Happy Nurses Week

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Nurses all over the country take pride in the fact that the public has rated nursing as the most honest and ethical profession for the past 16 years. Nurse’s commitment to protecting, promoting, and improving health care for all is well recognized, and they serve the public in a wide range of roles and work settings. Therefore, it is only fitting that we take one week each year to celebrate the nursing profession and the vital roles nurses play in health care.

I would use two words to describe a nurse. Nurses are Caring and Compassionate people.  You see, nurses encounter patients from all walks of life, many of whom are afraid of judgment they may receive from the medical community for one reason or another. A nurse can change a patient’s entire perspective by “showing them nurses value caring and compassion above all else,”

Nurses not only care for their patients they all so care for other nurses. Nurses inspire and mentor other nurses by providing them a springboard to elevate their practice and scope of other nurses and healthcare professionals they work with. They do so by recognizing the potential in people. This is just one way nurses inspire others in healthcare.

Nurses are innovators and act as agents of change to drive processes and policy and leverage technology to prove better, more affordable care for individuals and the community. Nurses have influenced innovation in the industry so much that the American Nurses Association (ANA) has updated the ANA scope and standards of practice document that calls for all nurses to be leaders within the profession, working to influence policies and encourage innovation (ANA, 2015a).

Lastly nurses are Influential; nurses must see themselves as professionals with the responsibility to influence current and future healthcare delivery systems. The nursing profession is based on the science of human health and the science of caring. It operates from a framework that values all people in a holistic way and seeks to foster and advance people’s health throughout their lifespans and across all levels of society. Through policy work, nurses can and do influence practice standards and processes to assure quality of care. Nurses who influence policy help shape the care that will be provided today and tomorrow.

Front Range Hospice and Palliative Care would like to take a moment to send a very warm THANK YOU and HAPPY NURSES WEEK to all the wonderful nurses who inspire, innovate and influence those who are currently working, retired, and those just starting out their journey into the healthcare profession.

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April is Stress Awareness Month

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By Victor Montour

The last month has been a bit stressful for me. In an effort to manage my stress I went on line looking for some great advice or ideas I could use to help decrease my stress level. Just like all of you, from time to time we feel stressed. If we leave this stress unchecked, it tends to be a real joy-killer. This, of course, makes it harder for us to live Complaint-Free, happy lives. Did you know stress can also lead to a number of major health problems, ranging anywhere from anxiety to severe depression, from mild acne to life-threatening heart attacks, so it is easy to see why it is so vitally important to keep life’s major stressors in check.

This blog comes at a good time being April is National Stress-Awareness Month, I thought this is perfect, I can share with you what I found on line to help me manage my stress. Now I know some of the items I list you may find silly or something you wouldn’t do. The important message in this blog is for you to manage your stress in a healthy way. So, here is a list I found on line of 10 positive ways you can respond to the stress in your life and keep your own stress levels in check or at a minimum.

Health

Taking control of your personal health can make a great difference in the amount of stress you feel. The best way to reclaim control of your life is by taking charge of your body. Whether it is through diet, exercise, or simply getting that checkup you’ve been putting off, let April be the month you put yourself back in control.

Change

It can be as simple as clearing the clutter off your desk or as elaborate as taking a well-deserved vacation, the important thing is that you do something different. Even a small change can make a big difference when it comes to stress.
 

Live in the Moment

Most folks live their entire lives in yesterday or tomorrow. In truth, however, there is only now. Focusing on this perfect moment, right now, provides a magical escape from the disappointment of what once was and the fear of what might be, and leaves stress stuck in a time warp.
Talk to Yourself

Sometimes a good pep talk is all that is needed to keep stress at bay. Maybe it is high time you gave yourself one by affirming what is right with your life instead of dwelling on what’s wrong
Get the Giggles

It’s true; laughter really is the best medicine. Watch a funny show or video, tell a funny joke, or go to a card shop and read funny cards. Whatever it takes, give yourself time for laughter each and every day.

