Reflections from Ontario

Ted and I have been travelling for the past week and have packed a lot into a short period of time!

We attended the PSNO PSW Conference 2014 in Markham, ON on October 21st. It was wonderful to meet 300+ personal support workers! One PSW, Derek, spoke about his work in hospice palliative care and highlighted some of the challenges. What stood out me was his emphasis on the value of team.

A big thank you to the PSW’s who stayed for the closing plenary. I know you were tired after attending for the entire day. I appreciate being able to tribute you and reflect on my learnings in HPC.

Next was the OCSA Annual Conference on October 22nd and 23rd.  Harry van Bommel, M.Ad.Ed., CTDP, spoke on Putting the ‘Care’ Back into Healthcare. Mr. van Bommel has developed resources to help people navigate and negotiate the system and these resources can be used and adapted to people’s local areas. He is as warm and as kind as when I met him in 1992 after the CHPCA conference in Winnipeg (my first HPC conference). I had the pleasure of meeting with Kathy Duncan from PalCare Network.  They have regular courses they offer in Newmarket, ON and an extensive library of palliative care books, manuals and journals available for loan. They also have a special conference coming up in March 2015 for PSW’s and community members that sounds fabulous, so if you’re in that area you may want to contact them to find out more information.

In the morning I met a beautiful woman named Jenny from Thunder Bay. She spoke about her work with such joy. Then she talked of the challenges and violence that has been happening in her community.  Within an hour she came to our table and told us about the shootings f the soldier in Ottawa.

As the day progressed and the story unfolded, my heart went out to those who mourn the death of Nathan. And along with other Canadians I share the collective sorrow that comes with witnessing violence born in mental illness.

Next up is Niagara Falls, Ottawa and then the OLTCA Fall Symposium in Markham which we’re really looking forward to.

 

Seeking your advice…

I am writing “Essentials in Hospice Palliative Care: A Guide for Personal Support Workers”  (PSWs are also known as Health Care Assistants, Community Health Workers etc.)

As many of you who read this blog know… The PSW is often the eyes and ears of the health care team. It is often the PSW who observes a problem, reports to the nurse or supervisor in order to get the needed supports to help address the problem.

In the section on Physical Comfort, I discuss common symptoms experienced by the dying, what the PSW might see and hear, what they might report, and comfort measures that they can provide.

When a PSW is in the home setting or in a busy long term care facility, the PSW needs to provide the nurse with enough relevant information so that the nurse will understand the needs and be able to respond in a timely way. In these cases it is helpful to report more than the basics “I think Mr, H is in pain, can you see him”.  A more thorough report is needed.

I like the OPQRSTUV acronym used by many health care professionals to prompt them to complete a more thorough assessment.  “O=Onset P=Palliating or Provoking… etc… but these more complex questions are not really in the scope of the PSW practice…. So, I have taken the basic concepts and developed this list of questions that the PSW could apply to any symptom…

I would appreciate your critique, comments, feedback… what do you think of the questions?
Are they too much for a PSW to consider?
Does the flow of the questions make sense to you?
Are they helpful?

When you respond, please indicate your background, are you a PSW, an instructor, a supervisor, a family caregiver etc…

Here you go:

“Consider these questions when you observe the person. You may be able to ask the person or the family these questions, or you may be alone with a non responsive person, and you may need to use the information you have gathered by observation to answer these questions.

What is happening?
When did it start?
Where do you feel it?
What does it feel like?
What makes it better?
What makes it worse
Can you rate the symptom on a scale of 0-10 (no symptom, or the worse you can imagine) or small medium or large?
What can I do to help?

Use the information you have gathered to report to the nurse/supervisor.”

I would appreciate your input. If you are not comfortable replying in the public blog, you are welcome to email me directly.

Warm regards,
Kath