Calling all Hospice RNs...I'm teaching future DOCS!!!

[Werblessed]

Our hospice just got the green light to start orienting 3rd year med students (almost docs!) to hospice and palliative care. Apparently there was new requirement for med students for this rotation. Most of our nurses were too busy and some I suspect a bit intimidated to sign up to provide this lecture. Heck, I've been a nurse long enough that I've gotten past the "They must be smarter than me because they are DOCTORS" thing.

I signed up to teach and got my first rotation last week. OMG...these students are young enough to be my kids!!! LOL!! But what a GREAT opportunity to reach our target audience about what we do and what tremendous support can be offered by our teams to their patients. And for all of us Hospice RNs who've been in this field for a while will appreciate, I had one slide that said simply (in bold letters) "Death is NOT failure". It certainly opened up a lively discussion!

:smiley_ab

So....my question for all of my wonderful colleages is, "What would YOU like for me to get across to our future Physicians as it relates to the specialized field of hospice and palliative care?" I have my own talking points but would LOVE to hear some suggestions to consider as well. I want these groups of Physicians to walk away knowing that another option for care exists for patients who are not responding to curative treatments any longer. We've been talking about prognosis, how we sometimes 'graduate' patients who improve under our care (and no longer meet the eligibility requirements), our care being patient-driven and not Provider-driven. Also have discussed quality of life and collaborative approach to meeting the patient/family goals. Lots of good-old patient/case study examples. They really liked that a RN would be seeing their patients at least weekly and would be able to give them a strong clinical report on how things are going.

Thank you for any/all suggestions. I want to get as much across as possible in the 1 hour lecture I get to provide before we send 'em out for the day with our staff to shadow on visits (then one of our Medical Directors does debriefing for 90 minutes after the shadowing part is complete).

Bring 'em on, team!

[leslie :-D]

i really think if you can ingrain that "death is not a failure" into their mindset, that alone would be a huge accomplishment.

ask them who has reservations about addiction in eol.

i've known too many dr's who do, and prescribe sparingly.

ask them who are they treating - the pt or the family?

how many times have our pts wishes either been ignored, or even unspoken, just so the family is placated?

and, when someone is dying, at what point (and cost) does quality of life, supercede quantity of life?

this is when the waters become muddled.

most often, pts aren't even placed on hospice until days before their death.

up until that point, there are futile, expensive and highly invasive treatments the pt endures.

what kind of quality of life is that??

DEATH IS NOT A FAILURE.

if they can grasp that, our pts will be afforded the quality of life they so very deserve.

there is much more to dying than the cessation of vs.

and it takes time to be able to die well...

something that most pts are robbed of, only because families and doctors are scared out of their mind.

i am excited for you, to have this opportunity...

and have believed for yrs, that eol issues should be part of a med student's core curriculum.

keep us updated, please?

i would love to hear their concerns.

leslie

[caliotter3]

No recommendations here but wanted you to know that I thought the title to your thread meant that you were teaching the new Director of Clinical Services.

[tewdles, RN]

Congratulations! No real recommendations here...you clearly have a good handle on it...the "death is NOT a failure" point is SOOOO important. Encouraging the PCPs to somehow find a way to discuss advanced directives, and palliation of symptoms before the patient is actually dying would be a huge benefit to their clients.

[Ginapixi, BSN, RN]

Werblessed, i think Leslie got it

if you can get in half the new docs heads what Leslie wrote you deserve a gold medal!!!

i had several med students "shadow"; few are interested and leave after the first pt visit (they fulfilled their mandated time); some will get involved, ask questions, even though it may not be their chosen field to practice in later;

the home setting and the right to die at home does not mean pts cannot have good nursing care and dedicated docs!

Blessings!!