 

Meditate

A still mind is a stress-free mind, so take a deep breath, quiet your thoughts and let the stress melt away. Even ten minutes of meditation done daily for the next 30 days will do wonders for releasing stress in your life.

 

Journal

Every evening for the next 30 days spend a few minutes reflecting on the day you just experienced and list five things about the day that delighted you.
 

Positive Spin

No matter what challenge you may be facing, do your best to think about it positively and then let that new positive mindset become your focal point.
Helping Others

Sometimes the best way to deal with stress is by providing relief to someone else. Putting your focus on others takes the focus off your own challenges leading to less rumination and stress. So, look around you, see who needs a hand up, and then offer yours.
I hope you find some of the items on this list helpful. If you or someone you know would like more information about stress and stress management, please contact your primary care doctor. Your primary care doctor will be able to direct you to other resources in your community.

 

 

By Victor Montour

The last month has been a bit stressful for me. In an effort to manage my stress I went on line looking for some great advice or ideas I could use to help decrease my stress level. Just like all of you, from time to time we feel stressed. If we leave this stress unchecked, it tends to be a real joy-killer. This, of course, makes it harder for us to live Complaint-Free, happy lives. Did you know stress can also lead to a number of major health problems, ranging anywhere from anxiety to severe depression, from mild acne to life-threatening heart attacks, so it is easy to see why it is so vitally important to keep life’s major stressors in check.

This blog comes at a good time being April is National Stress-Awareness Month, I thought this is perfect, I can share with you what I found on line to help me manage my stress. Now I know some of the items I list you may find silly or something you wouldn’t do. The important message in this blog is for you to manage your stress in a healthy way. So, here is a list I found on line of 10 positive ways you can respond to the stress in your life and keep your own stress levels in check or at a minimum.

Health: Taking control of your personal health can make a great difference in the amount of stress you feel. The best way to reclaim control of your life is by taking charge of your body. Whether it is through diet, exercise, or simply getting that checkup you’ve been putting off, let April be the month you put yourself back in control.

Change: It can be as simple as clearing the clutter off your desk or as elaborate as taking a well-deserved vacation, the important thing is that you do something different. Even a small change can make a big difference when it comes to stress.

Live in the Moment: Most folks live their entire lives in yesterday or tomorrow. In truth, however, there is only now. Focusing on this perfect moment, right now, provides a magical escape from the disappointment of what once was and the fear of what might be, and leaves stress stuck in a time warp.

Talk to Yourself: Sometimes a good pep talk is all that is needed to keep stress at bay. Maybe it is high time you gave yourself one by affirming what is right with your life instead of dwelling on what’s wrong

Get the Giggles: It’s true; laughter really is the best medicine. Watch a funny show or video, tell a funny joke, or go to a card shop and read funny cards. Whatever it takes, give yourself time for laughter each and every day.

Meditate: A still mind is a stress-free mind, so take a deep breath, quiet your thoughts and let the stress melt away. Even ten minutes of meditation done daily for the next 30 days will do wonders for releasing stress in your life.

 Journal: Every evening for the next 30 days spend a few minutes reflecting on the day you just experienced and list five things about the day that delighted you.

Positive Spin: No matter what challenge you may be facing, do your best to think about it positively and then let that new positive mindset become your focal point.

Helping Others:Sometimes the best way to deal with stress is by providing relief to someone else. Putting your focus on others takes the focus off your own challenges leading to less rumination and stress. So, look around you, see who needs a hand up, and then offer yours.

I hope you find some of the items on this list helpful. If you or someone you know would like more information about stress and stress management, please contact your primary care doctor. Your primary care doctor will be able to direct you to other resources in your community.

 

 

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National Doctors Day

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By: Victor Montour

Doctors can sometimes be under-appreciated, but today seeks to combat that. March 30th marks National Doctors’ Day and it’s the perfect opportunity to thank your own doctor or physician for their service.

The annual event was first celebrated March 30, 1933, when Eudora Brown Almond, wife of Dr. Charles B. Almond, set a day aside to honor physicians. From those beginnings in Winder, Georgia, the celebration spread, and the House and Senate officially declared March 30 “National Doctors’ Day” in 1990.

