Monday, March 15, 2010

An office kind of day...

Stayed at the office for most of the day trying to get ourselves organized and plan out the week, especially Thurs and Fri since my MT supervisor is leaving me!! (It's all good, she'll be back Monday:) )

The one pt she did take me to see is one we have had on our services for over a month now I believe, but I personally was yet to meet her. She was sleeping and did not awake to the music. I recently received an email saying that the RN visited her just a bit ago, and the pt is unresponsive and declining :(

I left to go run over to another town where our admissions nurse was admitting a new pt. My GPS told me to enter their neighborhood through the side that was gated and locked, so I called the nurse to ask for help. I could hear the daughters in the background trying to give the nurse directions to give to me. Their last direction was to look for a lady in a black shirt with red hair. It seemed like a strange thing to look for, but as soon as I turned the bend, I saw a woman standing on the side of the road waving her arms at me. One of the daughters ran outside and down the street to lead me to their home! What service! hehe :)

The RN was sitting in the kitchen talking to the pt's three daughters, educating them on what our company has to offer and how we can help. It's important to make the distinction between her selling our services and educating the family on how we can help them through this hard time. At no point did the nurse pressure the family into choosing us over another hospice company (which they had already called first) nor provided any false hope or promises in hopes of getting the consent forms signed. She was upfront and honest, yet sensitive to the situation and supportive. I admired the nurse for her ability to calmly talk the family through their decision. I tried to offer the family reassurance or insight when I could, but I felt almost unfit to even open my mouth. Who am I to tell this family about hospice? This nurse right next to me has been a hospice nurse for years, and I've only been working in hospice for a month!

The daughters were a most fascinating trio. All sisters with the slightest similarities, but all so completely different. One had red hair, the other blonde, and the third brunette. They had a great relationship though, and were able to laugh and warn of us of their mother's bluntness. Although a bit concerned for their children (pt's grandchildren), the daughters themselves seemed to not be experiencing any anticipatory grief, are accepting of their mother's condition, and just want her to be comfortable and not in pain anymore.

With the previous pt, the MT tried showing me how to follow a pt's breathing to match the tempo of the music with the pt's respiration rate. I tried to do the same with the new admit's heart rate (the two are different - how often a person takes a breath vs. how often their heart pumps blood), since I could see her heart was racing from the pulse in her neck, pounding away like an angry woodpecker. It took me awhile to get the music to line up with her pulse, but finally, and almost surprisingly to me, the two tempi became one. The speed of my guitar playing and the pulse in her neck lined up for a good 30 seconds. Once the music and a pt's heartbeat are in sync, theoretically, according to the iso principle, you should be able to lead the heartbeat to a slower pace, once meeting the heartbeat at its current fast tempo. I however was unable to find any success with this. I felt like I was gradually slowing the tempo of my playing, but the pt's pulse did not follow. Looking back, I'm sure I was not changing the tempo gradually enough and was expecting too much of a result too quickly. I think it's because I got so excited that the heartbeat and music became in-tuned to each other that I thought everything else would just fall into place. I'm excited to try it again with her, hopefully next time with a more controlled and patient approach.

And that was my day. Full of office-ing, driving, traffic-sitting, and observing admitting! As much as I was frustrated by sitting in traffic on my way to the admit, I'm really glad I was given the chance to go. I really learned a lot about the pt and was given a more complete understanding of the entire picture. The pts whose admits I have witnessed obviously seem different in my mind than the ones I just met through MT sessions. I feel like I know the new admits much better. It helps me gain a more complete perspective on the situation which can prove to be ver beneficial when offering a therapeutic service.

Until tomorrow...

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