Selma Rabin defied medical odds and lived longer with metastatic cancer than anyone expected. Her family credits two reasons for this: One is Selma’s remarkable love for her family and determination to be around for them as long as she could. The other is the outstanding care provided by a team of nurses led by Mary Feng, R.N., M.S.N., OCN.
Mary is a bedside nurse. That is her profession and also her calling; it is one of the most crucial yet underappreciated jobs in medicine. Bedside nurses are the foot soldiers; they’re right there alongside their patients, in the medical trenches, day and night. The best ones, like Mary, are astute, compassionate, and empathetic. They’re the patient’s best advocate and the family’s greatest friend. Mary and her team kept a careful eye on Selma, anticipated her every medical and personal needs, enabling her to maximize her energy and strength; they also kept the family informed and reassured that Selma was getting the best care possible.
They first met when Selma was in the hospital recovering from a major operation to treat her pancreatic cancer. The surgeons thought they had caught Selma’s cancer early. The family were told all the cancer had been removed and the margins were clean.
Selma got better and went back to her normal life – to live happily ever after, Mary hoped. Artie called her about a year and a half later. “He said, ‘Mary, I really need you to come help me and do what you can to save my wife.’ The disease had come back and spread. The doctor said she didn’t have much longer, and wouldn’t make it to her grandson’s bar mitzvah” in six weeks. “They wanted her to at least be there.”
Mary took over Selma’s care. “From then on, we had day and night nurses with her,” she says. At first, Selma didn’t feel that she needed the private duty nursing. “She wanted her independence,” says Mary. “She was still able to do a lot on her own. But she didn’t realize that even very little effort took a lot out of her.” Having the nurses around improved Selma’s quality of life immensely, “because she was able to do other things without having to worry about simple little tasks that required a lot of her energy. We would take care of that for her, so she could enjoy her family. She didn’t have to prepare her meals or worry about when to take her medicine.” The nurses were constantly trouble-shooting, anticipating when Selma might experience pain, and “we made sure to give her medication before her pain escalated.”
Artie Rabin and his family talk often about how grateful they are for the nursing care, and what a difference it made to Selma. In turn, says Mary, “it was a real honor to work with Selma. Selma and the family gave us a lot of autonomy as caregivers and they trusted our decision-making. That really helped, because a lot of families and doctors don’t give nurses enough autonomy, and don’t trust our decision-making as much. But we’re the ones who are really by the bedside with the patient, 24 hours a day. We give each other very detailed reports, and there is no missing link. It’s continuation of care.”
Comprehensive reports were given to the entire nursing team every shift while maintaining confidentiality and protecting Selma’s identity. These reports included updates on tests, what foods Selma liked, her sleeping routine, and even such details as how she liked her pillows. “So nurses wouldn’t have to ask, ‘How do you like this?’ or ‘Where is your pain?’ We already knew.” Selma would ask, “How did you know that I needed that cushion?” It was in the reports! “Something so minor can make such a big difference,” Mary continues. “In a day, there are so many little things we can do to make a patient comfortable, and it means so much. If a patient has to retell what she needs every single time to every different nurse, it can get exhausting – just another reminder that she’s sick.”
With Mary at the helm, Selma not only made it to her grandson’s bar mitzvah: “She was the life of the party,” says Mary. “She lit up the room. She was just radiant; she stayed up later than anyone! I kept asking her, ‘How are you doing?’ and she kept saying, ‘I’m okay, what about you? Do you want to go home? I’ll go home.’ She was concerned for me! I said, ‘No, Selma, I’m here for you!’ She was so happy to be with her friends and family that day. She had so much energy, and was not tired at all. You would not have known that she was fighting this illness.”
“You could just see the life in her – in her face, in her eyes.” Selma had only left the hospital a couple of days before the bar mitzvah. “She really fought to be able to be there, and she didn’t once complain. She never complained about anything. Whatever we needed to do, she said yes. Whatever the family wanted, she said yes. She wanted to survive. She wanted to live for her family. She was so selfless, always thinking about everybody else. She was the sweetest.”
Losing such a patient is hard on the nurses, too. “You always wonder, is there something else I could have done?” The Rabin family would say No, Mary. You did everything you could, and then some.
This kind of nursing care takes dedication and hard work. “We’re not just here to give medication or listen to your lungs and leave the room so we can document that we gave care. It’s actually caring – providing that care. We take care of our patients like you would your own family.”
But providing that level of care often has a price. Burnout is a serious issue in nursing, just as it is in medicine. “I’ve been in bedside nursing for 16 years,” says Mary. “I don’t know what the average is; maybe five years.” In nursing school, the R.N. degree is often looked at as a first step, not an end in and of itself. “There are so many different avenues for nurses now; research, outpatient care, nurse practitioner, and careers in nursing pharmaceutical. People go to nursing school to not stay in bedside nursing. Instead, they ask you, ‘Where do you want to go from here?’ Nurses are encouraged to advance their career, go back to school, get their master’s, become a nurse educator or an advanced practice provider. There are so many directions for nurses, many of them don’t think of bedside nursing as a destination. Nursing care is so different now than it was 16 years ago,” Mary continues. “I really admire the nurses I learned from; it’s unfortunate that a lot of them have left the field because of burnout.”
How can we keep nurses like Mary at the bedside? And how can we give patients like Selma the kind of nursing care that will make a real difference in their lives?
Selma’s Slice of Life will help. The Prostate Cancer Foundation (PCF) is the proud beneficiary of Selma’s Slice of Life. Through the generous support of Selma’s Slice of Life donors, PCF will allocate funding to help vulnerable patients and families by providing $50,000-$75,000 grants to outstanding oncology nurses.
These grants will support continuing education and expand precision oncology nursing capabilities in the clinical setting. Through these efforts, the Prostate Cancer Foundation and the Rabin family hope to honor Selma’s enduring legacy of compassion and caring.