amy Stapleton:
I am Amy Stapleton, manager of bereavement services here at the Hospice of the Chesapeake and Chesapeake Life Center. I’m joined today by my colleague, Tammy Turner.
Tammy Turner:
Hey, Amy. I’m Tammy Turner. I am the community education manager for Hospice of the Chesapeake. And the story that we got to listen to today is by Karen Crosby. She’s a nurse case manager for Hospice of the Chesapeake. So what was your impression of Karen?
Amy Stapleton:
First of all, Tammy, Karen is kind of a legend around here. She’s been around a long time. And her service to the patients and families that have come through hospice for years is so well-known and respected.
Tammy Turner:
Absolutely. She, and her presence, just coming in like the lightness. And I hope that I’m guessing it’ll come across in her voice as well, but she just has this conviction and this, this is her purpose.
Amy Stapleton:
Yeah. This is her ‘why’. This is why I’m here, what I’m meant to do. I couldn’t help thinking myself in that that’s who I’d want beside me.
Tammy Turner:
For real. Yeah, absolutely. What better way to go out with somebody like Karen Crosby by your side?
Amy Stapleton:
Exactly. Me and Karen Crosby.
Tammy Turner:
Yep. That would be amazing. I’m with you. I think it’s great. I think her story is so interesting and just her history. So let’s take a listen.
Narrator:
What is lost?
Amy Stapleton:
Hi, I’m Amy Stapleton, manager of bereavement services, and I am here today with my colleague, Karen Crosby. She is a legend at Hospice of the Chesapeake. So I am just so grateful, Karen, that you’ve taken time out today to share with us a little of your experience and your knowledge and your deep wisdom. Thank you so much for being here.
Karen Crosby:
Thank you for having me. I’m very honored that you all asked me.
Amy Stapleton:
So really, I think you are kind of a legend around here. Would you introduce yourself and talk a little bit about how long you’ve worked for Hospice of the Chesapeake and what you do?
Karen Crosby:
Yes. My name is Karen Crosby and I’ve worked for Hospice of the Chesapeake for 20 years. I have been a hospice nurse for 25 years, so I feel right at home doing hospice. I always say this, that I feel like it’s what God put me here to do. And I really feel so honored to able to be with people when they’re dying. And so that’s what I do. I started at Hospice of Chesapeake where we just went and did home visits. Now we have a facilities team and I’ve been on that team for now at least 10 or 11 years. And we go into assisted livings and nursing homes and do hospice care in there. And so we’re working with the patients, the staff, who become part of the family, as well as the family members too. And it’s been hard in the last year just because of family members not being able to come in because of COVID. So really being that intermediary with families too, to really help them see what is going on with their loved one.
Amy Stapleton:
What an incredible gift that is. To A, feel like you’re called to do something. But to be able to meet people at this time in their life when their need is so great. So thank you on behalf of humanity for doing that and showing up for people in their most vulnerable time.
Karen Crosby:
Thank you.
Amy Stapleton:
What about hospice work attracted you to it? Or was there a personal experience in your own life with death that kind of, I don’t know you wanted to give back or contribute in that way?
Karen Crosby:
I had always felt like I wanted to work in hospice. When I graduated nursing school, I worked in oncology at University of Maryland for about four and a half years.
Amy Stapleton:
So you started with the light work.
Karen Crosby:
Right. Exactly. Exactly. And then I just kind of got this pull and that I always felt like I had wanted to do that. And I always feel like it kind of relates back to… My parents never hid us from death. We went to funerals when we were little and I just felt like I was very open to that and it was never taboo for me. It just was-
Amy Stapleton:
… Part of life.
Karen Crosby:
Part of life. Exactly. And I had an uncle that had severe cerebral palsy. And so again, my parents never sheltered us from that. We were in it. And so it just kind of… I think that’s part of the thing that got me into nursing in the first place. And then hospice just kind of seemed the next step.