This Year Front Range Hospice and Palliative Care would like to take this opportunity to thank all of our community physician partners. Your dedication to quality medical end of life care is appreciated. We would also like to take a moment to say a special thank you to Dr. Gregory Maeder the Front Range Hospice Medical Director.

Greg Maeder, MD, MBA, Medical Director 

Dr. Maeder attended the University of Cincinnati College of Medicine and completed residency at the St Anthony Family Medicine Residency. He currently works in advanced wound care and hyperbaric medicine as well as graduate medical education for resident physicians. He also serves as the medical director for Goodness Health Group, specializing in post-acute and long-term care. His philosophy of care centers on offering patients the best treatment options and honoring patient autonomy.

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Happy Social Workers Month

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As we continue with Social Worker Appreciation Month, we wanted to express how grateful we are for the hard work and tireless dedication of our Social Workers at Front Range Hospice and Palliative Care.  Our Social Workers are the people holding the hands of the patients and families in our care who may be sad or missing their families, helping families work through unstable times, and connecting individuals and families with community-based support services to help them take advantage of the opportunities available to them now and in the future.

Social Workers are the ones encouraging families and individuals to do better, even when they feel the weight of the world on their shoulders. In short, Social Workers are a lifeline for so many families who have no one else to turn to.

This year we hope you will take a moment with us to recognize all the work Social Workers do to better the lives of people in our communities. Many times, a week I hear “you have to be an angel to work in hospice and palliative care”. Well our Social Workers are the unsung heroes of hospice and palliative care. Our hospice and palliative care Social Workers work tirelessly to make the impossible happen. They do this with very little recognition. I mean how many times do you hear people talk about the Social Worker who helped them navigate the stress, depression or financial challenges caused from caring for a sick or dying loved one. Not often, most of the time it’s the nurse who gets all the credit. Our hospice and palliative care Social Workers don’t like being in the spotlight. They prefer the spotlight be on the success and wellbeing their patients are experiencing from their services. Well this month we would like to move our hospice and palliative care Social Workers from the shadows of care and move them up front in direct sunlight for you all enjoy. Please take a moment to learn a little bit about our hospice and palliative care Social Workers. They are amazing individuals who truly make best days possible for all of our patients.

 

Tyyne Andrews, LCSW, South Team Hospice Social Worker 

Tyyne Andrews graduated from Eastern Michigan University with a Bachelor of Social Work degree in 1996. After working for a couple years in chemical dependency she went back to school and got a Master of Social Work degree from the University of Michigan. She has worked in health care as a medical Social Worker since then and finds that her passion is working with those facing chronic or terminal illnesses and supporting the person and their loved ones through the challenges that go along with these types of health crises.

Tyyne moved to Colorado in 2010 and likes to take retreat in the high mountains of the Rockies a couple times a year. When the weather is good she likes to bike and hike with her close companions.

She loves working at Front Range Hospice and Palliative Care and is very grateful to work with such a kind and caring group of people whose hearts are in the right place.

 

Nicole Brandon, MSW, Palliative Care Social Worker and North Team Hospice Social Worker

Nicole Brandon graduated from Canisius College with a double major in psychology and criminal justice. After graduation Nicole completed her graduates’ degree at the University of Denver in 2002. Nicole worked for Child Protection Services in Gilpin County for a short period of time after graduation. Prior to becoming a Social Worker Nicole worked as a head start and preschool teacher and supervisor. Nicole loves being a Social Worker because she feels like she is making a difference in people’s lives. She loves the feeling of giving back to the communities she serves.  Nicole loves to spend time with her three daughters and baking sweet treats for family and friends.

Nicole loves being a part of the Front Range Hospice and Palliative Care. She loves the team work approach to care and the kind and loving people she gets to work with every day. Nicole says hospice is her true calling and she doesn’t see herself working anywhere else.

 

Pam Ware, MSW, LCSW, Owner and Administrator of Front Range Hospice.

