Say Thank You To A Nurse Today. May 6th – 12th is National Nurse Week.

May 6th – 12th is National Nurse Week

I want to say thank you, thank you, thank you to all of the nurses. Whether you are a hospital nurse, a home health nurse, an office nurse, a nursing home nurse, a surgical nurse, a hospice nurse or some other type of nurse, thanks for everything you do. And thanks for putting up with the doctors. And thanks for putting up with the patients and their families. We all don’t make it easy for you. But you still show up and take care of us.
I truly appreciate you and hope you will keep being a nurse. We need you. I encourage every one to do something nice for a nurse today. Maybe send a thank you note to the nurse that works at your doctor’s office or drop off a healthy treat. If your loved one is in a care facility, do something nice for the nurses there. Maybe offer to volunteer one day a month and help with meals at the skilled nursing facility. Anything you can do will help. We already have a shortage of nurses so if we want the future to be safe for us, be nice to a nurse today and remember to thank them all year long.

Blog Updates: Newsletter, Interviews, Resource Pages, Listen Feature

I just completed this month’s newsletter.  The feature article is “Communicating with the dying.”  To get a copy, sign up on the lower side of the blog and I will send it out to you.   If you want to get blog updates, notices about new blogs being posted, sign up on the upper side of the blog.  They are separate services.  You are welcome to both.

I feel very fortunate to be able to include a thank you I just received from Elizabeth P in New Jersey.  “Viki helped me in my crisis. There was no wait, no down time, and she knew her stuff!”

She called for help a month ago and just wrote back to tell me that things worked out well.  I was so glad I was able to help.  She was in a medical crisis with her mom and the doctor was not listening and was going against her mother’s wishes.  I told her what steps she needed to take and gave her insight into how to communicate best with the physician. I wish Elizabeth and her mom the best.

There are more Blog Talk Radio interviews scheduled.  They are listed on the side panel.  To hear the show, you can listen live through http://blogtalkradio.com/KindEthics, or you can listen on the phone at 347-945-5152.

You can also use 347-945-5152 to call in to ask questions live.  If you want to listen later, then you can listen through the computer, just click on the link on my site, or download it through itunes.

If you know someone who is doing amazing work that I should be interviewing, please have them contact me.

I was happy to hear that people in Indiana and Maryland used my resource page to get their state-appropriate advance directive.  I just hope they will fill them out.  (smiling)  If anyone needs help with this, email me viki@kindethics.com

I also added a California POLST section to the resource page.  POLST stands for Physician Orders for Life Sustaining Treatment.

Lastly, my great blog strategist and social networking expert, Michelle Price, AThirdMind.com, just installed the listen to the blog feature.  Now you can press listen and while you are doing your housework of playing with your cat, you can listen to the updates.  You can also go through and download them.  I wanted to make sure that this website is accessible to all those with types of needs.

Have a kind and respectful day.

Today is National Healthcare Decision Day

If you read Monday’s blog you will know that medicine can be corrupt and the best defense you can have is to put your wishes in writing. So, what should you be doing today?

1. Talk to your loved ones about what you would want if you were going to live in a terrible condition. And talk to your loved ones about what you want if you were dying. Not just the medical choices but where and how you would want to die and what else might make it a good death for you.

2. Tell your doctors about all of these wishes as well.

3. Fill out your advance directive for healthcare decisions. Go to my resource page to download an advance directive. Print out copies for everyone you care about.

4. Give copies of your completed form to your loved ones and all of your doctors and your local hospital. Keep a note in your wallet stating the phone numbers of your decision makers and where your advance directive is kept. It should be kept on your refrigerator, in your medicine cabinet or at your bedside.

5. Be comforted in knowing that you have taken care of things so it won’t be a burden on your family. It is a gift to them to make sure they aren’t burdened by having to make these difficult decisions for you.

6. If you need help, please contact me at viki@kindethics.com.

Have a kind and respectful day.

Got a question?  Ask Viki.  <!–coldform–>

Hospice Foundation of America Teleconference – Diversity at End of Life

It is time for the 2009 National Bereavement Teleconference – Diversity and End-of-Life Care put on by Hospice Foundation of America. Wednesday, April 29, 2009

The program will focus on ways of understanding diversity and how cultural histories, traditions and beliefs can affect end of life care.