Amy Stapleton:
So one of my favorite questions is like, what do you tell people on the airplane? When they’re sitting next to you, and they’re like, “What do you do?” What do you tell people?
Karen Crosby:
I’m honest. I tell them that I’m a hospice nurse. And sometimes they say, “Oh.” And most people say, “Oh, how can you do that?”
Amy Stapleton:
Yeah.
Karen Crosby:
I have chills right now because I’m telling you this. Because I just feel so honored to be with people when they’re dying to help them. We’re not speeding anything up or slowing anything down, but we’re just there with their journey. And so if we can be there to help them be comfortable and their families be comfortable, it’s what I want. Some people just turn the other way. If I’m in an assisted living and there’s a resident that is not on hospice and is walking in, what are you doing here? I’m a hospice nurse? And then, “I don’t need you.”
Amy Stapleton:
Yeah, right. That H word.
Karen Crosby:
They run away. Yeah. But some people are very interested. Strangers, like on an airplane or something, they want to know about it. They want to understand it. And then some don’t.
Amy Stapleton:
Yeah. I always tell people, I talk to people about grief and death and trauma all day. And then either that starts a whole new conversation and they’ll go, “That must be so hard.” And I said, “Actually not.
Karen Crosby:
Exactly.
Amy Stapleton:
Again, as you say, it’s such a sacred privilege, what we get to do and where we get to meet people.
Karen Crosby:
I’ve always said too, that when I’m with somebody that is dying, it is a complete honor. And I feel like it’s the same thing like when labor and delivery nurses are with a birth. It’s just like to be there at that time is just incredible.
Narrator:
What remains?
Amy Stapleton:
Is there a client or a family that you’ve worked with that really stands out to you over 20 years? So many, right? But one or two that you could tell us about that you’re like, wow, that’s why I do this.
Karen Crosby:
It’s one that I talk about a lot. And it was only about my second year of doing hospice. I think I could tell you so many. And we, as hospice nurses and hospice employees, can write a book I think for all the things that we have come in contact with. But there’s a lady, and I tell this story often, that it was just, I walked in… She was a lady I’d been seeing and she was in her home. I walked in and her daughter said, “She’s very confused today.” And she had described herself prior, the times that I saw her as a very religious lady, two hours of prayers in the morning, two hours of prayers at night. She was very faith filled. And so her daughter, when I got there, said she was very confused. And I sat with her and did my assessment of her.
Karen Crosby:
And then I was sitting. This was before we were on computers. So we were on paper. And I was writing my notes. It was kind of an overcast day, kind of like today. And so her bed was sitting… I was sitting next to her bed. And so I was looking not directly at her, but in my peripheral vision, I could see that she started waving. And I didn’t see anybody. So I thought, well, I’m going to be bold and I’m going to ask her, what do you see? And eventually this kind of went on a little bit. She was quiet for a while. And then she said that she saw her doctor. And then she eventually told me that all her loved ones were around the bed and they were all wearing pink and they were all holding flowers and they told her it was okay. Again, still I’m getting chills right now telling you this because it was… So that was 23 years ago and I can still feel like I’m right in her room.
Amy Stapleton:
You remember.
Karen Crosby:
Right.
Amy Stapleton:
You feel that in your body.
Karen Crosby:
Right.
Amy Stapleton:
Yeah.
Karen Crosby:
And she looked at me and she looked at my left and my right shoulder, and then my left shoulder, smiled really big both times that she looked. And I was like, okay, who’s here with me because… And I walked out of the room in tears and I said to her daughter, she is not confused. She’s going through this beautiful process of transition. And her loved ones are there to help that transition. So it was just, that’s one that I’ll never forget. And when I do orientation… Well, when we used to do orientation here, I would always tell that story because it meant so much to me. But there’s been so many over the years of people, but that one always stands out to me.
Amy Stapleton:
How incredible that you’re able to see that for what it was.
Karen Crosby:
Yeah.
Amy Stapleton:
Right.