Pam graduated from California State College in Fullerton with a B.A. in Psychology and San Diego State University with a Masters in Social Work. Pam moved to Colorado in 1995 and worked in acute care hospitals as an oncology Social Worker. After working closely preparing many patients and their family to make the decision to stop aggressive treatment and choose hospice care she was given the opportunity to run a hospice in Denver in 2003. In 2006, she took her life savings, moved to Erie and started Front Range Hospice. Front Range Hospice and Palliative Care represents Pam’s belief that everyone deserves a dignified death. Her staff is highly trained and the standards of the agency are voluntarily the highest in the industry.

We would be truly lost without the dedication and compassion of our hospice and palliative care Social Workers. Please join us in commending and thanking these individuals who continue to make profound differences in the lives of families across the front-range and beyond.

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Community Based Palliative Care. What is it? Do I need it?

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By Victor Montour

Community Based Palliative Care is a multidisciplinary approach to specialized medical and nursing care for people with life-limiting illnesses. Front Range Hospice and Palliative Care focuses on providing relief from the symptoms of a patient’s disease process like, pain, physical stress, and mental stress of a terminal diagnosis and so on. The goal for Front Range Hospice and Palliative Care is to improve the quality of life for both the patient we serve and their family so all can live the best days possible.

Community Based Palliative Care is provided by a team of physicians, nurses, social workers, chaplain’s and other healthcare professionals who work together with the primary care physician and referred specialists and other hospital or hospice staff to provide additional support. Community Based Palliative Care is appropriate at any age and at any stage in a serious illness and can be provided as the main goal of care or along with curative treatment. The sooner patients are referred to a Community Based Palliative Care program the better outcomes patients and families have.

Although it is an important part of end-of-life care, it is not limited to that stage. Community Base Palliative Care can be provided across multiple settings including in hospitals, at home, and in skilled nursing facilities. Interdisciplinary palliative care teams work with people and their families to clarify goals of care and provide symptom management, psycho-social, and spiritual support.

Physicians sometimes use the term palliative care in a sense meaning palliative therapies without curative intent, when no cure can be expected (as often happens in late-stage cancers). For example, tumor debulking can continue to reduce pain from mass effect even when it is no longer curative. A clearer usage is palliative, noncurative therapy when that is what is meant, because palliative care can be used along with curative or aggressive therapies.

Medications and treatments are said to have a palliative effect if they relieve symptoms without having a curative effect on the underlying disease or cause. This can include treating nausea related to chemotherapy or something as simple as morphine to treat the pain of broken leg or ibuprofen to treat pain related to an influenza infection.

Community Based Palliative Care increases comfort by lessening pain, controlling symptoms, and lessening stress for the patient and family, and should not be delayed when it is indicated. Evidence shows that end-of-life communication interventions decrease utilization (such as length of stay), particularly in the intensive care unit setting, and that palliative care interventions (mostly in the outpatient setting) are effective for improving patient and caregiver perceptions of care.

Community Based Palliative Care is not reserved for people in end-of-life care and can improve quality of life, decrease depressive symptoms, and increase survival time. If palliative care is indicated for a person in an emergency department, then that care should begin in the emergency department immediately and with referral to additional palliative care services.  Emergency care physicians often are the first medical professionals to open the discussion about palliative care and hospice services with people needing care and their families.

In some cases, medical specialty professional organizations recommend that sick people and physicians respond to an illness only with palliative care and not with a therapy directed at the disease.

A World Health Organization statement describes palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.” More generally, however, the term “palliative care” may refer to any care that alleviates symptoms, whether or not there is hope of a cure by other means; thus, palliative treatments may be used to alleviate the side effects of curative treatments, such as relieving the nausea associated with chemotherapy.

The term “palliative care” is increasingly used with regard to diseases other than cancer such as chronic, progressive pulmonary disorders, renal disease, chronic heart failure, HIV/AIDS and progressive neurological conditions. Anyone with a life-limiting illnesses that is in need of symptoms to be managed is eligible for Community Based Palliative Care.

