…Because each year builds on and informs the next, incorporate your head and your heart into your career decisions. Some years I just needed a schedule that accommodated my kids or paid the bills but all along, I wanted to feel some passion for the work I was doing. Right now I am working part-time as a hospice nurse, writing often, and reviewing nursing policies for a new hospice home in Oregon. It’s fun to look back on my career of 25 years in nursing and think, “Oh, that’s how I got here.” I kept paying the bills while following my heart’s whispers.
Beth Cavenaugh is a certified hospice and palliative care nurse and educator with over 14 years of experience in caring for terminally ill patients. She has been a registered nurse for over 24 years and holds a bachelor’s degree in nursing from Creighton University. Beth has supported hundreds of patients and their families at inpatient units, in the home setting, and behind the scenes in hospice care. Compassion, patient autonomy, and transparent communication are at the core of her care philosophy.
Beth hopes to demystify death and dying so this powerful moment will be embraced as a normalized and celebrated life event. She continues to work in hospice and has a private Reiki practice to support physical, emotional, and spiritual healing for adults and teens. Beth lives with her husband in Portland, Oregon, where they have (almost) successfully finished raising their three kids. Learn more at BethCavenaugh.com.
Thank you so much for joining us in this interview series! Our readers would love to “get to know you” better. Can you share your backstory with us?
I never contemplated becoming a nurse until I worked in nursing homes as a mental health assistant with the Jesuit Volunteer Corps. I worked with a small team that held therapy groups for geriatric residents who lived with a mental health diagnosis such as depression or anxiety. I was surprised and delighted by these octogenarians. I remember one patient told me she wanted to be cremated because it was the first time in her life she would finally be warm; I choked on my coffee when I heard this. Another patient had MS and lived with fluid restrictions for years so any beverage she drank required artificial thickener. One day, I brought her a small vase of flowers. She grabbed the flowers, threw them on the floor, and drank the vase of water so quickly my head was spinning. She howled with laughter after that. These wonderful patients changed my life. I went back to college and started moving forward to get my nursing license.
Can you share the most interesting story that happened to you since you started your career?
I had been collaborating with the doctor to get our patient’s terminal agitation under control. After two hours of restlessness and intense medication titration, the patient finally relaxed and the family settled into their chairs. The patient began to exhibit Cheynes-Stokes respirations, signaling the end was near. The family requested to speak to the doctor. The physician went into the room and came back 10 minutes later, ghostly white. He said, “The patient died while I was in there. I have never been in the room with someone when they died.” And I thought, “Oh my God, and I am taking orders from you?” It was at this moment that I finally realized the powerful role of the bedside nurse. Do not get me wrong, I thank my stars every day for the brilliant physicians I work with, but this event gave me the clarity I needed to step into my powerful role as a bedside nurse/advocate/activist for my patients.
What were the main lessons or takeaways from that story?
Bedside nurses have an interesting and critical vantage point. We see the relief and healing in our patients and families, but we also see the inadequate access to proper care for some, the family dynamics, the existential suffering, the inadequate pain relief, and the agitated patient who is combative to the staff. We are healers, advocates, and activists.
Can you share a story about the biggest mistake you made when you were first starting?
After a year of hospice nursing, I began to feel the weight of my patient’s suffering along with responsibility for the good deaths, the not-so-good deaths, and everything in between. Around that same time, my beautiful brother-in-law Jeff died at the age of 41 from ALS. My sister lovingly took care of him, and I stayed with them a few days before his death. We bathed him, repositioned him, and gave him Ativan and morphine. I drove away one day. He died four hours later. I was so surprised and ashamed that, as a hospice nurse, I did not see it coming. How could I have missed his death? I should have been there. I ruminated on my “miss” for months.
My shaman nurse friend invited me to partake in soul retrieval. The ritual intends to call back parts of your soul that are missing, and this resonated with me — I felt parts of my soul were missing or unhinged from a year of hospice nursing and my brother-in-law’s death. During this ritual, I had this vision of my spiritual team which, at that time, included God, my mom, angels, saints, and now, Jeff. This two-hour session with my spiritual guides felt like 15 years’ worth of therapy.
Can you tell us what lesson you learned from that?
I realized death was a divinely orchestrated event, which doesn’t mean it will be tidy or simple, or predictable. Death is mysterious and mystical and much bigger than little ol’ me. My role as a hospice nurse was significant and, in the same breath, insignificant. I would do my absolute best for my patients on my eight-hour shift. I would rapidly titrate medications if needed, run to alleviate their suffering, sprint to the parking lot to find family members if a patient was actively dying, but how they died, when they died, why they died, and who was there, had nothing to do with me. In the end, their death had nothing to do with me. I was not present for Jeff’s death, but that was ok. Whoever was there needed to be there, and I was supposed to be on my way home.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are?
Anything I know about being a solid hospice nurse, a compassionate nurse, a strong patient advocate, I learned from the extraordinary nurses I have worked with and continue to work with. I learn something every damn day: how to manage someone’s pain better, a softer way to deliver tough news, or a more present approach to my patients. I am consistently open to revising and improving the way I practice as I watch and learn from them.
Can you share a story about that?
I started a new job this year and was oriented with a nurse. She brought me to my knees with her compassion. She has been a hospice nurse for about two years, and I have been a hospice nurse for 15 years. Our patient was dying, and we instinctively grabbed his hands, I on one side and she on the other. She said, “We, have you. We are here with you.” She looked into his soul, and he looked into hers. She kept talking to him, soothing him, and laughing with him, while affirming that he was going to be ok. And she breathed with him. It really felt like we walked with him to the other side of this mystery. He died peacefully with us there.
