Putting her heart into care
Hospice nurse with the Visiting Nurse Service of New York on her dedication to her patients
BY ANGELA BARBUTI
While earning her nursing degree, Claudia Paul knew she wanted to focus on geriatrics. Now, as a hospice nurse for the Visiting Nurse Service of New York, she is certain of her career path. “With the geriatrics population, you learn a lot. It helps you grow as a person,” she said. “I’ve learned to love the relationships that are being built, the stories that I’ve heard and the people who I’ve helped. Even if it is cooking that one boiled egg or sitting down or playing a game of spades.”
A Haitian native, she came to the States United in 1985 at nine years old and settled in Brooklyn. Paul began her career as a home health aide at the suggestion of her mother, who worked as a home health aide as well. She explained that her role was always centered on building relationships and trust with her patients. One of her first assignments was caring for New Yorkers with AIDS.
When asked how she maintains her composure around terminally ill patients, she said it’s important to be confident and not bring any fear or stress into the environment for the patient as well as the family. “And even if we don’t have all the answers, maybe just your presence is enough,” she added.Your mom was also a home health aide. How did you get your start in the profession?
She had suggested that I get into the field, so I wouldn’t be too dependent on them. I was about 22, going to John Jay. She had referred me to her agency and I did attend the class and get the certification. And my first patient — I was not as confident as I should have been — was able to help me build my confidence by practicing on her what I would be doing.What was your experience like as a home health aide?
Basically, what I’ve encountered were relationships that were being built around trust. Because we are going into these patients’ homes. They are not knowing our background, criminal background, yes, but personally, they don’t have a clue of who’s coming into their house, but they have to trust this person to come in and take care of them. And I’ve been able to provide that at a pretty young age. And I’ve moved forward to get my nursing degree. I was working at the VNSNY Lombardi Program, making home visits as well, again, building relationships and trust. We were able to teach medication compliance. If they are forgetting their medications, we will pre-pour the meds for them, do injections if needed and provide wound care.Tell us a story about a patient you had a special connection with.
There was one patient in particular at the Haven [VNSNY Haven Hospice Specialty Unit]. Her daughter and I went to EMT school and we lost the connection. She happened to see me when I was giving birth to my twins and she was also pregnant with her twins. But the last time I saw her was when her mom was being admitted at hospice and that’s how we reconnected. I lost my twins, but her twins were 11 years old and seeing them I’m picturing my boys would have been that age. I’m seeing what could have been. But, in the end, her mom always requested, “Claudia, come in. Claudia has to do this. She does it better.” It was not that I did it better. It was just a familiar face of comfort, a connection, not only with her, but her daughter. And when her mom died, it was very emotional. I did not know her mom until she got to the Haven, but I knew her daughter. When she was leaving that day, her statement was, “I hope we meet again, but not under these circumstances.” And then she thanked us and said that her mom couldn’t have been taken better care of. Her mom died peacefully and comfortable. It’s a small world, the circumstances that bring us back.You worked with New Yorkers living with AIDS. What do you want people to know about the disease?
One thing I learned from my early experience was that the side effects of the medication can be a factor in non-compliance. In my experience, most patients were non-compliant with meds because they were not aware of the potential side effects like distended stomach, loss of appetite, and so on, and how to manage these conditions. If people could be taught what to expect before they start the regime, I think they would have been more compliant. However, I think with antiretroviral therapy and new treatments things have grown tremendously. Now, instead of 14 or more pills, many patients are on only three or four. And also, with the internet, people have easier access to information about medications and side effects. However, if a trusted primary physician, nurse or case worker had sat down and said, “This is what to expect from this medication when you take it,” I think that would have made it easier back then for compliance.When did you start working for the VNSNY? How have they supported you throughout your career?
In the city, back in 2012, but I’m with Visiting Nurse Service of New York since 2008. I’ve been very lucky that I’ve had managers who knew my potential and acknowledged my work. As a LPN in Lombardi, my manager Yveline Louis-Champagne has always pushed me forward to continue my education and get my RN degree. And my manager at the Haven, Theresa Feeney, who is my director right now, has acknowledged my dedication to my work in pushing me forward to not just stop here, but continue with education because, like I said, the health field is moving and we have to keep up with the changes that are taking place, so we can better serve our patients and our clients.Tell us about the VNSNY Goodman Brown Hospice Residence located on the Upper East Side and your role there.
I am the manager here. For these patients, home is no longer an option. Sometimes, safety is of concern at home, the patient might be falling a lot. Sometimes they are relocating to be closer to family members who work or live around the area. Our residence consists of eight beds. I oversee five LPNs and five HHAs. I coordinate the care with our team, which consists of our doctor, social worker and our spiritual care counselor. The goal of care while the patient is here is discussed. If they wish to remain here or go home, then we will discuss and plan that. Also, because it’s a home setting, we assist the family, and they can spend the night. It’s 24 hours and we provide a pull-out couch for family members to spend the night with their loved ones.What are your future plans?
To obtain my master’s in health education and public health. To continue teaching, because as I get older, I’m hoping to leave a generation that has the care and passion that I have. And if I’m able to teach that, I think my generation will be taken care of as well.
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