Palace of Care – Three Wishes

Photo by Vladyslav Tobolenko on Unsplash

They had told him time was short. He had asked them how long they meant. He couldn’t recall them giving him a clear answer. He set himself three goals before leaving hospital. Grass underfoot, the taste of green apple and to eat an ice-block.

The ice-block would be easy, we had plenty of ice-blocks as our patients may have swallowing difficulties and icy treats can be most welcome. Plain old lemonade ice-blocks can be most refreshing.

I asked if our kitchen had green apples. No – this was not something that patients usually ate. Too hard to chew for some people and too sour for most people. The kitchen usually was stocked with canned fruit, stuff that would not perish. I asked the universe for green apples, the universe provided me with five of the best. (A quick trip to the local convenience store was made. Sorry, we just sold our last green apples to another customer. A longer trip to a local fruit and vegetable store was successful. Five bright green Granny Smith apples were chosen. 10 minutes spent travelling in a hospice EV. )

I dropped off four apples to our kitchen staff.

“Could you make an icy treat with these apples?”

“Sure, I’ll blend them with ice.”

I went off to be the teacher’s pet. Giving our patient the fifth apple I left the room as he was busy with another staff member. I walked down the corridor and the chef was holding a glass jar that contained bright green icy slush. I hadn’t expected this to be prepared so quickly. I presented our patient with the drink. As he sucked on the straw the look on his face was pure pleasure, “Ahh, that’s good.” He hadn’t been allowed to eat and drink for a long time in hospital.

Grass underfoot was going to be a bit more challenging. His mobility had worsened as he had become weaker. Stuck in bed for weeks. Stuck inside the hospital walls, breathing conditioned air. His only sunlight exposure was through a window that could not be opened. The first day he was too tired to do anything. Could he be hoisted into a wheelchair? Would we have to push his bed out into our courtyard, over to the lawn? Could he sit up in bed? Or could we bring a piece of turf into his room? Maybe a combination of all three wishes, an icy green apple and grass slushy? Maybe not. Thanks to the kind efforts of our physiotherapist (not terrorist) and our nursing staff a short trip in a wheelchair was enabled.

Out into the sunlight, a gentle breeze on his face wheeled out towards a fine collection of chlorophyll. Slippers off. Feet resting on lawny goodness. A man communing with nature. He lay back in a reclined position, his head propped up by a soft pillow. A satisfied smile in his eyes and mouth. Contented bliss. A momentary escape from hell. A relaxing dose of normality. A simple pleasure.

Missions Accomplished team!

I think therefore I am? – Why Can’t We All Just Get Along?

Photo by Husna Miskandar on Unsplash

Hospice/Palliative Care people have a reputation for being nice to patients and patients’ families. We try and treat people with respect and kindness. We try to be compassionate in our dealings with people who are extremely unwell, people who are dying and their loved ones. When time is short we want to deal with people in a calm fashion. We try to take as much stress out of their lives as possible. We work on the individual’s quality of life which is defined by them. We try our best to relieve what they think of as suffering. I’ve been working in Palliative Care for almost 16 years and I’ve often wondered why Hospice/Palliative Care teams are not always so nice to their own team members.

We don’t always treat our own team members well. Is it because we have used up all our kindness in dealing with our patients and their families? By the end of the day has the milk of human kindness been out for too long? Does it return back to base soured? Our faces may not be so cheerful. Our patience levels running on empty as we have worked on patients for hours. Why so glum chum? Have we shone our lights of external kindness so brightly that when we return back to base, the shadows we cast are that much darker?

We might not always like our patients, but we have a duty to treat them with respect. I can’t get angry with my patients so I look for other people to take it out on. Does this lead to us saving up our bad behaviour for our own people? External facing angelic beings, but the wings become whinges when we look inwards at our own people? It doesn’t have to be this way. What can we do to change Hospice/Palliative Care? Do we need to do a complete re-haul? Start all over again and involve patients and their families as co-designers. Can we encourage our team members to behave better towards each other? Can we create a more understanding, respectful and resilient workplace culture?

Palace of Care – A Change of Plans

Photo by Adam Borkowski on Unsplash

We knew he would die soon and we asked him if he wanted us to contact anyone. He told us he would like his son to know, but he didn’t have his phone number. By this time he was too unwell and needed help with communication via social media. Our nurses helped him to send a message via his accounts. He died before he received any replies.

As per his wishes, we had arranged for a funeral director to uplift his body as he had wanted a simple cremation. He had limited savings and arrangements had been made with social welfare for a funeral grant to pay for his cremation. Our nurses again checked his social media accounts and found a reply from his son, including a phone number. A phone call was made overseas and was answered by the young man’s foster mother. She was told of our patient’s death, and said that his son wanted to come over to see him, and would arrive in town in three days’ time.

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Palace of Care – There’s no place like home

Photo by Andrew Umansky on Unsplash

It had taken some convincing for her to be admitted into the hospice inpatient unit, after two rough weeks in hospital. COVID lockdown restrictions had meant that she had not been allowed visitors for most of the time. She hadn’t been locked up but she had felt like a prisoner in her hospital room. For safety reasons not windows could be opened. Things kept changing, and the doctor with the sad face kept on bringing bad news. It seemed like nothing ever went right. The treatments were not working. Her calcium had risen to dangerous levels which required repeated treatments.

When she arrived at hospice her COVID swab result had not come back yet, so for the first day she still had to be under restrictions. She had a room to herself, and she could open the window and door to the balcony. The fresh air was a nice change after being cooped up inside the hospital. The food was delivered in takeaway containers and they only provided plastic cutlery. A small thing but just something else to add to the list. The people were all nice and really tried to make her feel at ease, but deep inside she felt uneasy.

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First Person: The therapeutic value of touch

photo by Jonas Vincent via unsplash.comThe first time one of my medical professionals touched me for comfort rather than during a physical exam, it was during my liver biopsy.  I was extremely frightened of the procedure, due to how painful I’d been warned the procedure was, and I was, and still am, slightly uncomfortable with needles (though daily Clexane shots sure sorts that out fast).  The medical team at the imaging clinic I attended had gotten in a second nurse, just to hold my hand during the procedure.  It was her 60th birthday, and she had been called in, literally, just to hold my hand.  I was incredibly moved by this, and incredibly comforted to have someone gently talk me through what was going on – to warn me to look away when the giant liver biopsy needle was brought out, helping me count holding my breath as the needle drew up the cancerous cells, and gently walking me to the recovery room after the procedure finished. It was one of the kindest things I have experienced with my medical professionals – and I have experienced more kindness than I can even recognise. Continue reading