You can find out who is hosting a viewing in your area at http://www.hospicefoundation.org/teleconference/default.asp

The Hospice Foundation of America puts on a great educational presentation every year at this time. This year we are lucky because an encore presentation will be available.

A replay of the live event will be available, via webcast only, beginning at 7:30 p.m. EDT (4:30 p.m. Pacific Time). Continuing education credits (CE’s) are also available for both the live program and the encore presentation. However, it is required by boards for continuing education credits to host a 30-minute local discussion, held directly after each program.

Learning Objectives

1. Define diversity and discuss sources of diversity such as ethnicity, class, sexual orientation, religion, and disability;
2. Describe the ways that cultural diversity can both complicate and facilitate end-of-life experiences, including grief and adaptation to loss;
3. Discuss the knowledge, sensitivities, and skills necessary to work with culturally-diverse populations in end-of-life care;
4. Assess the challenges hospice and palliative care present for culturally diverse groups including, but not limited to, African-Americans, Latinos/Hispanics, Asians and Islamic-Americans;
5. Describe effective strategies and programs to work with end-of-life issues with culturally diverse populations including, but not limited to, African-Americans, Asians, Latinos/Hispanics, and Islamic-Americans.

Have a kind and respectful day.

Got a question?  Ask Viki.  <!–coldform–>

I don’t use the Golden Rule, I use the Platinum Rule.

What is the Platinum Rule? Let me tell you how it differs from the Golden Rule. The Golden Rule, which is found in almost every religion says, “Treat people as you would like to be treated or Do unto others as you would like to be done unto.” The Platinum Rule is even better. It says, “Treat people as they would like to be treated or Do unto others as they would like to be done unto.” It is actually a more respectful way of treating people. The Golden Rule assumes that everyone is the same and would want exactly what you would want. But we aren’t alike and we can get into trouble making this assumption. Let me give you an example.

When someone you know has died and people want to give you comfort, “Do you want people to hug you or would you prefer people to not touch you?” Well, I am a hugger so if I use the Golden Rule, then I am going to hug you whether you like it or not. But if I use the Platinum Rule, then I am going to ask you if you could use a hug and depending on what you tell me, I will respect your answer.

The Platinum Rule works really well in America. We are all different. We have different religions, cultures, values and basic preferences. What I personally believe in is respect. Therefore, I will ask how you like to be shown respect and try to honor it. That is why if you tell me you don’t want to have surgery, even though you might die without it, I will respect your answer. I won’t agree with it but it is not my body that has to go through the experience. It is yours. And you are the only one who can say what is right for your life and your body. Now I might ask you if you would consider changing your mind because I don’t want you to die, but ultimately, it is your decision.

I will respect you and I hope that you will consider asking me how I like to be shown respect too.

Have a kind and respectful day.

Got a question?  Ask Viki.  <!–coldform–>

April is National Donate Life Month (Organ Donation month)

No, you don’t have to actually donate your organs this month but it would be great if you registered as a potential donor. Did you know that if you only sign the card that comes with your driver’s license saying, “I want to donate my organs” then your family can go against your wishes and refuse the donation. You must register your desire to donate your organs with your State Donor Registry or in person at your Department of Motor Vehicles. You can register right now at:

http://www.organdonor.gov/donor/registry.shtm

Just click on your state and follow the instructions. You should also let your loved ones know about your organ donation preferences. That way if they are in ever in this situation, they will know that this is what you wanted and that they need to be respectful and cooperative with the organ donation process.

Who can donate?

Age, most medical conditions or sexual orientation do not exclude you from being a suitable organ and tissue donor. (In fact, there has been a 93-year-old kidney donor and a 99-year-old cornea donor!) There are very few automatic rule-outs, and due to medical advancements, even some of these may change over time. In the event you are in a position to be an actual donor, medical specialists will evaluate your medical history to determine your suitability to donate. (donatelifecalifornia.org)

Pass this information on. In some other countries, being a donor is automatic. You are a donor unless you decided to opt out. We live in a country where you need to opt in. You have to choose to save lives by donating.

Other ways to share the message is you can encourage your company, association, union, or other organizations to which you may belong to join the Workplace Partnership for Life. Tell your local high school about Decision Donation, a school program that educates students about donation. Participate in local National Donate Life Month events sponsored by your local organ procurement organization.

