Nurse shares life-or-death moments
What Ellie Powell sees in her mind's eye -- a sobbing woman trying to deal with the decision of taking her mother off life support -- causes her to wince, as though the memory pressed hard on a psychic bruise.
It was shortly after noon Tuesday as the tiny, gray-haired 71-year-old nurse sat inside the chapel at Valley Hospital and recalled how people agonize over a huge decision they never want to make.
"The day I don't cry with a family who's going through that, that's the day I'll quit," Powell said. "I keep my cool when I'm helping people get through a terrible time, but that doesn't mean I can't show the compassion I feel. I'm human."
Her business card for the Valley Health System reads: "Ethics Coordinator, System Clinical Nurse Ethicist."
What that often translates to is that she is called by hospital officials when families with loved ones near death at the Valley, Centennial Hills, Summerlin, Spring Valley, and Desert Springs hospitals need help making end-of-life decisions.
Day or night. Seven days a week.
The message she delivers in many different ways, the one that finally helps convince people that it's best to let go, boils down to this: Do to others as you would have them do to you.
Frequently, she walks into a hospital room where grieving relatives are hysterical, unable to cope with the word from physicians that there is nothing more they can do.
"Relatives often feel guilty that they didn't say how much they loved them. They feel they didn't spend enough time with them," Powell said. "They just don't feel that they can bear to let their loved one go. They still have so much to tell them.
"Even though the patient may be brain dead, their relatives still see him breathing on a ventilator and can't believe he won't get better. But then I ask them if that's the way they would want to live, and they start to understand."
Twice in her own life, Powell has had to make the end-of-life decision, with a premature baby boy and her mother. The only way they could have lived was through feeding tubes and ventilators.
"I knew that wasn't life," she said. "It would be cruel."
That experience convinced her that people needed help in working through end-of-life situations. When a position opened up in the field a decade ago, the grandmother with a graduate degree in ethics jumped at the chance.
"I went into nursing to help people, and I believe I have the skills in this area to do it," said the former critical care nurse who has literally held a heart in her hands. "It isn't easy to get through seeing a loved one pass."
It is when Powell asks distraught family members if they would want to be kept alive by a seemingly unending maze of tubes and medical equipment that she says she often sees a grudging acceptance of reality begin to set in.
She often shares her experiences with people.
"It's important that people know that I've been there," she said.
Sometimes it takes a week of meetings, or even more, for the family to make the very personal decision to take a loved one off life support.
"No one wants to see someone they love in that kind of situation; they wouldn't want to be there," Powell said. "I am an advocate for the person in that bed, and I think relatives become one, too."
Dr. Thomas Alfreda, a resident physician in the Valley Health System, is awed by Powell's ability to work with families.
"Sometimes families just can't process what physicians have to say and we call Ellie," Alfreda said.
"It's very emotional. It never gets any easier. She almost becomes a member of their family. She gets them to realize that it's in the patient's interest, not the family's interest, to let them go. It ends their suffering. She shows them that it's the quality of life, not the quantity, that's important. She doesn't make the decision for them, but she gets them to see the situation in a different way."
Letters from families are often sent to Powell. She recently received one from California.
"Thank you for all of your support and help in the decision and aftermath of taking my mother-in-law off life support," the letter reads. "You truly put the word 'care' back into health care. ... You were a small beacon of light for us on a very dark day."
It is that kind of feedback, coupled with grandchildren she spoils and a loving husband of almost 50 years, that keeps her positive.
"My work doesn't get me down because I know I'm doing something important," she said. "I'm helping people at one of the most difficult times in their lives."
Powell is an advocate of people making living wills, or advance directives, designating their wishes regarding end-of-life situations.
She remembers a situation at Valley Hospital in 2008 where a man sat in a hospital room as his longtime companion took her last breaths.
That case, written about in the Review-Journal, involved Joe John Sorce and Mary Clark, the woman he referred to as his common-law wife.
Because Nevada doesn't honor common-law marriages, Valley Hospital officials had to consult Clark's estranged children on end-of-life decisions.
"I couldn't believe I didn't have anything to say about this," Sorce cried as he spoke to the Review-Journal about the woman he had lived with for 18 years.
Though not brain dead, physicians had judged Clark as terminally ill. Sorce wasn't ready to let her go, but her daughter was.
"My heart went out to him," Powell said. "And that situation wouldn't have occurred with an advanced directive."
An advanced directive can be prepared for free. People can go to legal websites, such as www.livingwillockbox.com, and fill one out. It's a simple three-step process that takes only a few minutes.
Less than 25 percent of adults ever make one out, Powell said.
"We're afraid of our own mortality," she said.
And so the agonizing end-of-life situations crop up again and again.
Powell will continue to do her best to make the pain more bearable.
"I don't plan on retiring," she said, standing to leave the chapel where she often talks with grieving families. "As long as I can help people, I will."
Contact reporter Paul Harasim at
pharasim@reviewjournal.com or 702-387-2908.
