By Lisa Schaffer, BSN, RN, CIC, CRRN, CCM
Nursing is difficult to define because it encompasses so many responsibilities at once—assessment, patient and family education, compassionate care, and above all, advocacy. Although nurses may only be part of a patient’s life for a short time, our impact can be profound. Throughout my nursing career, one of my personal goals has always been to be a strong patient advocate.
In February 2007, I cared for Veronica, an 88‑year‑old woman who had lived with her daughter and son‑in‑law since her husband passed away nearly twenty years earlier. She had been in her usual state of health until one morning when, according to her family, she “wasn’t herself.” They noticed a sudden facial droop, slurred speech, confusion, and left‑sided weakness. She was brought to the hospital, and after a CT scan of her head, she was diagnosed with an inoperable cerebral bleed.
A few years earlier, Veronica had been diagnosed with Alzheimer’s disease. She remained independent with her ADLs, but she required a fair amount of supervision. Previously, she could be left at home alone for several hours, but over the past few months she had begun experiencing panic attacks when left by herself, even for just a few minutes. Her decline had been gradual but unmistakable.
Veronica was fortunate to be admitted to the hospital where her granddaughter—a nurse—worked. The neurosurgeons were honest with the family: she was not a candidate for surgery. Although the granddaughter had consciously decided to be “the granddaughter” rather than “the nurse,” she found it impossible to separate the two roles. As Veronica’s daughter became overwhelmed by the realization that her mother was dying, she turned to her daughter—the nurse—for guidance and understanding. The granddaughter’s familiarity with the hospital routine, the staff, and end‑of‑life care allowed her to support her family through an emotionally devastating time.
The primary care physician ordered a repeat CT scan, labs, and therapy consults. However, the family knew that Veronica would not have wanted physical or occupational therapy. What she would have wanted was to eat—she loved cookies. This simple truth reminded the family that honoring her wishes mattered more than following routine orders.
By this time, Veronica’s other children—her two sons, one a physician and the other a corporate executive—were involved in the decision‑making process. As the family gathered and discussed her poor prognosis, they agreed that she would not want to be kept alive by artificial means. Veronica had lived a relatively healthy and independent life. Her husband, George, had passed away more than twenty years earlier, and for the past two years she had often spoken to the ceiling, asking, “Why haven’t you come to get me?” The family knew she was ready to be with him again.
The granddaughter asked her mother and uncles to consider hospice. What followed was a true nursing moment—one filled with compassion, teaching, and patient advocacy at its highest level. The family agreed that a hospice consult was the best choice for Veronica. The granddaughter spoke with the primary care physician, and the orders for repeat CT scans, labs, physical therapy, and occupational therapy were discontinued. A more appropriate hospice consult was placed.
As all of this unfolded, the granddaughter naturally stepped into the role of “the person in charge”—the one everyone looked to for strength, guidance, and comfort. Yet questions rose in her mind. Had she made the right choice? Had she guided her family in the right direction? She had recommended hospice to many families throughout her nursing career and had never regretted it, but this was the first time she had ever suggested hospice for her own.
Veronica was transferred to an inpatient hospice facility. During her time there, a remarkable group of compassionate caregivers supported Veronica, her children, her grandchildren, and even her great‑grandchildren as they prepared for her peaceful passing. Surrounded by comfort and family, Veronica died quietly a little over a week after entering hospice.
Patient advocacy is something to be taken very seriously. Nurses have an ethical responsibility to be the best advocates they can be—for every patient they care for. Now, when I am approached by a patient or family member about hospice and asked, “Is this what you would want for yourself or your family?” I can answer honestly. The answer is yes. Veronica was my grandmother.
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Bio: Lisa Schaffer, BSN, RN, CIC, CRRN, CCM Lisa brings over 30 years of diverse nursing experience and a deep commitment to patient advocacy. Her clinical background includes roles in medical-surgical nursing, intermediate care nursing, burn unit nursing, private duty nursing, charge nurse responsibilities, and volunteer service as a camp nurse. Following her time in bedside care, Lisa pursued further education and earned her Bachelor of Science in Nursing (BSN). She holds professional certifications in Infection Control (CIC), Certified Rehabilitation Registered Nurse (CRRN) and Certified Case Manager (CCM) and has actively contributed to numerous interdisciplinary teams focused on Performance Improvement, Quality Assurance, Education, Survey Readiness, Hazardous Materials, and Emergency Preparedness. Lisa played a key role in the development of Nevada’s original Inter-Facility Infection Control Transfer Form, an experience that underscored the critical importance of collaboration beyond individual healthcare facilities. In 2025, Lisa received two awards related to her role as a case manager, Excellence in Nursing 2025 (Case Management Category) presented by The Arc of Nevada and 2025 Excellence in Nursing – Women & Leadership (Case Management Category) presented by Las Vegas Healthcare and Vegas Heals. Her professional goals include fostering networking and collaboration among Case Managers, Social Workers and the many community resources available in Southern Nevada.