For more information: http://www.organdonor.gov/get_involved/donatelifemonth.htm

The Good News And The Bad News About Hospice

The good news is that I was just in Scottsbluff, Nebraska and their hospice program is doing such a great job of providing people with the option of a good death that 46% of their dying patients are dying with the help of hospice. Amazing. Nationwide the average is 33%-38% with some states as low as 14%. I am even more impressed with what is happening in Nebraska since they are covering 9000 square miles. I know local hospices in Los Angeles that are struggling to cover their few hundred square miles. Usually those who live in rural communities are limited by the minimal medical services that are available. Nebraska has found a way to move beyond those limitations and to get people what they need. I congratulate the hospice workers of Nebraska.

The bad news is that not every hospice is the same. I was told about a hospice in another state that was providing terrible care. They weren’t using universal precautions to prevent infections from spreading to other family members, were putting the patient at risk when transferring the disabled patient and were not calling the family back when they called to complain. Like any industry, there are good and bad hospices and good and bad employees. If you are on hospice and you don’t think you are getting the care you need or they are not being respectful and responsive, change hospice providers. The bad hospice I just mentioned tells people that they can’t change their hospice provider for 90 days. That is a lie. You can change any healthcare provider any day. You are never locked in.

There are many types of hospices. There are inpatient hospices which are part of hospitals, inpatient hospices that are in their own building, for profit hospices, not for profit hospices and volunteer hospices. Any of these can provide good, loving care and most do everyday. It is not the type of hospice but the people running it and working in it that makes the difference.

Getting the most out of this website/blog.

This blog is divided into two sections. The first section is my dual blog. What is a dual blog? Well, most blogs are written for one audience. But I designed this site to help two audiences, patients and their families and the healthcare professionals that are taking care of them. I will be writing about the same topic, side by side, from both perspectives. So if I am talking about organ donation, I will tell patients and families what they need to know about the organ donation process. And then I will write a sister blog piece which will help the healthcare professional understand what the patient and family will need from them during the organ donation process.

I believe that information is power so I encourage you to read what I have written for the other group. If you want to know what secrets I am telling doctors about working with patients, then read their section. If you want to know what I am doing to help patients be better patients and to help them get better care, then read their section.

The other main section I encourage you to read and to participate in is the “Ask Viki” section.

Who might need to contact me? Everyone and anyone.
If you have been to the doctor or are in the hospital and you have questions about how to get the care you need, write to me.
If you are a healthcare professional and you are dealing with difficult patients or situations, then ask me about it and I can help.
For anyone who has to deal with an aging parent or grandparent, I can help you.
And finally, if you are dealing with someone who is dying, or you’re dying, I can help.

Your questions will help me reach my goal of helping as many people as I can. I want things to be better for all of us.

The Unbefriended Senior

What is an “Unbefriended Senior? The “unbefriended” is a word used to describe someone who doesn’t have any friends or loved ones in their lives that the doctor can talk to when the patient is sick or injured. This term could also apply to someone younger without any family or friends.

Let me tell you about what just happened. An 80 year old woman collapsed at the market and was brought to the emergency room. She has had a massive stroke and may not live. The social worker looks through the patient’s wallet to find her insurance card and any information about who to contact in case of an emergency. Only the insurance card and an address are found. The social worker begins to make calls, goes to the patient’s house and tries to find anyone who might know this person. But nobody is found.

So what can the doctors do? If the patient gets better, then the patient will be able to speak for herself but if she doesn’t wake back up then the doctors will have to apply the “Best Interest Standard.” What is this? The Best Interest Standard is used when the healthcare team doesn’t know what the person would want and when nobody is available to talk to.

The healthcare team and possibly the bioethics committee will meet to evaluate what medical options are available for this patient. This way it is not just one person making the decision but a moral community. Next, there will be a discussion about the benefits and burdens of each of the options. Then they will do the best they can to decide what should be done. They may have to make the difficult decisions about dying and death for this person.

The other option for the healthcare team is to have the court assign a public or private conservator or guardian for them. This court appointed person will make their medical and/or financial decisions for the patient. But of course, they don’t know anything about this person either so the choice they will make might be wrong.

My question for you is, “Would you want a stranger to be making life and death decisions for you?”

If the answer is no, then please tell your doctor who they should talk to if you are injured, write it down in your wallet and fill out your Advance Directive. I don’t want you to ever be the unbefriended patient.

Got a question? Ask Viki.

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