Karen Crosby:
Yeah.
Amy Stapleton:
And bear witness.
Karen Crosby:
Yes, absolutely.
Amy Stapleton:
You mentioned this earlier. How has your work changed as a result of COVID in just the last year and a half?
Karen Crosby:
It’s been really difficult because I had patients that were on hospice before COVID officially hit. I think of one specific lady that really wasn’t declining so much. And I thought, okay, we may look at discharging her. And then COVID hit. And her nieces and nephews couldn’t come in to visit her like they were doing on a daily basis. And she quickly declined and passed away. And so, that’s been hard to see the emotional effects of what it’s done to residents in assisted living. So I can’t speak for homes, but just from my standpoint, I’m calling families more than I ever have because they can’t go in. They can do window visits in some facilities and look in the windows and see their loved ones. But if somebody has got dementia, they don’t know what they’re looking at. They don’t understand. It’s confusing or they can’t even see them through the windows.
Amy Stapleton:
I’m thinking of COVID and I’m thinking about just all the rituals that you have to put on to even get in the door, if you can get in the door. How touch is limited, how interaction is limited. What have you found about your job even in COVID that matters the most to people?
Karen Crosby:
I think being able to be there with them, especially when families can’t come into the facilities and especially in the beginning of COVID. Even longer than just the beginning, but that they couldn’t come in. And so us being able to be there and letting them know that we’re going to be able to give them that love that the families can’t do because they can’t get in there. And there were some facilities in the beginning that weren’t letting us in at all. And so we were doing window visits, which I felt was not good hospice care.
Amy Stapleton:
Not what you signed up for as a nurse.
Karen Crosby:
Right. Exactly.
Amy Stapleton:
How hard that must have been.
Karen Crosby:
Exactly.
Amy Stapleton:
And yet, some ways I’m guessing you were the most consistent presence that some of these people had.
Karen Crosby:
Exactly.
Amy Stapleton:
To be able to see you and you see them.
Karen Crosby:
Yeah. What’s interesting too, you talk about all the garb and everything that we have to put on. I have a lady that I’ve had since COVID hit or maybe right after COVID hit. No, it was before, because she knew me before the mask and everything because I took care of her husband. But she has dementia too. She recognizes me now with everything on. My double mask, my face shield, she knows who I am. In the beginning I don’t think she put it together, who I was before and who I am now. But now, just my eyes-
Amy Stapleton:
… Just your eyes.
Karen Crosby:
She knows who I am.
Amy Stapleton:
Wow.
Karen Crosby:
Yeah. It’s again, an honor to be able to be with them, especially when families can’t. And really it’s, we have the whole team, the social worker, the chaplain, the aides. But sometimes they weren’t even allowed to come in. So we ended up being everything. And that’s fine. I’m not uncomfortable with that. I feel okay with it. I still feel like we need those team members, of course.
Amy Stapleton:
Right.
Karen Crosby:
But in this situation being able to be there and help them.
Amy Stapleton:
You could hold it.
Karen Crosby:
Yes.
Amy Stapleton:
Yeah.
Karen Crosby:
Yeah.
Amy Stapleton:
Thank goodness we have a team.
Karen Crosby:
Yes, exactly. Absolutely.
Amy Stapleton:
That image of putting on the personal protective equipment and just the time that it takes.
Karen Crosby:
Yes.
Amy Stapleton:
I’m a big believer in rituals. I love rituals. And I think they, in so many ways, ground us in our work and our life. Do you have any rituals that are meaningful to you that kind of keep you going these days?
Karen Crosby:
I like to be outside and just get some fresh air. If it’s even just taking my dog for a walk in the backyard, but just being able to kind of breathe that in. Prayer is very important to me. We haven’t been able to go to our church. And so we do online church every Sunday. But just taking the time to try to decompress is very helpful. And reading, praying and my children.
Amy Stapleton:
Yeah.
Karen Crosby:
Keep me crazy still.
Amy Stapleton:
The things that we rely on.
