Reducing stigma in hospice nursing: Christine Merchant, BSN '98

“Society is so afraid of death, we squander our final moments we could be spending with loved ones,” said Palliative Nurse Christine Merchant, BSN ’98.

For the past five years, Merchant has worked on a palliative care team at Honor Health Deer Valley Medical Center in Phoenix, Ariz., the northernmost level one trauma center in the city.

Her team consists of a chaplain, social worker, physician and nurse practitioner, all of whom work in tandem to help manage symptoms of critically ill patients. Their days start with an overview of each patient, with new arrivals being assessed on a team approach to conclude the reason for consultation and what needs to be addressed.

“When meeting with patients and families, we don’t discuss the medical at first, we get to know them as a person,” she said.

Getting to know a patient’s background is key to Merchant’s work. Family medical history, spiritual beliefs, and even their life story are taken into consideration when developing a care plan.

Beyond managing symptoms and performing day-to-day assessments, she spends time helping families understand the reality of what their loved ones are faced with.

“I help families understand that the focus is about the patient and not them,” said Merchant. Often, she finds her patients’ families pursuing aggressive treatment for a poor prognosis, as their fear of losing a loved one overrides what is best for the patient. “Patients listen to their families too often and not don’t choose what they really want,” she said.

Having spent most of her career in critical care nursing, the transition to palliative care forced Merchant to shift focus with patients. “My approach before was, ‘how can I make this patient get better?’ Now, it’s ‘how can I change the focus of where this is headed?’”

Aside from having a natural sense of empathy, Merchant learned many effective communication skills for those in grief through the master’s degree she received in palliative care from the University of Colorado-Anschutz Medical Campus. Subtle ways to approach terminal illness can make a lasting impact for
patients.

Unfortunately, Merchant has been exposed to the pain and suffering that families endure, but like many who practice in palliative care, some of life’s greatest lessons have been learned. In addition to realizing the importance of advanced care planning, an appreciation for life itself keeps Merchant rooted along with practicing mindfulness and resiliency and what that can mean for coping and daily living.

As for her team, the pandemic has brought an extra layer of stress and grief to her work. During the daily debrief, team members go over patient deaths they have experienced. Recently, her team provided a training taken from ELNEC (End
of Life Nursing Education Consortium) for the medical-surgical team on how to better handle grief, due to the increase in deaths caused by COVID-19.

Dr. Barry Sargent serves as the chaplain at Deer Valley Medical Center and brings close to 40 years of experience to the palliative care team. Patients share their honest thoughts with Sargent regarding their diagnosis, which in return, he provides the tools for them to cope with their personal grief.

“Patients just need someone to talk to and say, ‘this sucks’ or ‘my family’s making me do all of this treatment when I just want to be done.’” Sargent continued, “It fosters critical conversation and I’m able to work with the families.’”

Sargent works alongside Merchant to provide the true meaning of well-being for their patients, and he considers her an asset to the team. “She’s the nursing version of myself and has such a great mannerism and way of working with patients
and families,” he said.

While raising four children as a student at the Michigan State University College of Nursing, Merchant was a leader in her class and spoke at graduation. She credits the college with giving her the confidence to aim high. She lives in Phoenix, Ariz., with her two dogs and remains a die-hard Spartan fan.

“The college taught me that sky’s the limit and showed me the basis that anything was possible.”