‘I feel people have a lot to say about when they’re going to die

Valerie Peterson finds joy in something that most people are afraid to even contemplate: death. As a San Diego hospice nurse, she loves being able to comfort the terminally ill and guide them through what she sees as the most important change of their lives. At 27, Peterson is younger than most nurses who have chosen to devote their life to the process of dying, but she figures it provides the perfect counterpoint to her mother’s job as a delivery-room nurse. “There are a lot of similarities between life and death,” she says. “We both are involved in a coaching process, helping families through a transition phase.” Times staff writer Leslie Wolf interviewed Peterson, and David McNew photographed her.

We provide home care for the terminally ill. People are so much more comfortable in their homes, and it makes the families feel good too that they were able to help out near the end. When people are dying in the hospital, the family feels so useless.

There has to be somebody at home who can take care of the patient when we’re not there. Hospice isn’t just hand-holding, it’s a science. There’s a lot of teaching to do about recognizing symptoms and pain control. I usually have between 10 and 13 patients, and I see most of them once a week. But there are times when I have to see them every day, and I’m also on call 24 hours a day for emergencies.

I’ve been a nurse for three years. I graduated from nursing school at San Diego State and went to work at Sharp Memorial Hospital. But I was getting really discouraged in the hospital. I didn’t feel I had the time to really spend with the patients--I just felt like a robot running around most of the time. I was seriously considering alternatives to nursing.

Then a friend who is a hospice nurse called and said, “Why don’t you try this?” I went out on a visit with her, and that was the deciding factor. There was such a closeness between the nurse and the family, such a warmth and a mutual respect, and you could see how much the family appreciated her.

The ages of the patients vary a lot, from 20 to 95, and there’s one nurse here who specializes in working with children. I would say the majority of my patients are in their 70s, and that’s what I like. I just love old people. They have so much to share, so many stories. I get the feeling that some of them have been neglected a lot of the time. They’re just real special.

Coming in here, I really didn’t know how I would deal with death, but I’ve learned a lot. I guess it depends on your philosophy. I don’t see death as a bad thing--it’s not something that frightens me. The majority of times it’s a positive thing, an end to suffering. I see it as a transition phase.

It is often sad because you’re losing a friend who you’ve spent a lot of time with. I find it helpful to come into the office and talk with my colleagues. You can’t just let it build up inside of you or it’ll overflow into other areas of your life.

I’m in constant awe of the strength that people have, both patients and families. The majority of the patients have accepted the fact that they’re dying. Some fluctuate back and forth between wanting to fight and wanting to just go, but most are at peace with it. People tend to die the way they lived. If they are real fighters, they tend to die that way.

I feel people have a lot to say about when they’re going to die. I do feel the mind has incredible power. Some patients really are doing a lot of positive thinking exercises, listening to tapes and doing visualization, and I don’t discourage that. Their emotional state is going to improve their physical state, and it helps if they feel better.

It is really hard on the younger ones. There’s anger, and they ask, “Why is this happening? I’m not a bad person.” I usually just support the way they’re feeling and say, “You’re right, this is crummy and it doesn’t feel fair, but there’s got to be a purpose.”

I do feel there is at least a spiritual dimension after death, but I’m still struggling with that question myself. In a way, you have to feel something like that in order to deal with this. I’ve been with a lot of patients at the moment of death, and it’s a very special moment. One 95-year-old woman was lying there and said, “Valerie, I can see my Lord and he’s coming to me!” She was at peace completely at that time. It really gave me some hope.