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From Hospice Nurse to Life Doula

The word doula is most familiar to people as a support to women during pregnancy and the birthing process. Doula symbolizes non-medical support of a whole person: physically, mentally, emotionally, and spiritually. This support extends as a peaceful energy guiding a spirit entering our world in the birthing process, and through a Life Doula walking beside a spirit preparing to leave our world. 

Our positive death movement has brought many changes to our culture’s views on death, dying, funerals, and beyond. The spirit of the movement has allowed many compassionate and deeply spiritual caregivers to become recognized as Life Doulas, Death Doulas, End of Life Doulas, and Soul Midwives while providing the support that our previous generations instinctively offered to aging and dying family members. This aid had been gradually lost as families distanced from one another, and aging elders began being cared for by agencies and care homes. The spirit of compassionate support, provided without regulations and systematic care plans, sprang up quietly over past decades among caregivers working as independent doulas. As our perception of death and dying changed, these doulas not only began to be noticed, but training and certification programs were developed by pioneers that recognized the need for standardization and a means to assure competency. 

Many professionals within the hospice community, funeral industries, religious denominations and many more, find that the work as a Life Doula resonates with their deepest selves. These professionals experienced an awakening to a spiritual calling to work from their hearts while ministering to the entire person. This was my own journey from a Certified Hospice and Palliative Care Nurse to a Certified Life Doula. 

My role as a Life Doula is inherently spiritual: I recognize the sacredness of my clients, something that was always alive in my caring throughout my nursing career. Yet that role rarely allowed me the time and presence to offer my deepest self and just BE with a patient. Now, I am free to reach out to the very peaceful, serene, and knowing place that is at all of our centers. In my many discussions with people interested in the work I do, it is this heart to heart, soul to soul connection that we resonate with. And that is the very essence of my work that creates a gift that I give but receive much more than I share. As always giving and receiving are points of the same circle.

I had a client several years ago that invited me to walk with her, to both relieve her family as well as to support them during this time. She had been an avid business owner until her husband became ill as his retirement approached. Always filled with a zest for life, a joy in meeting new people and making each one feel as though they’d found a soulmate friend, she had begun her own decline several years after her husband passed. Living alone was certainly what she preferred now, and it was possible with the right support. She needed a compassionate friend to check on her. The family needed assurance that she was being monitored, that her safety and social needs were attended to. My client’s very outgoing nature hungered for me to listen to her joyous stories of life begun on a different continent, emigrating to the US, beginning a new life here as a young bride. To help her feel alive and vibrant, to reconnect with the many experiences that held deep emotional memory and meaning to her. To affirm her life, her spirit for living, and guide her through this final chapter of her life. 

I learned much about real courage and strength as I listened to the steps she took while finding her way without the comfort of family and long known friends after moving to the USA.  She discovered a new culture, traversed her way through the geography and legal challenges to her new life. Ultimately owning several successful businesses, all while raising a wonderful family.

I visited several times a week, chatting and listening, all while providing oversight on the safety of her movements, sharing nutritious lunches and assuring the refrigerator held no outdated foods. We took road trips to visit the businesses she once owned, had lunch out at times for a boost to her social esteem, often meeting others from her past that she had not connected with in many years.  It was a joy. And while I was there to support and guide her, she viewed me as a friend rather than an employee. And friend I was. I continue to hold her as one of my closest, truly soulmate companions. I honored her life by listening and helping her to reconnect, yet it felt as natural as what I would do for my own family member, and just as precious. I was honored by her intimacy and power of her spirit.

She was hospitalized from an event that ultimately was her end. I visited her in the hospital in her unresponsive state. As I held her hand and spoke to her, her heart monitor showed a strong reaction. I was pleased to stay with her, to support her family, to help guide their understanding of hospice and the dying process. And I cried with her family as we gathered later to celebrate the life of this dynamic and loving woman. These years later, I pause when I near one of the places she wanted to revisit before she passed, reconnecting again with the gift of her presence in my life.

My long experience as a registered nurse allows me to observe clients and to help guide them and their families towards appropriate health and wellness practices. Yet my role as doula is non-medical, which frees me to guide clients rather than advise. I seamlessly combine all of these as a Nurse Advocate and Life Doula with Ikor Life Care Management and I can utilize my nursing background in many advisory ways, always advocating for our clients. My Life Doula role forms a perfect addition, offering our clients nursing oversight with holistic, life affirming support. I am free to spend unstructured time with my clients, allowing the space for difficult words that may need to be shared. Space that allows deep conversation, and many good laughs as memories flow. I use my skill with reflective writing to encourage clients to journal, to create legacy letters or photo memories for their loved ones. I know I’ve found my heart’s work. It is the outcome of many years of education, work experience and growth, and following my heart’s lead to explore and create the role that is correct for me. It includes all of me and flows straight from my heart without thought. Isn’t that what mindfulness presence is?

In 2018, the National End of Life Doula Alliance (NEDA) was developed as a part of the hospice programming within the National Hospice and Palliative Care Organization (NHPCO). Life Doulas now have a competency badge which is recognized by the medical system and provides assurance for families seeking this support for their aging loved ones. For more information about the development and credentialling of End of Life Doulas as well as a directory, visit http://www.nedalliance.org
 

About the Author
Marggie Hatala, Certified Elder Care and End of Life Doula, combines these services in combination with her experience as an RN to offer holistic, non-medical support as a Life Doula. In this way, Marggie walks with her clients through the challenges of chronic illness, aging and decline and through their final days. Her deep spiritual presence, extensive knowledge and experience, and peaceful assurance allows them to feel the depth of her support. Additionally, Marggie seamlessly includes this support with her role as a Nurse Advocate with Ikor Life Care Management for clients that benefit from the inclusion of medical advocacy.

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