Karen Crosby:
Yes.
Amy Stapleton:
Right?
Karen Crosby:
Yes.
Amy Stapleton:
And I think in so many ways have become more precious over the last year.
Karen Crosby:
Yeah.
Amy Stapleton:
You mentioned your uncle. Anything in your early beginnings that kind of, I don’t know, impacted how you see grief, loss, death, this work?
Karen Crosby:
I think it goes back to what I said before, too, about how my parents never shielded us from anything. That we always went to funerals. I had, on the same side of the uncle that had cerebral palsy, there was a great uncle that was deaf. And so to see, I don’t know, there was just that connection from that standpoint of all these different things. My mother used to say to me that I always wanted to wear a uniform. So I was either going to be a nurse or a waitress. Since I was little. It was never a thought, like, what am I going to do? I just always knew I was going to be a nurse.
Amy Stapleton:
You just always knew.
Karen Crosby:
It’s what I feel, what I’m supposed to be doing. And I love what I’m doing.
Narrator:
What’s next?
Amy Stapleton:
When you think about helping, witnessing, supporting, honoring people at the end of their life, it’s your presence there with the patient, but it’s also, as you mentioned, the family that gathers around them, however they define that family. What would you offer them or what do you offer them in those moments about what’s happening and about loss? You’ve, in so many ways, been a container for a lot of losses over the years. What do you offer in those moments to people who are feeling their loss and their grief so intensely?
Karen Crosby:
I think a big part of it is helping them understand that everybody grieves differently and just because the son isn’t here and the daughter is here, vice versa, or they can’t come, we don’t try to condemn that they’re not there. But just that it’s normal that everybody grieves differently. And we can’t condemn them for not doing what the other one thinks that they should be doing. And so that’s part of it, just to normalize that everybody grieves differently to loss. And so some can come, some can’t come, and I try to explain to them too what their loved one is probably going to be going through. What signs and symptoms they’re going to have. And so they can be prepared for it. They may not go through everything that we discuss, but I try to give them what kind of symptoms that their loved ones going to go through.
Karen Crosby:
So I feel like if they can be prepared in that way, it helps them and they’re not as scared when something comes up and they think, what is this about? And that goes with the facility staff too, because if they’re somebody that’s new working there and they’ve never dealt with death, it’s terrifying to them and they don’t want to be in the room. Or if it’s a new medication tech, they’re not going to want to give that dose of morphine because they feel like that’s going to make them die. And it doesn’t. And so it’s that education that we have to do. When I was in homes, that was the same thing. Just trying to explain that to families also that it’s not… Especially morphine is a big discussion all the time.
Amy Stapleton:
You mentioned this earlier, everyone’s grief journey is different and unique. Is there anything you could share that you feel could help someone out there who’s experienced a loss?
Karen Crosby:
I think just to be gentle with yourself and know that that grief is going to come in waves and that you’re going to feel okay one day and you’re not going to feel okay another day. And so that’s the best thing I can say because while I’ve been a hospice nurse, I’ve lost both my parents. And being the daughter and not being the hospice nurse is a little difficult at times, but that’s what I had to just keep telling myself, to be gentle with myself and not try to think that I’m going to be fine because I do hospice and this is going to get easier and it’s still hard.
Amy Stapleton:
I’m so glad you said that. I also have had two parents die while I’ve worked for hospice and I’m starting to think it’s like an occupational hazard. I’m not quite sure.
Karen Crosby:
Right. Right.
Amy Stapleton:
But I did wonder, have you had… This is the personal side. Have you had a patient that you’re like, “That reminds me of somebody I love?” And if so, how did you work through that?
Karen Crosby:
I always remember nursing school, they said make sure that there’s boundaries and you don’t… I don’t know if they said don’t show emotion, but it was just… But I can’t.
Amy Stapleton:
Right. You’re human.