While palliative care may seem to offer a broad range of services, the goals of palliative treatment are concrete: relief from suffering, treatment of pain and other distressing symptoms, psychological and spiritual care, a support system to help the individual live as actively as possible and a support system to sustain and rehabilitate the individual’s family.

If you or your family would like to know more about Front Range Hospice and Palliative Care and our palliative program please call us at 970-776-8080 or 303-957-3101.

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2017 Outcomes in Palliative Care

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Front Range Hospice and Palliative Care once again stands out among our competitors. As of April 14, 2017, Front Range Hospice and Palliative Care’s Palliative Care program was  certified by the Joint Commission. You’re probably asking why does that matter to you? Well let me tell you why it matters.

The Joint Commission’s Advanced Certification Program for Palliative Care launched in 2016. The program recognizes community based palliative care programs that demonstrate exceptional patient and family-centered care and optimize the quality of life for adult patients with serious illnesses. Palliative care addresses a patient’s physical, emotional, social and spiritual needs, and facilitates patient autonomy, access to information and choice. The Advanced Certification Program for Palliative Care from the Joint Commission emphasizes:

  • A formal, organized community based palliative care program led by an interdisciplinary team whose members have advanced training in palliative care.
  • Leadership endorsement and support of the program’s goals for providing care, treatment and services.
  • A special focus on patient and family engagement with advanced care planning.
  • Processes that support the coordination of care and communication among all providers in the community.
  • The use of evidence-based national guidelines or expert consensus to support patient care processes.
  • A full-time service, where patients can access palliative care as needed, 24 hours per day.

 Certification process
On-site certification reviews are conducted by reviewers with expertise in palliative care. The certification decision is based on the evaluation of standards, clinical practice guidelines, and performance measurement and improvement activities. Community Based Palliative Care programs that successfully demonstrate compliance are awarded certification for a two-year period. To maintain certification, the cycle repeats with an on-site review conducted every two years and a biannual submission of an acceptable assessment of compliance by the organization.

The standards for palliative care advanced certification are built on the National Consensus Project’s Clinical Practice Guidelines for Quality Palliative Care, 3rd edition 2013 and the National Quality Forum’s National Framework and Preferred Practices for Palliative and Hospice Care Quality. Standards and expectations were developed using experts in palliative care and key stakeholder organizations.

Performance measurement
To achieve certification, the community based palliative care programs must use performance improvement processes to improve care over time. Performance measures selected by the palliative program or service should and must be evidence-based, relevant, valid and reliable. Data collection for five performance measures is required. A minimum of four months of performance measure data must be available at the time of the initial on-site certification review.

Benefits of Joint Commission Certification

 Improves the quality of patient care by reducing variation in clinical processes The Joint Commission’s standards and emphasis on clinical practice guidelines help organizations establish a consistent approach to care, reducing the risk of error.

  • Provides a framework for program structure and management – Certification standards help organize the disease management program. This helps to maintain a consistently high level of quality, using effective data-driven performance improvement.
  • Provides an objective assessment of clinical excellence – Joint Commission reviewers have significant experience evaluating disease management programs. They are trained to provide expert advice and education on good practices during the on-site review.
  • Creates a loyal, cohesive clinical team – Certification provides an opportunity for staff to develop their skills and knowledge. Achieving certification provides the clinical team with common goals and a concrete validation of their combined efforts.
  • Promotes a culture of excellence across the organization – Meeting Joint Commission standards is an accomplishment recognized with the awarding of The Joint Commission’s Gold Seal of Approval®. Certified organizations proudly display the Gold Seal to advertise their commitment to health care quality.
  • Strengthens community confidence in the quality and safety of care, treatment, and services – Achieving certification makes a strong statement to the community about an organization’s efforts to provide the highest quality services.
  • Recognized by select insurers and other third parties – In some markets, certification is becoming a prerequisite to eligibility for insurance reimbursement, or participation for managed care plans and contract bidding.
  • Can fulfill regulatory requirements in select states – Certification may meet certain regulatory requirements in some states, which can reduce duplication on the part of certified organizations.Page1.jpg

We look forward to working with the patients in the communities we serve to assist them in creating their best days possible. If you or someone you know is interested in learning more about our Community Based Palliative Care Program please call 303-657-3101 or 970-776-8080 you can also reach us at info@frhospice.com

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Response to: This was not the good death we were promised.

