Saturday, April 30, 2011

Conclusion: Personal

Conclusion: Personal
In the blog area of this class we have discussed many issues involving hospice using scholarly research and articles. As we have come to a close of this course I want to give each and everyone time to discuss their personal views of hospice. There are no rights or wrongs to your views. I will open this last blog share with my views of hospice to break the ice. I would like to know if you came into this course with one view of hospice and ended this class with another. Discuss why and what changed your minds.
I came into nursing with little to no experience of hospice and then my father was given a terminal diagnosis of intentional cancer that was inoperable. Being the only female child and the baby of six, Dad spoiled me rotten. My mother only had myself and one surviving brother to lean on during this time.
My father’s physician called a family conference and stated that all that could be done for my father had been done and we were at a cross roads in his treatment. The physician had a hospice case worker present for the conference to educate the family on what we were facing in the months to come. We could let nature take its course or we could go with hospice either in the home or a facility. Dad had always stated he wanted to die at home in his own bed so this decision was set in stone.
The physician educated us to the pain processes that my father would go through if we let nature take its course and what hospice could offer my dad. It was a no brainer for me but it was a very hard decision for my mother and brother. They had always believed in life at all cost. I asked for a little time to talk with the family. I played a little dirty by pulling my dad’s brother into the discussion and he had seen members of his family suffer and other use hospice. Mom and my brother finally came around to the idea of giving hospice a trial run.
After one week on hospice my mother was given the gift of a hospice volunteer that was there to help her, give her breaks and time to herself. Mom called my brother and myself and said the trial was over and hospice was in the home until the end.
Eleven months into the diagnosis my father passed away. The time could not have been worse. He died on the anniversary of the deaths of his parents and brother that were killed in an auto accident, Christmas Eve.
This has been 19 years ago and I never forgot the loving care that my dad and mom received from the hospice nurses, aids, chaplains, and volunteers. They staid involved with the family for a year after dads passing.
When given the opportunity to go into hospice I was a little torn as to what to do? I was worried that that it would be too raw on me and bring back my dad’s death. Well it did bring dad’s passing back to me but it was in a very good way. I had been given the path of how patients and their families should be taken care of. Hospice will always be a love for me due to the great people that helped my family through a very hard time.

Dee

Cultural Issues:

Class, we have touched on culture and hospice in previous postings to this blog. I Would like to re-address this issue.

Race
U.S. Population 2000
Utilization of hospice
Black/African American
12.3%
9%
Hispanic/Latino
12.5%
4.3%
Asian/Hawaiian/Pacific Islanders
3.7%
0.9%
Multiracial
2.9%
4.6%


Please explore and discuss the reason behind these facts and figures. What are the cultural blockage to families/patients not seeking or accepting hospice care.

Dee

Hospice Facts and Figures. (2003). Retrieved From: http://www.shcpo.org.
United States Census 2000. (2000). American factfinder. Retrieved from: http://factfinder.census.gov.

Hospice and the End:

Hospice is considered the “Gold Standard” for end of life care (Hill, 2005). If hospice is the gold standard why is only 43% of the population that is eligible for hospice utilizing the service (Harrison, Ford, & Wilson, 2005)?
Many families have been surveyed and reported that families members that died in a hospital were in discomfort and pain rated at moderate to severe in the last week of their lives and other studies have found that the patient spent the last week of their lives on in a coma state and on artificial life support (Lynn, et al., 1997).
I would like a comparison and contrast of the hospice services and hospital services on the end of life care. Discuss the pros and cons of each and give your opinion on what you believe would be YOUR choice for the end of your life or that of a family member. Use the articles that are referenced in this blog and others to for your opinion.

Dee

Harrison, J., Ford, D., & Wilson, K. (2005). The impact of hospice programs on U.S. hospitals. Nursing Economics, 23(2), 78-90.
Hill, J. (2005). Hospice utilization: political, cultural, and legal issues. Journal of Nursing Law. 10(4). 216-24. Retrieved from: http://web.ebscohost.com.lib.kaplan.edu/ehost/pdfviewer/pdfviewer?vid=3&hid=126&sid=0463c73e-46e0-4af8-87ea-1a79cc59fab4%40sessionmgr115.
Lynn, J., Teno, J., Phillips, R., Wu, A., Desbiens, N., Harrold, J., et al. (1997). Perceptions of family members of the dying experience of older and seriously ill patients. Annals of Internal Medicine 1236(2), 97-106.

