Bill Bicek said his patients, especially the women, are sometimes taken aback when he comes to tend to them as a hospice nurse.

"The fact that I'm a male RN makes a big difference," he said. "It makes a difference in the way you're looked at. They think, is he the doctor?"

But once he establishes contact with a patient, they begin to accept him, he said, especially the men, who don't always have a male caregiver.

Bicek, who spent five years as a hospice nurse in Naples, Fla., moved home to the Shenango Valley in May to take a job with Family Hospice and Palliative Care in Hermitage. The hospice program also has offices in Mt. Lebanon and Shadyside in the Pittsburgh area.

"I was born and raised here," Bicek said. "I got a little homesick."

Bicek is one of two nurses in the Hermitage office, which also employs a social worker and a part-time spiritual counselor.

"It's a team approach to caring for a patient," said Michelle Dreyfuss, spokeswoman for Family Hospice and Palliative Care. "It's important to take care of all the needs that have arisen."

Hospice is a philosophy of care dealing with the quality of life of terminally ill patients approaching the end of their lives. When they enter hospice, patients stay with their own physician, who works with the hospice team.

Before he was a hospice nurse, Bicek worked in "all kinds of facets of nursing." He worked at the John XXIII Home in Hermitage, at Sharon Regional Health System and in sports medicine.

He used to travel to Naples frequently to visit friends. While he was there on a trip, he saw an advertisement for a hospice nurse.

"It sounded like I could really make a difference," he said.

So Bicek sold his house, his furniture and moved from Pennsylvania to Florida.

"It seemed like everything just fell into place ... I slipped into the job like a well-fitting glove," he said.

When he decided he wanted to come home, he knew he wanted to stay in hospice. He now tends to patients in Mercer County.

Bicek emphasized that hospice is a way of living, not a way of dying.

"We're concerned with quality, not quantity," he said.

He named one of his mentors as Patch Adams, the physician made famous by actor Robin Williams in the movie of the same name.

"I believe that humor is such a strong part of medicine ... I believe so much in the Patch Adams philosophy of care about humor," Bicek said. "Humor is so important."

He also tells his patients they have to smile at least once a day.

Bella Garts, formerly a resident of Woodland Place, had a smile on her face the day Bicek came to see her.

The 97-year-old Mercer woman, who had been diagnosed with terminal cancer, was watching her stuffed musical frog, a gift from a relative, do the twist as she relaxed in her recliner.

Her daughter, Elsie Bell, said the hospice program was "a big relief to have."

"It gave me such a sense of relief to know I had them to depend on," she said. "I was able to bring her home from
Woodland Place. If I need help, I can call them any time."

Bicek said he visited Mrs. Garts about three times a week. He said she spent most of her time sitting in her recliner and looking out the front picture window.

"You find people (in hospice) are eating less and sleeping more. She takes more frequent naps," Bicek said.

Sadly, Mrs. Garts passed away on Aug. 19 in her home after she had been in the program for about a month.

Both Bicek and Mrs. Dreyfuss said they hope in the future people will think about hospice before coming to the last week of their lives.

"Most people think of hospice services as only useful at the very end," Mrs. Dreyfuss said. "Hospice was meant to come before that. They can get to know the hospice staff."

"I think a lot of people don't know what (hospice) does," Bicek said. "Doctors need to be educated. They do not understand either."

Bicek said hospice nursing is a very personal thing, comparable to birth, when nurses help bring people into life. Hospice nurses aid them as they're leaving life.

"This is not nursing anymore," he said. "This is such a different, special part of nursing. Someone once told me hospice nurses are not hired, they are called. You get to be the one to help someone slip away, to ease them out of this life and into the next. It's a very special thing."