Karen Crosby:
I’m just an emotional person. I have cried along with daughters that have lost their mother. Right along with them. But supporting them while… I’m not having them take care of me. But just supporting them during that time. Because I can totally feel what they’re going through from having gone through this. And both my parents were on hospice with us, with Hospice of the Chesapeake. I just think that as much as we can support people. But yeah, there’s a lot of people.
Amy Stapleton:
Yeah. I love that you also offer that testimony about your parents being on hospice, because you wouldn’t give the best to your parents if you didn’t believe in it. Right?
Karen Crosby:
Exactly.
Amy Stapleton:
And you want that best, that goodness, that care to be available to everybody.
Karen Crosby:
Yeah, definitely.
Amy Stapleton:
And you make sure that that happens.
Karen Crosby:
Yeah.
Amy Stapleton:
Are there any other myths about hospice that you would like to debunk here and now?
Karen Crosby:
As soon as you go on hospice, you die.
Amy Stapleton:
Yeah. That’s so not true, right?
Karen Crosby:
Exactly.
Amy Stapleton:
And actually we know from research, it actually increases one’s life expectancy and the quality of one’s life.
Karen Crosby:
Exactly. Yes. Yes.
Amy Stapleton:
Often, people access our services too late.
Karen Crosby:
Yes. Agreed.
Amy Stapleton:
What’s the question that you get asked most often from patients?
Karen Crosby:
From patients, not families?
Amy Stapleton:
Yeah. You can do families too, but I’m just thinking of somebody …
Karen Crosby:
Yeah, that’s a good question. And so I think about more when I was in the home because right now a lot of the patients I have being in facilities do have dementia. And so I don’t so much get questions from them. But a lot of times people will say, “What’s going to happen to me? How am I going to feel? Or what am I going to go through? Is it going to be painful?” It’s those kinds of things. We have a little booklet that we give to families that talks about signs and symptoms. And I remember years ago I gave it to a lady and the patient herself wanted it. A lot of times it’s families will say, “Do you want this booklet?” But this patient wanted it. And she said, “That’s the best gift you could have ever given me.” Because it just kind of prepared her. She knew that she wasn’t going to go through everything in that book, but that helped her know these are some of the things. And so it relaxed her because I think sometimes when the unknown-
Amy Stapleton:
… Exactly.
Karen Crosby:
You could think horrible things.
Amy Stapleton:
I mean that information, that truth telling, that I’m here and I’m not going to leave and I’m going to be with you. That holding a hand when we could do that. That reassuring presence goes so far.
Karen Crosby:
I agree with you. And I think that that’s what’s so helpful with having specified teams and case managers. So that’s what I do. So I have the same patients all the time, unless I’m on vacation or something. So I think that that helps. That’s why I always think before, when you were saying about people getting on hospice too late, when they do come on and they’re still doing fairly well, I feel like that’s the perfect time because then they can get to know us. They can trust us. So when that time comes, and same with the family, when that time comes, when they are getting close to dying, they trust what we’re going to tell them. This is what we’re going to do. And the doctor ordered this. This is good. This is going to help you to keep you comfortable. And so I think that it’s always good. It is difficult when people are referred too late, but we still-
Amy Stapleton:
… You still show up.
Karen Crosby:
Exactly.
Amy Stapleton:
Yeah, exactly. This is holy work. Thank you so much for just being the hands and feet. And again, on behalf of humanity for showing up, especially during these times when so much has been taken from people.
Karen Crosby:
Yeah.
Amy Stapleton:
I’m so grateful to know that you’re in the spaces where many of us still can’t go and to be with people in a way that honors the fullness of who they are. So thank you. It’s been my pleasure to talk to you today.
Karen Crosby:
Thank you.
Amy Stapleton:
And this was totally epic.
Karen Crosby:
Thank you.
Narrator:
Grief From the Other Side podcast is made possible thanks to the generous support from the John & Cathy Belcher Institute. For more information on grief and loss services, visit ChesapeakeLifeCenter.org or call (888) 501-7077.
