Making Each Day Meaningful…
My nursing career was born in intensive care units and emergency trauma rooms, serving patients in fast-paced, critical settings. When dealing with cardiac arrests or other life-and-death emergencies, I felt highly comfortable helping patients in these crucial moments.
So when my nursing focus shifted to hospice and palliative care (first in Northern Virginia), I was also comfortable asking the tough questions.
My mentor, author and RN Maggie Callanan, taught me to use the first two to three hospice visits with our patients to build trust and understand their beliefs, wishes, and needs so that we could best serve them in whatever time they might have.
Maggie stressed the importance of hoping for the best by preparing for the worst and so during the initial visits we intentionally asked: “If you could design your own death, how would you do it?; Where would you want to be and who would you want to be there?; Do you believe in something after death?; What do we need to do to make you feel as comfortable as you can be?”
Sometimes patients easily expressed relief in sharing these types of conversations. They were too worried to add this as a burden to family.
Others had creative ideas like, “If I could design heaven, it would be a golf course” or “I imagine heaven as a sea of chocolate.”
Once they arrived at the important answers to all of these questions, the next step was to set them aside temporarily and talk about the here and now.
In other words, we’d ask, “What do you want to do for fun?” or “What would bring you joy?”
That final question often led to the most beautiful experiences for our patients, each based on their very personal and meaningful life goals.
One gentleman especially wanted to come home from inpatient care, but he could not because he was in a wheelchair and the main floor of his house was sunken in. Additionally, he was concerned about finding homes for his family of cats after he died.
So in addition to tending to his medical care, we set out to find a construction company that could donate services to level out his floor. We also found loving future homes for each of his cats. With this done, the man was able to come home and receive care alongside his beloved felines until he died.
Another older patient insisted he needed to travel to the beaches of Normandy, France, to witness a D-Day reenactment from World War II before he died. Doctors were skeptical due to his advanced cancer, which required a morphine pump and a wheelchair. But, due in part to this man’s determination, doctors gave him the go-ahead.
That meant we not only had to figure out how to keep him comfortable during his travels, but we had to research how to handle an emergency in French waters and American waters; how to get permission to take regulated medications like morphine into a foreign country; and how to transport our patient around the actual beach.
The research paid off and our patient experienced the trip of a lifetime. In fact, he had such a wonderful time that he declared his wish to go camping next. Although he died shortly after he returned, he lived his final days to the absolute fullest.
That is what is so wonderful about the work we are able to do every day at JourneyCare. Our teams promise to help our patients live with dignity and without pain, but we also promise to help them live each day to the fullest.
This starts by creating teams of nurses, CNAs, social workers, chaplains, volunteers and others who are excellent and confident in the work they do. Sometimes, they even have to step outside themselves and be flexible in moments of need. I’ve seen chaplains run to the pharmacy, social workers wash the dishes, or nurses say prayers in critical times.
This blend of clinical excellence and personal commitment is the most important component in providing the best outcomes for our patients.
But we are also working on technology strives to make care as simple as possible for both our patients and team members. In the coming year, we plan to launch technology that will help patients to give us alerts in real-time, so our teams can serve their needs as quickly and efficiently as possible.
Ultimately, our goal at JourneyCare is to marry helpful technology with excellent symptom managements for our patients and create great care teams behind them. With that combination, we see our patients live longer and achieve their goals.
And that is a wonderful thing.