Moderator Pick
July 1st, 2020

Hospice team making an impact in an Acute Care hospital

We are an inpatient hospice located in northern New Jersey and our highly trained staff provides care for patients at end of life. When the Covid crisis began we worried about the health and well-being of our staff and residents. All of our nurses were deployed to assist in care for patients at the hospital . Our team was stressed but we all showed up. The nurses, home health aids, and team members worked MedSurg units, quickly getting up to speed on the procedures at the hospital and patient care protocols. The hospice team wanted to make a meaningful impact. A need arose when the burden of all the dying patients had reached its peak. Hospitalists were pronouncing patients at an alarming rate. The doctors and nurses were struggling with the losses. It was heart wrenching. The hospice team came together and created a program to alleviate some of the stress and struggles of the staff. We became the pronouncement and post mortem team. Our team took on one of the hardest jobs during the pandemic. In the state of New Jersey, a registered nurse can pronounce patients in an acute care hospital. This came together with the assistance of many departments and disciplines. In creating this team, we worked with administration and medical affairs to get credentialing for all the nurses. Information technology generated a beeper and paging system in our electronic medical record. We collaborated with the nurse managers and nursing education to educate the staff. Infectious disease and nursing set up an expiration checklist and postmortem procedure to meet the guidelines of the CDC and the department of health. IT created pronouncement charting in the EHR and all of our nurses were able to access the electronic death registry. Our nurses went to the bedside of every patient that died. They cared for each person in a dignified way. This alleviated the stress from the front line doctors and nurses. It allowed them valuable time to spend with patients in need. We also collaborated with transport and the morgue team to track all of the patients. The hospice counselors provided emotional support and telephone counseling to the families of the deceased. Our staff assisted families with funeral plans and coordinated with funeral homes. After each pronouncement, patients were treated with the utmost reverence and respect. It was the last act of kindness that we could do for so many suffering with the virus. Hospice provided education and support to the nursing staff.
Our hospice nurses rounded on palliative patients. We assisted with interventions to alleviate distressing symptoms. iPads were used to FaceTime and connect families to patients in the most meaningful way. We were present for patients, helped alleviate their fears, made them comfortable, and feel safe.
The response from the nurses and doctors at the hospital was tremendous. They thanked us for providing each patient with the time and care that they deserved. The hospice staff are the finest professionals. We provided dignified post mortem care to over 100 patients. We facilitated over 117 face time calls with patients and families. Our compassionate group provided bereavement support for all the families and assisted with all funeral arrangements. It was difficult for everyone. This work gave us an enormous sense of purpose. Thankfully, our pronouncement team is no longer necessary and COVID cases have decreased dramatically. We are now trying to regain our resilience and move forward. The team takes comfort in being able to have a meaningful impact on patient care and staff support at our hospital.

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Comments (2)

Comments (2)

Hi Lisa:

Thanks for sharing your story. It's moving and brilliant. What do you think needs to happen for similar programs to be created in other highly impacted hospitals? Did this work because your staff was already in the hospital? Could it also work by bringing in outside hospice?

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Thank you for your comment. I hope that sharing our journey will inspire others at high impact hospitals. It was easier for us as being part of a medical center, but we were not on the hospital campus so we did need to assimilate to the hospital environment. Most outside hospices have relationships with hospital systems. I think it could work if the hospital and education could onboard the staff quickly. This was working in our hospital when on boarding outside nursing staff.
Hope this is helpful