A response to the NY Times article from a hospice Director of Nursing. Link to the original article:  https://mobile.nytimes.com/2018/01/06/opinion/sunday/hospice-good-death.html?referer=https://www.google.com/

 

Dear Don,

Thank you for sharing this article with me. I have read it several times over the last few days and have been thinking of the best way to respond. This article raises many questions and concerns for me as a hospice professional. I do want to start by saying that hospice is highly regulated by CMS (Centers for Medicare and Medicaid Services), we also have over sight by the OIG (Office of the Inspector General).  I do not believe that most hospices are running amuck with little government oversight as the article seems to imply.

We have seen a shift in our area (Northern Colorado) in the last few years with larger corporations purchasing smaller hospices. I have not heard great things about this shift, which makes me very happy that I work for a small privately owned hospice.

Another concern that I have with this article is the statement about for profit hospices. I spent the first nine years of my career working in a nonprofit hospital. I believe that people misinterpret the word nonprofit to mean that particular business is charitable and not out to make money. That is not the case at all; it simply means that a certain percentage of the profits must be used for the betterment of that business. Nonprofit healthcare companies typically pay their leadership team exorbitant salaries while the bedside personnel are under paid and overworked. Ultimately the patient and family suffer from lack of care when bedside personnel are stretched too thin. You can see this throughout the healthcare system.  One of our competitors was in the news in the last few years with these issues it ultimately lead to the dismissal of one of their Administrators.

Front Range Hospice is a privately owned hospice, however, that does not mean that we do not provide charity care. We also have a nonprofit memorial fund that is used to help patients and their families to obtain things that they cannot afford. We use our memorial fund for things such as propane to heat homes, books, slippers, art and craft materials, anything necessary to help improve the quality of life for the patients that we serve.

Our CEO Pam Ware believes strongly in always doing the right thing. We follow Medicare regulations to a tee and we strive to provide excellent end of life care to all that we serve. We know that there are no do- overs in end of life care, so we work to get it right every time.  I believe to the core of my being that hospice is a far better alternative than dying in a hospital with unnecessary interventions being performed. I have seen both ways, I have performed those unnecessary interventions and watched people miss the last precious few moments of their loves one’s life. I have also sat at the bedside and watched a young Wife lie in bed holding her Husband as he took his last breaths in the comfort of his own home. There is no question in my mind that the second scenario is a more kind and dignified way to pass from this world. Death is a beautiful, natural process. A patient’s Wife once told me, “Our Mother’s birth us into this world and we birth ourselves out of it.”

Hospice allows a person to pass at home in the care of their loved ones, with dignity and comfort. We cannot always anticipate every issue that may arise for each patient, but we are experts in end of life care. Our staff is highly trained and most end of life journeys do have many similarities, so we typically know what to expect based on normal disease progression. We provide comfort medications to each patient to ensure that we avoid as many “crisis” situations as possible. When a crisis does arise, we are experts at symptom management and can typically get any symptom under control very quickly, without relying on IV medications. Our team of nurses, social workers, chaplains, community liaisons and home health aides provide education on the dying process and what to expect to all patients and their caregivers and support for any and all emotional or spiritual issues that arise along the way. We ask each individual to define what excellent end of life care means to them and we strive to help them obtain their goals throughout their end of life journey. I believe that overall, hospice professionals are the most caring, compassionate group of individuals you will ever have the pleasure to meet. We laugh with, cry with and love our patients and their families and the last thing any of us want to see someone passing with uncontrolled pain.

 

Jesse Harmon, RN

Director of Nursing, Front Range Hospice and Palliative Care

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