Hospice Work Experience Write Up

Sozzles about the lack of posts over the past 3 days! I've been away working at a festival for the past 3 days and I've been camping, so no access to internet over there!
Anyways here is the write up of things I've been observing during my work experience time at the hospice.

• The hospice I went to observe only holds 8 people at a time, so it is a really intimate environment.
• I shadowed the Medical Director of the hospice, who went to visit each of the patients on Monday morning to find out how they did over the weekend. The relationship she had with the patients was obviously completely different to the GP - patient relationship. There was a lot of touch, and contact she had with the patients, holding hands, which obviously would have been a bit inappropriate for a GP to do on some occasions! The doctors at the hospice are almost like a friend that is there to look after you, which was lovely :)
• Patient care in the hospice in very intensive and so organisation in key in making sure everybody knows what is happening with each patient every day. The hospice had a huuuuuge board in the staff room with all sorts of codes and colours and keys which each member of staff updates every time something happens.
• It is patient directed, so whatever the patient feels like they want, the staff will try and do for them, such as pain management on a day to day basis. 

There were several patients that had a SUPRA PUBIC CATHETER inserted, as they sadly had a tumour present in the vaginal region that meant they were unable to have a normal catheter inserted.
This involves a tube being inserted into the bladder through the abdominal wall.






One patient also had an INTRATHECAL CATHETER, which is a fine plastic tube inserted under the skin and into the space surrounding the spinal cord (it's called the intrathecal space), pain medication is then given to the patient through this tube, kind of like an epidural! Pain medication is much more effective when taken this way than by mouth as it means pain killers can be given regularly to prevent the pain breaking through, rather than letting the pain get bad and having to rescue the patient from it.

I was also able to observe a PARACENTISIS, which is where a large needle is inserted into the peritoneal cavity to drain excess fluid from around the stomach. This excess fluid can cause discomfort for the patient, is can also press on the diaphragm, meaning the patient may find it hard to take a deep breath and so many be short of breath all the time. The procedure was done using local aesthetic, and this particular patient had 3 LITRES of fluid drained off her stomach! so hopefully she felt much more comfortable afterwards! To the right is a big swollen tum!

 

 

 

 

I asked the Dr how she managed to work around patients that were ultimately there to die :( , here are some of the things she said:

• She keeps her work and her home life in separate boxes, you can't take the problems home with you otherwise you will end up worrying and worrying about them.
• Yes the patients are sadly there to die at some point, but the satisfaction she gets is from making sure that the patients quality of life is as good as it can be in their last days.