Going the Extra Mile
By Pam Ware and Victor Montour
It’s simple… go the extra mile and you will stand out from the crowd.
A quote from Robin Crow.
Recently Front Range Hospice received a referral from one of our hospital partners that we currently have a General in Patient contract with. The patient is the matriarch of her family and had been in the hospital or an Acute Long Term Care Hospital for a little over a month. She had endured a lot in that month and so had her family. Multiple surgeries, multiple infections, the need for a ventilator, central lines and a number of other interventions. It was a constant roller coaster of emotions for her large and loving family.
When the decision was made for hospice, the patient was not conscious. Front Range Hospice received the referral at the end of the work day for most people, but Front Range Hospice is open 24/7. We are keenly aware that when a decision is made to move away from aggressive treatment and just focus on comfort, it is important for the family to see and be able to talk to a caring hospice representative.
Our hospice liaison arrived within an hour of receiving the referral and our admitting nurse was not far behind. Our liaison gathered all the family together and provided a detailed informational session about hospice and the services provided by hospice. During this meeting our liaison was able to establish the family had further clinical questions that needed answered before they could agree hospice care is the best approach. After this meeting our liaison met with the physician caring for the patient and updated the physician about the questions the family has and worked out a plan to have the physician meet with the family immediately. After all the questions, concerns and fears were answered by the physician the family agreed to move forward with hospice care. Our liaison met with the family again to review services again and to establish goals the family would like the hospice team to achieve while caring for their loved one. This family had two number one goals, comfort and to get the patient home. The liaison meeting with the family is also a nurse; the liaison was able to provide education to the family about the risk of moving the patient in the fragile medical state their loved one is in. The liaison educated the family about the risk of the patient expiring in the ambulance on the way home. Knowing the risks, pros and cons the family made it very clear that they wanted the patient kept comfortable and wanted to take her home in the morning. They knew that their loved one wanted to die at home and they were prepared to do whatever needs to be done to grant her that request.
At the time of the admission, Front Range Hospice nurse was concerned that she might not live until the morning but we at times underestimate the will of an individual’s soul. Her care was switched from aggressive treatment to comfort care and the family was told that we are available 24/7. We were just a phone call away and that our staff would plan to be in the hospital at 8am if not called sooner.
She lived through the night. The Front Range Hospice nurse, liaison and Chaplin arrived at the hospital at 8 am and began ensuring the patient was comfortable, supporting the anxious family with the big change to home and started to arrange for a rush delivery of the needed durable medical equipment (oxygen, hospital bed, etc), got written orders from the physicians so medications could be picked up at a local pharmacy, completed a Colorado MOST form, scheduled an ambulance to take her home. During this organized chaos, the nurse took the time to slow things down to meet with the family and gently informed them again that their loved one might die in the ambulance. She was that close to death. Knowing this the family remained firm, they wanted to take their loved one home. Our nurse with the patient on an ambulance gurney and the family following behind made their way out of the hospital to the ambulance. Our nurse followed the ambulance to the patients home and resumed caring for her immediately upon arrival.
She was home, surrounded by her family, and comfortable by 12noon. She then woke up and spent the next 3 hours talking to her family in her very familiar role as the matriarch. She then closed her eyes, went to sleep, and gently her soul left her body and she died. Her peaceful passing in her home surrounded by her loved ones was what we call a “good death”. Although the family members will miss her and mourn her loss they have those last 3 hours of pure joy that they were able to spend together.
The goals set before us at Front Range Hospice were simple. Keep her comfortable and get her home. Going the extra mile to meet the needs of a patient and their family is what we do best. Front Range Hospice exists to provide Legendary End of Life Care. Going the extra mile is the only way to meet this goal/expectation.
Front Range Hospice will always go that extra mile.
If you would like more information about Front Range Hospice please call 303-957-3101 or 970-776-8080 or email us at firstname.lastname@example.org
Watch out for our next blog: A Major Distressful Symptom in the Dying