Onc Nurse On Call, a new podcast from Oncology Nursing News, features editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers, DNP, MSN, RN, AOCNS, BMTCN. This episode spotlights Melinda Mayorga, RN, MSN, CNS, AGCNS-BC, OCN, a clinical nurse specialist at Norris Comprehensive Cancer Center, University of Southern California, who discussed end-of-life care and the concept of “last responders.”
Mayorga recounted accompanying a patient through the final 32 minutes of life — time that would otherwise have been spent alone — and said the experience inspired a volunteer program that pairs individuals with patients at the end of life to prevent solitary deaths. She also developed an interdisciplinary toolkit that includes chaplaincy, mental health professionals, the arts and environmental services.
The toolkit supplies QR codes linking to chaplain-prepared prayers and videos on stages of grief, battery-operated candles, and options such as painting a memorial rock. Mayorga said these resources help staff and families support patients and navigate emotional decisions.
A conversation with her brother, who works in the funeral industry, led Mayorga to adopt the term “last responders” to describe those involved in a person’s transition from life to death. She later published an article on the concept in the Journal of Hospice and Palliative Nursing.
Mayorga is focused on outpatient oncology, where nurses and advanced practice providers often receive abrupt or casual notifications of a patient’s death. “So many of the notifications come so casually as a physician is walking by you: ‘Oh, by the way, Mr. So-And-So died,’” she said. “You’ve been taking care of those patients for 2, 3, or 4 years as part of their cancer care, and all of a sudden they’re gone. …You’ve shared life’s discussions woven into assessments.”
To improve postmortem care, Mayorga interviewed restorative cosmetologists and funeral directors and learned that removing tape and tubes when possible helps preserve a patient’s appearance. She emphasized that families often have time to make decisions and that guiding caregivers through care stages can make the emotional aspects of the end of life more manageable.
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