Wednesday, March 25, 2009

Caring for Caregivers

“In today’s health care reality, caregivers are caring for much sicker and more complicated patients,” said Dr. Melissa Schepp, medical director of the palliative care program at St. Joseph’s Hospital in Atlanta. “We’re all being asked to do more with less time and fewer resources. I started to worry about how caregivers could keep their compassion.”

Knowing that compassionate care was integral to St. Joseph’s mission, Schepp began searching for a way to support caregivers. He turned to the Kenneth B. Schwartz Center at Massachusetts General Hospital in Boston.

The center was founded by Schwartz in 1995, before his death from lung cancer at age 40.

“As skilled and knowledgeable as my caregivers are, what matters most is that they have empathized with me in a way that gives me hope and makes me feel like a human being, not just an illness,” Schwartz wrote in a Boston Globe magazine article in 1995.

The Schwartz Center fosters programs and research dedicated to strengthening relationships between patients and caregivers. One of those programs, Schwartz Center Rounds, is a multidisciplinary forum that allows caregivers to discuss emotional and social issues involved with patient care, with the goal of improving caregiver/patient relationships.

“We knew that it had been put in place in 160 hospitals, and a survey showed that people valued the method,” Schepp said. “We wanted a place for our caregivers to be able to explore and process the emotions that come from being at the bedside every day.

“After meeting with the program coordinator, we could see that this was a formula that worked.”

The format invites caregivers from all health care disciplines for breakfast or lunch and a discussion of the nonclinical issues involved in their jobs. The discussion is centered on one topic based on a specific, difficult case. The idea is that there are common themes to all tough cases and exploring them can help workers devise better strategies to handle similar circumstances in the future.

The first event was sponsored by St. Joseph’s palliative care, ethics and clinical pastoral care departments.

“We planned lunch for 50 and we had 70 people come, including nurses, physicians, case managers, social workers, pharmacists and physical therapists,” Schepp said. “We were really pleased by the response and that it was a good cross-section of disciplines.”

Marlene Kennedy-McKenzie, RN, a bedside nurse in the critical care unit, was a member of the panel that presented the case for the first 15 minutes of the program.

“At first, I was scared seeing all eyes on me, but when the doctor and the physical therapist joined me at the table, I relaxed and just talked about what happened,” she said. “I surprised myself and actually enjoyed the discussion. No one was pointing a finger at anyone. It was a learning experience.”

The 45-minute discussion afterward made Kennedy-McKenzie realize that she wasn’t the only worker who had felt angry and frustrated by the situation.

“Hearing others’ thoughts really helped you identify what you were going through and to see better ways to nip it in the bud if we come across this problem again,” she said.

What happens at the rounds, stays at the rounds, Schepp said.

“Caregivers get very close to their patients and families, and it can lead to a lot of stress,” she said. “They need a private and safe place to process their feelings and remember why they went into health care.”

Schepp believes the multidisciplinary forum will encourage teamwork, help decrease workers’ sense of isolation and let them see problems from different perspectives.

“This is a wonderful program that fills a gap,” she said. “It gives recognition to people who are doing hard work at the bedside and gives them a place to be heard. There is power in that.”

Original Article Source: AJC Jobs

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