In my mom’s last years of life, she was no longer able to decide what she wanted for dinner, let alone what she wanted for medical treatment. So the decisions fell to me. Another bone marrow biopsy? A spinal tap? Pain treatment? Antibiotics? I was faced with cascading decisions for which I was wholly unprepared…
 

The last thing my mom would have wanted was to force me into such bewildering, painful uncertainty about her life and death. I realized only after her death how much easier it would have all been if I heard her voice in my ear as these decisions had to be made…”

That experience led Goodman to co-found The Conversation Project, which is designed to help people have “the conversation.”  Eighty-two percent of people say it’s important to put their wishes in writing and yet only 23 percent have actually done it.

You may have strong opinions on whether you would want a doctor to hook you up to a breathing machine or insert a feeding tube. Or if your heart stops, you know if you  want to be resuscitated. You know if quality of life is more important to you than the quantity.

These are tough, but important, questions. Having a conversation about what matters most to you and your loved ones and then putting your wishes in writing is important. But far too few people do it before it’s too late and their families have to make the tough decisions on their own.

Sixty percent of people say that making sure their family is not burdened by tough decisions is “extremely important,” and yet, 56 percent admit that they have not communicated their end-of-life wishes.

While it’s important to put your wishes in writing, it’s also critical to designate a health care agent in the event you cannot communicate yourself.

Dr. Jim Stevenson talks about a case he had in which a middle-aged man with advanced lung cancer was brought into the emergency room following an accident. The man was unresponsive, but clearly in pain, and it took three or four days to identify a decision maker to determine what the patient would want for life-sustaining treatment.

Increasing the number of Advance Directives (a document in which you put your wishes in writing and designate a health care agent) executed by individuals 65 years and older is a stated goal for Waldo County General Hospital during 2013. The plan is to accomplish this through the hospital’s employed primary care doctors’ offices and at the five health centers.

To help with this goal, the hospital is offering a number of presentations to hospital personnel, Hospital Aid and Hospice volunteers, and the community through a presentation on the local cable station, access at Health Fairs and community classes, and placing Advanced Directive packets at nursing homes, Spectrum Generations, the local Agency on Aging and on the hospital’s website.

Dr. David Giansiracusa, who specializes in Hospice Care and palliative medicine, talks to WCGH staff about Advance Directives.

On April 23, Dr. David Giansiracusa, a physician in Portland, who specializes in Hospice Care and Palliative Medicine, did a presentation on Advance Directives for medical staff and other interested parties at the hospital. He said Advance Directives are important so doctors know what to do when a patient is unable to express his or her wishes. And based on the incident at the Boston Marathon, “everyone is vulnerable to being unable suddenly to express his or her wishes,” he added.

Giansiracusa said Advance Directives “prevent a huge amount of suffering,” adding, “It is difficult to care for a patient whose wishes are not known and it creates conflicts within the medical staff and within the family. The family has to live with uncertainty.”

He said advance care planning helps the health care agent understand the values and beliefs of the patient, which provides a foundation for making decisions. Advance care planning is “preparing for the in-the-moment medical decisions” that often need to be made, he said.

“If you don’t want to do it for yourself, do it for your loved ones,” Giansiracusa said. He said visiting The Conversation Project website is a good way to get the conversation started. And the decisions that are made should be shared with all involved “to decrease confusion and conflict and to provide peace of mind to the patient and his or her family.”

He said advance care planning should be a routine part of medical care for a primary care provider. “I think it is equally important as allergies and medications list,” he said, adding he thinks primary care providers should be asking their patients “what type of life would be intolerable.” And there should be notes in the patient’s medical record about the discussion.

So no matter what your age, if you are interested in making your wishes known and having them carried out, ask your primary care provider about completing an Advance Directive packet and providing a copy to your doctor, the hospital, with your health care agent, and at your home.

Sandra Weagle RN won the 2013 Nurse Excellence Award. Making the presentation was Director of Nursing Teri Young-Hise RN.

