Family Room at the Inpatient Hospice Unit at Penn
Lastmonth, I wrote
a post inanticipation of starting the training necessary to become a volunteer with
PennWissahickon Hospice. Since that time,I’ve completed training to become an inpatient hospice greeter and actuallyvolunteered twice. Although it’s still very early on in my experience, I thinkI’ve gleaned a few insights that I wanted to share.
Perhapsthe most important thing I’ve learned in this short time is just how extensiveand intensive the training process is – and needs to be – to become a hospicevolunteer.
It’sno easy assignment and volunteers need to be fully prepared for a variety ofissues in their new roles. Research has revealedthat hospice volunteers face ethical issues, including dilemmas about gifts,patient care and family concerns, issues related to volunteer roles andboundaries.
Otherstudies have looked at how the stress of volunteering can take a toll on theindividuals, with some studies (although there are few) finding attrition rates as high as 43 percent. Thereis very little research that has focused on volunteers, but stress plays amajor role (both personal and while volunteering) in why some people choose tostop.
Theseissues, and many that go unreported due to the dearth of research in this area,compel hospice programs to spend a lot of time and resources to train theirvolunteers.
AtPenn, the process is broken up into multiple training sessions. I have onlycompleted the most introductory orientation to help as a greeter in ourinpatient facility. This means that I help greet and direct patient’sfamilies and friends as they come into visit their loved one and answer thephone.
Forthis, I had to apply to the program, I was interviewed by our hospice volunteercoordinator, and I had to provide personal references to make sure I would bean appropriate candidate. I completed a two-hour educational session andbecause I’d be working in the inpatient unit, I needed a series of vaccinations(which thankfully I already had from working in the Department ofCommunications).
Thenext level of training is much more involved because it will allow me tovolunteer in direct patient contact programs. To be ready to interact with apatient one-on-one, a volunteer must complete two days of intensive workshopsto prepare for anything from psycho-social issues that patients and theirfamilies are facing at the end of life to the importance of verbal andnon-verbal communication while interacting with patients who may be unable tospeak.
Otherareas of focus revolve around the role of the hospice chaplain and spiritualityin end-of-life care, the boundaries of volunteerism, national patient safetygoals, and bereavement counseling for families. Volunteers that work directlywith patients may be deployed to clients in a private home setting, nursinghomes, hospitals, assisted living facilities and group homes. Penn WissahickonHospice attends to patients wherever they live. The complete training issuggested for everyone so all volunteers have the overall understanding of thehospice philosophy.
Evenin just my first two shifts, I understand why the comprehensive training isnecessary. On my first night, I greeted a family that had just learned theirmother had been transferred to the inpatient unit. They were flustered, notknowing where to go and how their loved one was doing. As I had beeninstructed, I asked them to sign-in, so that we can keep an accurate record ofpeople in the unit in case of fire or emergency and to know who is with thepatients at any given time. I could tell by their pained expressions that theyjust wanted to get to the room and my administrative request was wastingprecious seconds.
Theurgency of that moment for them was so palpable it made my stomach twist. Theysigned in as I told them what room their mother was in and they ran down thehall. It was my first “moment” of knowing how emotionally charged thisexperience will be at times. As the night went on, I signed several morepatient families in and directed them to their loved ones’ rooms. Many had beento visit multiple times and nodded knowingly when I stopped them.
Duringmy second shift, a large group of visitors made use of the cozy family area inthe unit, designedto offer patients and their families a beautiful and comfortable atmosphere torelax. A fire was burning in the fireplace and the visitors, family and friendsof a patient, were laughing and chatting as they each took turns in thepatient’s room. For a moment, it almost felt like I was in the living room oftheir house, experiencing a family party. Not at all what most people mightimagine a hospice unit to feel like. A few moments later, a somber visitor foranother patient asked if he was allowed to stay all night. He explained that hedidn’t want to leave his loved one’s side. At the end of my shift, a visitoremerged from a room with an adorable Corgi (patients are allowed to have theirpets visit depending on their currentcondition), bringing smiles to everyone’s’faces as he trotted down the hall and out to the elevators.
Theseexamples lead to my second observation, which I’m sure I will continue to grow and refine, involving the sweeping rangeof emotions that course through the hospice care experience. Everything fromsadness, fear, stress, and anger to love, solidarity, patience, and yessometimes, joy. Even though I’m not experiencing these emotions due to adirect connection with a patient, I’ll bear witness to them and internalize thefeelings of those around me.
Ithink this is one of the things that I’m most excited and apprehensive about.