A room in the back corner of a basement of a physicians clinic. Computers on tables with lots of wires lining the four walls of the room. Four long banquet tables pushed together 2x2 to make a rectangle in the center of the room. Sixteen clinicians sitting around the table, each with a laptop in front of them. Wires connecting the laptops to the wall--to electricity and to networks. Papers scattered on the table. The click click click of keyboard keys, various musical rings of cellphones, and an occasional overhead page. The confused delay in the conversation over the speakerphone connecting clinicians 40 miles away.
The report of how recently bereaved families are doing. The silent recitation of recent deaths. Discussion case-by-case of the 33 hospice patients the team I'm part of--Team 3--is responsible for. Concern about cares, or lack thereof, being delivered by caregivers. Problem-solving about something new ("anyone have any ideas?") that may take care of nausea not touched by any other med thus far. Other options for treating anxiety since the patient is allergic to the usual first line of treatment. Sharing of information learned at a recent conference about a new way to address a dry tickle cough in chronic COPD patients. Concern about a family's coping and the constant tears they shed. Rejoicing over a recent reconciliation of a patient to an estranged family member. Brainstorming about a patient and family not wanting to engage in any conversation about disease process or decline, despite the decline occurring. Pointing out a patient's estrangement from their faith background to keep an ear out lest there is increased anxiety/fear nearer to death. This person needs a volunteer to assist with attending a last-time fishing trip. That person needs a CNA to assist with her laundry.
We have to record this, sign that, document, document, document. But we play "the game" because it allows us to be present with families as their loved ones die. To make them more comfortable. So they don't feel alone. To answer their questions and teach them what to do.
To be present in the sacredness of the grieving of others heretofore strangers, but strangers no more.
Thursday, August 30, 2007
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