March 31, 2018 at 10:05 am #3488
April 23, 2018 at 5:59 am #3576
I appreciate the reading, “Integrative Health Care: Emerging Approach to the Art of Healing” and it echoed back to the model of patient centered care that our system has attempted in the last few years. I am hopeful the Catholic hospitals will have a better chance of succeeding because they will be under girded with faith and may not be short circuited by the ever present reality of meeting the bottom line. This article gives me hope that maybe it doesn’t have to be an either / or proposition as I have experienced in the past.
The clarification between taking a medical history and a clinical narrative is important. Our patients come to us as more than a diagnosis. We recently had a 20 year old patient who came in able to move her arms and now can’t but we can’t figure out why. I visit her almost every day. They are now paging Psych. She lives alone, has no family, could it be being in the hospital is more comforting than being home alone? Chaplains can help fill in the clinical narratives. I try to do that for our nurses and doctors when they are not aware of a patient’s home situation, recent losses, etc. I just did not have a name for it before. On page 18 the author states that “all team members are responsible for the psychological and spiritual aspects of a patient’s care.” I find that to be so true in our hospital. Recently a cafeteria worker asked me if I had visited a family in ICU who was from out of town because they had shared with him how they stressed they were! And I often get referrals from other support staff like housekeepers. I have wondered if a hospital fosters that environment or rather hires people who are compassionate and in the process of doing “their job” cares for those around them? Chicken and egg? Which comes first? Hiring or creating environment?I often say to caring nurses that I am not sure we can teach compassion and affirm it when I see it in action.
Perhaps I missed it but I did not see when this system implemented this program? Has it been successful? I think for system wide success, as least for our system we would have to start interviewing with fit into this type of system. I am not sure compassion can be taught and people can sense when team members are “just being nice” but it makes quite an impression when they feel sincerely cared for. I would be curious if this hospital system considers “fit” of a candidate into this new system when they interview candidates? In my 17 years as a hospital chaplain I have experienced, and even taught, several patient centered or patient care programs. As I sit here and reflect I do wonder if the problem remains systematic buy in, and maybe the answer is that we have to start with hiring, and only hire those who are already capable of holistic care, and not just doing a job. I am not sure we can screen for that but think its time to try. And that includes, perhaps especially includes physicians.
I am curious how this system cares for their employees as they care for others? I feel this is crucial. Employees who are treated well are more likely to transfer that good care to patients. In addition, the stress of working in healthcare has been well documented so we need to care for our workers so they can sustain the emotional health to continue to care for others. While the obvious answer is offer EAP, I have found that team members are not always trusting of such programs. Building trusting, supportive teams led by caring managers who seek out help when needed goes a long way. In addition at our hospital Spiritual Care offer a hospital wide tea each month where all employees come and are able to decompress off the floors, all disciplines can drop in. It seems a small gesture but the staff love it and schedule so they will be here for it on the second Tuesday of the month!
April 23, 2018 at 1:14 pm #3582
I had the same question as you. Was this initiative implemented and if so, how has it been? While I totally agree with the underlying premise of this initiative, I suspect that getting everyone to participate in the process as designed would be very challenging. Like it or not, the prime drivers continue to be physicians. Where physicians embrace this holistic approach and invite others in, I can see it being very beneficial.
Recently, my brother-in-law was diagnosed with cancer of the lung that had metastasized to his bones, brain, liver, and chest. He was transferred to the Catholic rehab, long-term care facility. No treatment was recommended for cancer. My wife, his sister is a nurse practitioner is assisting her brother and his two grown sons in deciding on future arrangements. It is clear that the left-hand doesn’t know what the right hand is doing. It is very confusing if with a very knowledgeable family member and medical professional trying to serve as an advocate.
I look forward to hearing what others think about this article. Have you seen this kind of process work?
April 25, 2018 at 7:05 pm #3598
Great work you are doing! There was a cancer hospital in Australia that in the past employed their hospitality staff to do what you describe. The rationale seemed to be that the cleaner/domestic person does ‘normal stuff’ so had time to talk and was more approachable (equality perhaps?). They were the early warning system for the docs and nurses and worked well as part of the team. In our oncology ward at the WCH our hospitality team certainly filled that role.
I think you are right about Catholic health care – here the Calvary system has a Mission Director who advises the CEO on staying true to the core values and briefs of the nuns who began the work.
Rick, Sorry to hear about your brother-in-law. A tough road ahead.
I think you are right – medicine still drives healthcare. Hence some of the consistent cost blowouts. It does matter the approach and philosophy of the docs/nurses/team. In my experience it is very individual. Some teams I worked with were inclusive and welcoming of holistic care, others (to be polite) focused on the ‘science’ – despite the patient first mantra of the hospital. I think sometimes it is the pressure of workload that is at play.
The article is a positive challenge to keep holistic care and spirituality in the conversation.
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