"I'm here to help you * * *! Practical nurse Cai Peishan, a nurse in Anning, Lin Xin Hospital, kindly asked the patient if there was any discomfort, and provided comfortable care for the patient with skillful pressing skills to alleviate the physical discomfort caused by the disease. The patient's original nervous mood was relaxed because of physical relief, and even asked her at the end: "When will you come again tomorrow?" " 」
In the face of patients who come into contact with "Anning" for the first time, the hospice care team often omits its title introduction: "I am a cancer manager. Let's see if there is anything wrong with you. " ""I'm a palliative nurse, and I'll help you treat edema! They don't care whether the topic is right or not, and they are not afraid of the patient's indifference. They just hope that they can do their best to provide care and comfort their families in the last journey of the patient's life.
An important source of silent listening to the fear of unknown life: authorized by hospice foundation. When the hospice care team took the first note, the most frequently asked question was: "How long can I live?" For many people, "peace" is a strange and distant term. Once close to the eyes, it is often terminally ill. In the case of necessity, patients can only accept hospice care, so that patients are wary of the arrival of hospice care team.
In the face of the patient's fear and sadness about the unknown, Cai Peishan will gently ask, "Are you worried about something? Transfer the right to talk back to patients, and let them take the initiative to express their inner anxiety and hesitation. She admits that until now, she still has no correct answers to many questions, but in the process of accompanying every life to the end, she gradually understands the importance of "silence" and "listening".
She said that some patients would even ask her, "Well, what are you going to tell me? The tone is calm, as if waiting for the team to pronounce death imminent, and then she will tell the patient with a smile: "I have nothing to tell you, so do you have any questions to ask me?" " 」
"In fact, in the face of peaceful patients, what they need most, in addition to relieving pain, is that someone listens. Liao Yijun, a practical nurse from Anning Home, became the founding elder of the team when Lin Xin Hospital started the pilot hospice family service. She said that illness is a lonely thing. Patients' fear of their own diseases, family members and the unknown may have been suppressed by the hope of treatment in the past. When active treatment has failed and hospice care needs to be connected, many patients' hopes will collapse instantly. In addition to accepting the fact that I am about to die, the pain and anxiety that I bear alone have become an instant.
"One of the things we often do is to pull a chair and sit down and start chatting with patients. Liao Yijun said that in her nearly 20 years of hospice care, not only did others think of "helping" patients, but in fact, many times patients were their life mentors and taught her the importance of listening and empathy.
Cai Peishan also said: "I feel very lucky, because this job, we don't have to personally experience the departure of life, but we understand the meaning of life. Every patient who is willing to open his heart and tell his life story before the end of his life has turned his life story into abundant energy, nourishing the whole Peace Corps.
Image source: Lin Xin Hospital, a regional teaching hospital, authorized by Hospice Foundation. The hospice care team has only four members, including 1 doctor, 65438 family doctors, 65 family doctors, 65 nurse practitioners and 65 social workers. Compared with large hospitals, they don't receive many cases, but they try their best to serve every patient in need with the best quality and the most reliable speed.
"I often comfort my colleagues who are frustrated because they can't help more patients because of limited manpower, saying: As long as we can take care of a patient wholeheartedly, we will do it for this patient 100%. Liao Yijun said.
Because the team is small, the communication speed and the patient's situation can be grasped relatively quickly and accurately. If outpatient departments and wards notice that patients need hospice care intervention, they will inform the team in time, and the team will immediately go to evaluate or provide assistance.
Of course, there are also patients who can't receive hospice care in a short time. What the team can do at this time is to actively provide hospice care information and maintain the relationship with patients so as to intervene and assist at any time. There is a cancer patient who has been hospitalized many times, but each hospitalization time is quite short. The patient doesn't want to stay in the hospital and wants to go home as soon as possible. During hospitalization, practical nurse noticed that he had an urgent need for hospice care, but he always declined to help, so he transferred the patient's information to the hospice care team. When Cai Peishan went to the note, she always gave the patient's wife Liao Yijun a business card and asked them to call if necessary.
"Well, when she needs it, my business card is still there. Recalling this case, Liao Yijun still said with emotion.
One night after repeatedly stuffing business cards, the patient suddenly went into shock at home, and the wife who took care of her husband alone panicked at this time. Now she realizes, "What if my husband suddenly leaves?" Who can help me? Although the patient soon woke up on her own, it also made her realize that she needed the support of hospice care, so she found Liao Yijun's business card and contacted her for a safe home visit.
Liao Yijun went to visit with the doctor immediately after receiving the phone call. In less than a week from the patient's death to his death, he took time to visit twice. Facing the patient who didn't want to be touched by anyone other than his wife, she laughed and called herself "cheeky", and took the initiative to roll up her sleeves to wipe the patient's face when she made a house call: "Brother, don't let your wife work so hard, let me help you change the medicine and shave! After helping him finish the comfortable nursing, she did not forget to praise the patient: "Big Brother, thank you for letting me help you. Isn't this very comfortable and much more handsome! " 」
Shortly after the second visit, the patient died at home, and his wife was very grateful to the hospice care team for their timely help at the end. She not only provided professional medical care, helped clean her face and body, and maintained her comfort and dignity, but also discussed her husband's death with her, and provided spiritual comfort, warmly accepting her panic and helplessness.
"I am going to get off work" The last preparation in my life journey Image source: The hospice foundation authorizes the use of hospice wards or family hospice care. Liao Yijun admits that hospice care is actually more difficult. Patients in hospice wards or at home have often passed the first stage of "accepting diseases" psychologically and physically, and * * * photos not only need to explain hospice care to patients and their families, but also need to communicate patients' expectations for medical care or a good death in detail, and discuss medical problems with the original medical team. In this process, the concept of hospice care is often different from the traditional active treatment, including the concept of referral time and the dosage of painkillers, which requires more energy to communicate and deal with.
Taking the first referral case when Lin Xin Hospital first started hospice care as an example, she said that at first, the original attending doctor had reservations about hospice care, but in the process of two teams' common care, the original attending doctor saw the care and delicacy of the hospice care team, as well as the patients' real feelings and feedback, which completely changed his view on hospice care, and now he even became the doctor with the highest referral rate in the hospital.
The referral time is the key to hospice care. Patients and their families have usually established a deep doctor-patient relationship with the original medical team. Whether the patient can be successfully referred to hospice care depends on the communication of the original medical team and the clear and adequate notification of his illness. Cai Peishan said: "We hope that the time for patients to enter hospice care can be promoted and referred as soon as possible, so that we can have more time to help patients and their families prepare physically and mentally. 」
Even though the concept of hospice care has been implemented in Taiwan Province Province for many years, there is still room for further progress in the time of referring hospice care. Therefore, when she finds that the patient is in urgent need of hospice care, and the symptoms of dying have appeared, but she is not "ready", she often spends the whole day at the bedside to help the patient and his family not to panic when facing the end of the life journey.
"I want to get off work; I want to give him back to you. I believe you will do well. When Cai Peishan feels that everything is ready, she will gently tell her family. Everyone will encounter the test of life problems in his life. In the general doctor-patient relationship, the family members will think that the patient is entrusted to the medical team, but she believes that at the last moment of her life, when she helps the patient and her family get ready, she can carefully "return" the patient to the family members who are most important to her.
Life and death, so we can live in peace.
Image source: Hospice Care Foundation authorized the use of the author/Liang Wenjing Figure/Lin Xin Medical Association legal person Lin Xin Hospital Hospice Care Team
This article is authorized by Taiwan Province Anning Care Foundation. See here for the original text. ※.