I walked away and thought, “Wow, that’s how you do it.”
Ok perfect. Now let’s jump to our main focus. When it comes to health and wellness, how is the work you are doing helping to make a bigger impact in the world?
I guess it depends on your definition of health and wellness. As a hospice nurse, I obviously cannot physically heal my patient from their disease, but I can work to alleviate their pain or shortness of breath which helps to maximize the quality of their life, not necessarily the quantity of their life. When patients’ symptoms are well managed, they have the energy to focus on the emotional, relational, and spiritual healing that can occur at the end of their life. My book and blog about end-of-life care are to make the dying process easier on the patient and the families. I am not sure I have moved the needle, but when people can experience more peace at the end of their life, that ripples out.
Can you share your top five “lifestyle tweaks” that you believe will help support people’s journey towards better wellbeing?
- Every day I try to meditate, exercise, drink more water, be nice, eat well, blah blah blah. I rarely do all of these things in one day and rather than beat myself up, I practice self-compassion. I go to bed and say, “Nice try, Beth.” When I wake up I say, “Let’s try again.”
- I hate self-deprivation; if I tell myself I cannot eat chocolate, all I can think about is chocolate. I don’t diet or eliminate things. I prefer to add something to my life like a walk or another glass of water or a green smoothie. 2a. Make a green smoothie that will last three days in your fridge.
- I regret that I never had a space to call my own while I was raising kids. The minute my second child moved out, I packed up their supplies and created my own chamber. I now have an office space with a bed so I can nap without anyone knowing. I have my own art and my own comforter and my own desk. I just close the door if I don’t want to clean it up. Find a space to call your own, whether it be a chair, table, an altar, or the inside of a closet.
- I made a promise to myself in August 2020 to insert myself into the world in a way that is uncomfortable to me so I decided to market my book. I say yes to podcast interviews which means each podcast is an opportunity for me to become more articulate on the spot. I am still clunky but improving. I am writing blogs every week with an unbelievable editor, and she just told me yesterday that I am improving as a writer. Before I post my blogs on LinkedIn or Facebook, I acknowledge my fear, take a breath, say “what the bleepity bleep,” and post it. All of this discomfort has brought personal satisfaction, improved speaking and writing skills, and continues to fuel my drive to improve end-of-life care.
- Because each year builds on and informs the next, incorporate your head and your heart into your career decisions. Some years I just needed a schedule that accommodated my kids or paid the bills but all along, I wanted to feel some passion for the work I was doing. Right now I am working part-time as a hospice nurse, writing often, and reviewing nursing policies for a new hospice home in Oregon. It’s fun to look back on my career of 25 years in nursing and think, “Oh, that’s how I got here.” I kept paying the bills while following my heart’s whispers.
If you could start a movement that would bring the most amount of wellness to the most amount of people, what would that be?
My movement of course involves a beautiful death. I have a dream that death becomes a celebrated and holy event in which people gather and support and tend to the patient and the family. I envision communities gathering around a dying person like a band of angels. These angels mobilize and offer help with laundry, shopping, and meals. The dying patient is supported to make a plan and loved ones know what the patient wants and what is important to them. Airlines offer cheap flights to visit a dying patient.
Patients can choose to die in their home with 24/7 care if needed or in a hospice home with nurses and aides expertly trained in end-of-life care. Or people could die in hospitals with death suites that are large enough for extended families to camp out. Everything is paid for by insurance. All of these options will include the possibility to die outside in nature — under the sun, the stars, or a big, sexy maple tree. And when the patient dies, family and friends are gathered around the bedside, whispering prayers, blessings, and a pause for this holy event. After the patient dies, there will be plenty of time for rituals and offerings in whatever way is meaningful to the patient.
And family can get plenty of paid time off to grieve and get their head back on their shoulders — and begin work when their heart is a little less shattered.
If we all knew what to expect when we are dying, that we would be taken care of and comfortable, we could relax into this process and die in a state of grace, which can only help one to live in a state of grace.
What are your 5 Things I Wish Someone Told Me Before I Started and why?
- Nursing is an incredibly intense profession. You need to incorporate rituals and habits like yoga, meditation, and exercise into your life that foster compassion, wellness, and stillness. In the book “How Doctors Care” (2020), Dr. Dominic Vachon says that caring compassionately for your patients actually improves patient outcomes and minimizes professional burnout.
- Build your support team of professionals. You may want a counselor, energy healer, chiropractor, esthetician, acupuncturist, LMT, coach… outside advisors, healers, and helpers are important people to have around you so you can call on them throughout your life.
- Invest 20% of your income in your company’s retirement plan or your own as soon as possible. Bedside nursing has an expiration date; you want to have some financial options later in life.
- If you are feeling like a burnt and crispy nurse, take a vacation or reduce your hours. If that doesn’t help, quit your job. Take a break or try something new. Do not muscle your way to retirement, everyone can feel it.
- Detail your car before you sell your car. Most people just want a cleaner car.
Sustainability, veganism, mental health and environmental changes are big topics at the moment. Which one of these causes is dearest to you, and why?
Today, it’s mental health. Mental health, defined by the World Health Organization, is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.” Wikipedia
Wow. Right? This definition feels like it’s the missing thread for all of our problems in the world today. Solid mental health allows us to do all the other things. I think if we all pondered this definition, we would work to integrate meditation, financial wellness, job skills, and mental health tools into our educational systems; we would work to live in harmony with the earth, value our resources, and care about climate change. Also, I am a true carnivore and will never give up my bacon, but I may try to instill meatless Mondays in my life. These are all steps towards a better world.
What is the best way our readers can follow you on social media?
Thank you for these fantastic insights!