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Participant Narratives Some of the earliest study results we are able to provide are in the form of participant narratives — actual accounts from participants as to how the knowledge they have gained from the PERT Program has influenced the care they provide. Following each series of PERT classes, participants are asked to describe one or two clinical situations in which they used information and skills learned from the PERT Program. In addition, they are also asked to recount opportunities in which they have been able to act as a resource for other staff caring for a resident at the end of life. What follows are actual narratives submitted by nursing assistants and licensed staff who participated in the PERT Program. I had a resident who was diagnosed with bone cancer. He is from another culture and didn't have a clue what hospice and palliative care are about. I spent some time talking to him and his family about hospice and the benefits they can get from it. Through good communication that I learned from the PERT Program, I was able to gain their trust and confidence in me. Eventually, this resident died, but was able to get support from hospice. He died peacefully and with dignity. I designed and implemented the facility's new "End-of-life Care Choices" system to assure that when a comfort care order is received, it is the resident (or surrogate) who determines the meaning of "comfort." I was at work one day, and one of my coworkers' residents was on the verge of passing away. He had never worked with a dying person. My coworker came and got me...since I was taking a course on end-of-life care. So I told him to come with me and I will help him through anything that needed to be done...and he was very grateful that I was at work that day, and my coworker always tells me thanks for all my help and that really made me feel very good inside. Thanks for the PERT Program! I was able to more confidently advocate for a resident wanting their death their way. We have a lot of family members who experience such anxiety if residents are "sedated." They want them alert and responsive to them, but overlook the probable pain and suffering of the resident. One recent experience with an only daughter whose greatest fear of over-sedation presented multiple complaints from her if the resident was given pain medication. I talked her through her fears and explained his "sedation" after medication resulted from relaxation after receiving analgesics — he was sleep deprived from pain and wakefulness, so he slept whenever the analgesic was given. We worked with her, explained the pain and analgesic relief process, and she allowed us to place a Duragesic patch. The results were incredible — he sleeps normally, has no pain with transfers, is alert and smiling and very receptive and communicative with her visits. She's thrilled! Recently, a family member made the decision to provide fluid replacement at the end of life. Many staff members had mixed feelings regarding this decision. I was able to help them to understand the family's wishes and rationale for this. Staff was better able to accept the decision when the pros and cons and rationale were discussed, they were allowed to express their feelings and were also able to accept the family's decision even though they may not have agreed. Fortunately, this resident passed quickly with very little suffering, with the help of hospice. Since participating in the PERT Program, I have felt more prepared to deal with family members. I felt more confident in answering their questions and assuring them, as well as validating their feelings. I comforted a patient just by looking at their eyes (with an understanding of what they were going through) and by touching them (appropriately) and soothingly saying words of comfort. She was in a lot of pain and she kissed my hand as a sign of "thank you" just for being there. Are you a PERT participant with a story or anecdote about using new skills and techniques from the PERT Program in your practice? If so, and it's something you'd like to share, please contact the PERT Program staff — we'd love to hear from you. |
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