Over the past two years despite all the stressors faced there has been a sound heard increasingly throughout the corridors of the hospice. As many doors and windows have been left open to allow greater ventilation to allow viruses and other infective materials to be circulated out of the building but the sound of the wind is not the subject of this post. It has been cold at times during the winter and the sound of fan heaters has been present at times but again it is not interesting enough to merit any writing. When patients are breathless an electric fan is lent to them for them to have the breathlessness relieving air across the face which is more effective than oxygen and other prescribed treatments for people who can’t catch their breath. Our cleaning staff continue to work tirelessly to keep our premises clean, without their efforts we could not keep our operation running, and the importance of their infection control toil cannot be underestimated. The sound of vacuuming, wiping and mopping are commonly heard again and are not the subject of this piece.
The sound can be contagious. When you hear it you feel different. It is something that resonates inside you and it makes you feel more human and less alone. It can change your facial expression in an instant. It can lead to a sudden and rapid expulsion of air from your body. No, I am not talking about passing gas, that’s what anaesthetists do for a living, I work in palliative care. The brass band will not produce these sorts of sounds, but maybe the sound belongs in the orchestra’s wind section. Sometimes, playing an air guitar or the world’s tiniest violin can produce the sound.
Heart Connection by Alisa Looney. Photo by Nancy Regan, taken in Puyallup, Washington, used under Creative Commons licence.
Talking to patients can be challenging, and it can be a struggle to make a connection sometimes. You need to have a plan as to how you are going to play the interaction game, and it can feel like a particularly demanding game of chess at times. You may have to pick your words carefully, as not everyone is naturally trusting, especially towards someone that they have never met before i.e. a total stranger. What worked on patient A in room 2 may fail dismally with patient C in room 5. Everyone is different as are their responses to your attempts to make a connection. That is what it is all about, through use of all the communication skills that you have learnt, you try to make a connection with another person. How can I ‘click’ with the other person in order for us to have important conversations?
We are honoured to bring you a guest post, in fact two, and indeed we hope more, from the fabulous Dr Chris Sanderson, palliative care physician. I have to say that I was so inspired by this idea, by putting patients at the centre of our communication, where they should be, that I totally stole this idea for my own Change Day pledge.
Below is part one of her description of her pledge for Change Day, #lettertome.
#lettertome : A twitter campaign to improve how we share information with patients.
Social media is such a wonderful space for spreading ideas – and sometimes the simplest ideas may convey a world of significance. Recently on twitter, there was a conversation between various doctors and patient advocates about how we speak to and about our patients, and the subject of doctors’ letters was raised. Thus was born a new hashtag, a pledge for Change Day Australia, and potentially a new way of doing things.
What the heck was going on in the lounge? A patient’s family and the doctors were sitting on the floor with their legs crossed. Were they about to break out into song? Kumbaya my lord, Kumbaya…? Was this part of the Hospice Yoga Initiative? Mat-time at a new New Zealand charter school? No, it was actually a family meeting.
Family meetings are common occurrences in healthcare settings and are organized in order to convey a point of view, or to try to bring together disparate points of views. These events may actually be the first chance that some of the key stakeholders, i.e. the family and the healthcare team, actually have to meet each other. The first time that the next of kin has made time to meet with the health care team looking after their loved one. First impressions as within any first meeting are important. As you can only meet for the first time once, you’d better do your best to make sure it goes well. In order to establish a trusting therapeutic relationship between the patient, their family and the health-care team, rapport must be established quickly. Every encounter can count, but not everything can be planned for. Continue reading →
I thought to myself while I was talking to him today, I’m really going to miss this guy, who I’ve been calling mate.
Some people will really pull on your heart-strings. Mate is one of those people. He’s really unwell, and his time is very limited, but he’s still charming the ‘socks off’ of all of the ladies. He’s always very polite, and well-mannered. I’ve been looking after him for the past week or so, and he has been deteriorating on an almost daily basis. He never complains and has never liked to cause a fuss. He’s a shy man, who doesn’t want to be a nuisance, I’ve had to almost beg him to ask for pain relief when he needs it. He has been through an awful lot of pain. It has improved since he came under our care, but it is still there. He has never complained, either before or after his illness was discovered. Continue reading →