[quote=UCGal]My mom’s cousin is a nurse who switched from being an ER nurse to being a home-care hospice pediatric nurse. It was a HUGE mindshift for her. And many medical personel can’t make the switch.
Hospital care, traditional medicine, is about doing whatever it takes, applying whatever technology can make an improvement, with less regard to the quality of life of the patient and family’s morale.
Doctors are totally in control in the traditional medicine mindset. Patients are not in the power position.
In hospice – the patient and their family is in control. They can make choices that may have a negative impact on time-till-death but a positive impact on happiness and emotional well being. My cousin had to advocate for a young boy with cancer to be able to join the cubscouts and go camping. (He really wanted to have some “normal boy” experiences – not live in a bubble.) The doctor felt it was too risky because of his weakened immune system. My cousin, the parents, and the boy were able to override the doctor because the boy was in a hospice program. Hospice is about pain management and quality of life, not life extension.
After her 20 years as an ER nurse, she LOVED being a hospice nurse. Even though the outcome was pre-determined (patients were terminal) it was about empowering the patient to live their remaining time as they wanted.
When my brother was nearing the end he was on the cusp of going into hospice. The transition was in place when he was told he could get an appt to a specialist he’d been trying to get in with. He was not allowed to do hospice if he saw the specialist because they were in conflict. As a family member, I wish he’d chosen hospice – he ended up spending his remaining weeks going through extreme surgeries and in the ICU and never made it back home. But it was his choice to make.[/quote]
I cannot say enough good things about hospice. As I mentioned in a post the other day, people (esp. Americans) are very much into “control” over their circumstances, and there’s never a time that you feel less in control than when you are very sick or dying.
You really need to learn “how to be sick”. I know that sounds stupid, but illness isn’t a natural state for most people, and not adjusting to the state of illness can be seriously detrimental to both the patient and his/her loved ones. Hospice care is really good for this. As you related, UC Gal, it’s a 180 degree departure from the traditional hospital medicine model. It doesn’t surprise me at all that many medical personnel cannot make the transition, which is really too bad. Many hospice-related concepts can be beneficially applied to traditional inpatient care.
