August 13, 2015
“Once a nurse, now a patient” is how Sherri Fillipo describes herself on her blog. Sherri was first diagnosed with breast cancer in 2010 just prior to her 50th birthday; her metastatic diagnosis followed in 2012 when she learned her cancer had spread to her liver. Sherri has done several guest posts (The Conversation, When a Nurse Becomes a Patient, Why Does My Oncologist Always Ask Me How I am Feeling and Improving Your Cancer Patient Experience). Sherri recently entered hospice–we have found her blogs very informative and hope you will, too. Here’s Sherri’s account of her first hospice visit.
My hospice nurse, Melissa, recently made her first visit. I fretted about the apartment, plumping pillows, dusting counters like I was having a dinner party. I don’t know why. I guess of all the people I have ever had come to my home in the past 55 years, hospice has not been one of them!
We ended up spending two hours together and I am not sure why except I had a million questions that I wanted answered, more from a curious nursing perspective than patient. At one point, she looked at me and said, “Most people don’t want nearly this much information this soon!” I told her I did. This is an area of nursing/healthcare that is a total mystery to me and I was determined to draw back the curtain and get some answers by dern!
Truly, it was what I would call an intake assessment. Basic demographic information from me, though we did tip toe around delicate issues of death (Did I have a ‘Do Not Resuscitate’ Order? Do I have a healthcare proxy?). I believe she would go as far as her patient would let her. Some of the things I wanted to know included:
- Can you use my port for medication? No, they do not use the port. They will provide medication by mouth until the swallowing reflex is gone and then they transfer to a liquid mixture that they say works well when given via a syringe (no needle on the syringe) into the back of the throat that slides down and does the trick.
- Will there be morphine in the home (the nurse in me goes, “WHAT?”) and the answer is yes.
- I asked her if my neighbor could administer it and the hospice nurse said she could. Then I shouted over my terrace to where my neighbor was sitting on her terrace and asked her if she would like to give me morphine when the time comes and of course she said, “I would love to but only if you will share! You know those old Bianca commercials where they spritz a little mouth freshener into their mouths?” She said she would just take a little. NO, she is not serious. She just knows how to make me laugh in tense situations.
Things I learned:
- Patients are placed on teams of which there is a nurse, social worker, spiritual liaison and host of others. There is a weekly interdisciplinary team meeting where you are the center of attention and the team discusses how you are doing, they review the meds you are on etc. I LOVE this idea. We do it in the hospital but not nearly enough. Everyone is together and everyone is looking at you from their professional perspective. Think holistic.
- Everything is conducted here in the home which I mentioned yesterday.
- When I begin to have difficulty with activities of daily living, there is an LPN who can come to the home an hour a week and assist with bathing, etc.
- Physical therapy is a benefit (I am working on some way to get a massage out of this but I can’t quite figure how to word my need for one to make it sound medical!)
- As a nurse I am used to the question (ten thousand times over), “One a scale from 1-10, how would you rate your pain?” Hospice has a different question which she said would be asked every time and it went something like this, “What is the one thing today that is most on your mind?”
All in all an oddly pleasant afternoon with this benevolent stranger. Next up, the social worker comes in on Monday. Stay tuned. All is well. Cats are curled up. The sun is shining. The temps are cool. I am drinking coffee.
Follow Sherri’s story at http://www.sherrifillipo.com