Tuesday, April 19, 2011

Legal Issues and Hospice

Class,

Physicians may have started the contributions to hospice but "nurses were central to the inception and development of hospice care in the United States"(Buck, 2010). Even though nurses were involved in direct care of the hospice patient and helped in the debate to frame policy in regards to wholly determine national policy; nurses were not able to extend their influence beyond their own realm of nursing.

What can nurses do to stop this practice? Nurses must have a voice in policy weather institutional or national. What can you do as an individual nurse to help your voice be heard in policy making in nursing?

Please research and post your answers to this blog as class is coming to an end.

Thanks,

Dee

Buck, J. (2010). I am willing to take the risk’: politics, policy and the translation of the hospice idea. Journal of clinical Nursing 18(19). Retrieved from: http://web.ebscohost.com.lib.kaplan.edu/ehost/pdfviewer/pdfviewer?vid=11&hid=125&sid=0df58f9b-e922-4cf7-888f-6397702c327c%40sessionmgr11. 

Monday, April 18, 2011

Compassion Fatigue

Class,

As the title suggest for this unit we will be discussing compassion fatigue or burnout. One of the biggest reasons for a nurse to leave the area of hospice is burnout. Often on call 24/7 for weeks at a time takes its toll on a person, add patients death to this mix and the burnout can come faster.

According to Abendroth and Flannery (2006), nurses that involved in the end of life care become attached and overinvolved to their patients  in relations to the amount of time spent caring for the patient in their journey toward death.

Abendroth and Flannery (2006) conducted a litrature review in an attempt to  identify the problem and significance of nurse burnout in hospice care. Your assingnement is to read this article and discuss this information in the blog.

Discuss how you feel your risk is for burnout is and how you plan on preventing burnout in your career as a hospice nurse.

Abendroth, M. & Flannery, J., (2006). Predicting the risk of compassion fatigue. Journal of Hospice & Palliative Nursing. 8(6): 345-56. Retrieved from: http://web.ebscohost.com.lib.kaplan.edu/ehost/pdfviewer/pdfviewer?vid=5&hid=13&sid=0df58f9b-e922-4cf7-888f-6397702c327c%40sessionmgr11

Memories

Class,
Every nurse has heard the term “Healing Touch” at some time or another. In hospice this is a must in treatment if the patient is able to tolerate touch. In this blog we will explore complementary and alternative medicine (CAM) in particular Energy Medicine (EM), (Eschiti, 2007).
Many Patients are kept in their homes or home hospice and others are in a dedicated hospice unit. Either setting can include high-tech machines, noises or other stimuli that may stress the patient relax more.
Healing Touch (HT) is part of the five major areas of CAM.  The five areas CAM are Biologically Based Practices, EM, Manipulation and Body-based Practices, Mind-body Medicine, and Whole Medical Systems (Eschiti, 2007).
Healing Touch is the area that is being explored in this section of our learning process of hospice. As stated previously HT is a part of EM. Other areas of EM include Reiki, Johrei, Therapeutic Touch, and intercessory prayer.
After reading the article in the reference posting please post your comments and thoughts to the information you have read.
Reference
Eschiti, V., (2007). Healing touch: a low-tech intervention in high-tech settings. Dimensions of Critical Care Nursing. 26(9): 9-14. Retrieved from: http://web.ebscohost.com.lib.kaplan.edu/ehost/pdfviewer/pdfviewer?vid=5&hid=125&sid=1fa7ae06-7cf1-41f0-aed4-0580e21481b6%40sessionmgr115.

Sunday, April 17, 2011

Memories

Memories:

Memories are a great gift that can continue to give to the families of hospice patients. The hospice nurse can help in preserving these memories for the family by utilization of other disciplines. Every hospice agency has volunteers that assist the patient and families.

The nurse needs the knowledge of what services are provided by the volunteers. A new program that is available to the agency is call Project Storykeeper. This is a program that has training courses and kits that help preserve the patient and families memories that was developed by Dennis Stack (n.a., 2009).

Storykeeper is a way to assist the hospice patient in the process of their life review prior to their death while they are still able to participate. Life review helps the patient and their family members to start closure.

Class, please follow the link in the reference to read about this program and post your comments and thoughts to the article.



Reference:
Become a Storykeeper, Project Storykeeper. Retrieved from:

Volunteers preserve memories for families: storykeepers record patient stories for posterity. (2009). Hospice Management Advisor, 14(1): 5-6. Retrieved from: http://web.ebscohost.com.lib.kaplan.edu/ehost/pdfviewer/pdfviewer?vid=3&hid=126&sid=c6351241-8b8e-41c2-be5d-3f2ec33b02f1%40sessionmgr13.