Bosque Farms nurse given 2012 New Mexico Excellence Award
Every parent lives with the secret dread of seeing their child die first, of watching them suffer through pain and breathing their last breath.
If that unfortunate time should ever come, the members of the Mariposa Program of UNM Children’s Hospital are there to assist families through the difficult challenge.
The team of specialists with Mariposa is varied, comprised of doctors, nurses, case managers, social workers, a chaplain, pharmacists and others.
Last month, one member of the Mariposa Program was honored not only for her dedication and work in the field of hospice and palliative care, but for the development of the Albuquerque-based program.
Lizabeth Gober, a Bosque Farms resident, was recently awarded the 2012 New Mexico Nursing Excellence Award in Home Health and Hospice Nursing.
Gober is credited with developing the pediatric hospice program for University of New Mexico Children’s Hospital and is now Mariposa’s nurse manager.
A nurse for 36 years, Gober graduated from the University of New Mexico in 1976 with a Bachelor of Science Degree in nursing, and became certified as a neonatal nurse practitioner in 1983.
She serves on UNM’s quality steering committee and pediatric practice council, and is a member of the Hospice and Palliative Nurses Association, the New Mexico Organization of Nurse Leaders and the National Case Manager Association.
A total of 179 nominations were submitted for this year’s Nursing Excellence Awards.
The awards recognize excellence in nursing practice, and honors nurses for the contributions they make to their organizations, communities and the state.
“I had no expectation to be nominated or even to win,” Gober said. “I was just doing the right thing. This is the most difficult time in a child’s life. We just use the skills we have to make the patient’s life the best we can.”
She also works with hospice agencies outside the Mariposa Program’s 60-mile radius that only take adult patients, to train staff, and collaborates with staff from local agencies so children can receive hospice in their home communities.
Gober also instituted a program that allows providers from throughout New Mexico to contact a toll-free number to obtain answers regarding care of children with end-of-life issues.
Crystal Frantz, the Mariposa executive director of case management, nominated Gober for the award.
“She is dedicated to providing compassionate quality care to pediatric patients and their families,” Frantz said in a recent press release. “She continuously worked with her team to improve quality by working on ways to assess a patient’s family members’ ability to safely provide care to their young family member. For example, for one family this meant color-coding medication syringes with exact dosages marked by the syringe.”
But Gober didn’t start her career helping those at the end of their lives. After 17 years working in newborn intensive care units, Gober said she needed some variety in her career.
She began working in home health care and became a home health care nurse, and eventually the director of several different agencies. She hired into the UNM-H home health care program, and in 1999 became the charge nurse.
Shortly after that, the hospital’s home care unit shut down and Gober was asked to stay on and do hospice care. In 2000, she was named the program’s director of hospice.
At Gober’s urging, in 2003 the program became dedicated to serving children — and occasionally young adults, depending on their diagnosis — during their end of life.
“I felt I could hire the right people. UNM-H sent us to conferences, training, gave us a lot of education on neonatology,” she said.
Calling the program Mariposa, the Spanish word for butterfly, was intentional, Gober said.
“When you hear the term ‘pediatric hospice,’ you know that’s not a fun place to send a child,” she said, unconsciously rubbing the silver butterfly ring on her right hand.
Being specially trained and credentialed is something Gober is very proud of, she says. She is a nationally certified hospice and palliative care nurse for children and adults.
Through Mariposa, she and the team care for about 30 children a year.
After nearly four decades of caring for patients, Gober says her biggest job is teaching the nurses who will take her place.
“I have to teach them what I know. The main thing is to never forget that the patient and family are in charge. What they say goes. They know best, despite what we experts think we know,” she said.
When most people think of hospice, they think the process is about death and dying. Gober said nothing is further from the truth.
“It’s about letting them live fully — to live every millisecond until the end in the best possible way,” she said. “Death is a millisecond in time. Everything before that is about living.”
Gober said while the experts with the Mariposa Program give all the control to the patient and family, sometimes they have to intervene.
“Part of what we do is give them real choices, help them do what makes sense for them and their loved ones. And sometimes that’s telling them the best thing isn’t getting on an airplane to Cincinnati at the last minute,” she said. “Sometimes we have to say no, the time for that is passed.”
In an effort to save their child, Gober says parents will do almost anything.
“They will look on the Internet, and find information that isn’t equivalent to their situation,” she said. “And there are predators out there, preying on families who are willing to help their child at all costs. At. All. Costs.
“Hospice is about making the experience as comfortable as possible, about making the best possible memories. How do you want to remember your child? Their last minutes with you? You have to help them make the best decision and understand, what does that look like? Suffering is not what they want to remember.”
Because of her experience working with children and families, Gober knows the importance of keeping a dying youngster comfortable and helping the family build good memories.
To be more immediately accessible, Gober often parks and stays in her RV close to a family’s home. All the nurses in the unit use the vehicle to stay close to the children who are at the end of their life and are in need of immediate pain relief.
“That way we are not in the family’s home, not in the way. When a child is in pain, it’s a lifetime,” she said. “When you get the call that they need a nurse and you’re doing 90 mph through Isleta, it’s ugly.
“And we found that people don’t want to interrupt us. They don’t want to call at 2 a.m. With the RV, we’re just a knock or quick call away.”
Not only does staying in the RV prevent family members from feeling like they need to take care of the health care provider, it also gives the nurses some space from the situation, Gober said.
“It’s good for self care, self protection. As health care professionals, we do a really bad job of taking care of ourselves,” she said. “I tell the families they don’t need to worry about us. We come fed and watered.”
And Gober says she and the team never stop learning from the patients and their families.
“After each case, we do a debriefing to talk about what went well, what didn’t,” she said. “And the only reason why I’ve been able to do what I do is through the support of the hospital, because the administration allows us.”
And there is a lot of support from home as well — her husband of 13 years, John Bach.
“I am able to do what I do with his support. I don’t have to worry about home,” Gober said. “He’s here to take care of everything, so I can go take care of them.”
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