Wednesday, March 20, 2013

Captain Obvious comes right back

"My job is obviously never done."

I was researching back issues of the HPNA journal for an upcoming class on assessing and managing pain when our friend Captain Obvious stuck out his size-13 black boot and tripped me right in front of an article by Ann Marie Dose and colleagues, "The Experience of Transition From Hospital to Home Hospice - Unexpected Disruption."

As Captain Obvious pointed out earlier, while we may take much for granted in the course of our work, our patients and families are experiencing each element of the hospice admission and care for the first time, most often with little preparation, understanding, or context; and always with some degree of emotional stress. Our routine is their disruption.

The authors note:

"Many patients hospitalized at end of life report ‘‘going home’’ as the most important task remaining to achieve. In order to meet this meaningful goal, patients in this study were discharged soon after the decision was made to go home with hospice care. 

Although the physical act of traveling home was relatively problem-free for the study participants, family caregivers experienced burden as a result of getting things ready for the patient’s homecoming often on very short notice. (for example) While securing a hospital bed for the home may be of little consequence for healthcare professionals...for patients and family caregivers, the hospital bed took on a larger meaning and added to the overall disruption."

I'm reminded of an old joke that goes something like this - 

Q - What are the two differing points of view with regards to a ham and egg breakfast?
A - The chicken has an interest, but the pig is committed.

to learn more - Dose, Ann Marie PhD, RN, ACNS-BC; Rhudy, Lori M. PhD, RN; Holland, Diane E. PhD, RN; Olson, Marianne E. PhD, RN. The Experience of Transition From Hospital to Home Hospice: Unexpected Disruption. Journal of Hospice & Palliative Nursing: November/December 2011 - Volume 13 - Issue 6 - pp 394-402. 

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