   Weagle, who works in the Emergency Department, has been with the hospital for 22 years, while Garcelon is in her third year and works on the patient floor.

The 2013 CNA Excellence Award winner was Taylor Garcelon CNA, shown here with Director Nursing Teri Young-Hise RN.

   In announcing the 2013 Nurse Excellence Award winner, Director of Nursing Teri Young-Hise RN, said of Weagle: “(She) was nominated by a peer who recognizes her as setting high standards for patient care and professionalism. She is seen as a valued colleague who serves as a good resource for others and as a leader who helps keep the patient flow moving smoothly and calmly…

   “She consistently puts the patient’s safety and comfort at the top of her list of priorities. She quickly responds to special needs for equipment or services, such as requesting social work assistance, to meet the patient’s requirements beyond the obvious medical needs…

   “She is a steady force in a fast-paced area providing everyone with calm, competent direction,” Young-Hise concluded.

   On the nomination form, Weagle’s colleague also wrote: “She not only performs the mandatory year-to-year training within the department of education and skills, but maintains the Advanced Care Certificate recommended. She has obtained and maintained her certification as a CEN (Certified Emergency Nurse) and exceeds even that goal by serving as president of the ENA (Emergency Nurses Association) in a nationwide capacity.”

   In making the announcement of the CNA Excellence Award winner, Young-Hise said of Garcelon: “(She) is described as a natural leader with a warm and intuitive approach that immediately puts her patients at ease. She is noted for her strong teamwork and for her collaboration with the nursing staff, consistently keeping them apprised of any changes in vital signs or in the patient’s condition…

   “Patient safety and comfort is her mission. She consistently discusses her patients with the nursing team to be sure that their safety and care needs are met,” said Young-Hise.

   The nurse, who nominated Garcelon for the award, wrote, “(She) brings her ‘A game’ regardless of what may be happening in her life. I have stood outside a patient’s door donning isolation garb and can hear Taylor inside the room calming a patient, laughing with a patient or settling down a patient…”

   Garcelon also serves in various committees at the hospital. She is described as eager to implement new ideas and remains upbeat with change.

Finalists for the Nurse Excellence Award were, back row from left, Sandra Weagle RN, Krystal Brouty RN, and Cate Bryant RN. In front are Director of Nursing Teri Young-Hise and finalist Patty Trask RN.

   The other nominees for the 2013 Nurse Excellence Award were Krystal Brouty RN, who works in the Women and Infant Health Care Unit; Cate Bryant RN, who works in the Intensive Care Unit: and Patty Trask RN, who works on the patient floor.

Nominated for the CNA Excellence Award were, back row from left, Jennifer Larrabee CNA, Taylor Garcelon CNA, Pam Ripley CNA, and Stella Littlefield CNA. In the front row, are Director of Nursing Teri Young-Hise RN, and nominees Diana Hills CNA, and Janice Boetsch CNA.

Nominated for the 2013 CNA Excellence Award were Janice Boetsch CNA, and Pam Ripley CNA, who both work on the patient floor; Diana Hills CNA in the procedure room; Jennifer Larrabee CNA in cardiac rehab; and Stella Littlefield CNA in the emergency department.

   The criteria for the awards are:

   •  demonstration of leadership at the bedside;

   •  commitment to professional development; and

   •  dedication to high quality, safe patient and family-centered care.

   This is the second year that Waldo County General Hospital has made the Nurse and CNA Excellence Awards. The winners last year were Carol Knight, LPN, and Cheryl Lucas, CNA.

Stan Blood works on the treadmill.

When the second annual Cardiac Rehab 5K, “Walk to the ♥ Beat,” heads out on Saturday, May 11, at 10 a.m., at the Belfast Area High School track, Stan Blood of Belfast will be there.

“It’s sponsored by the cardiac rehab program, so why wouldn’t I be there?” asks Stan, following a recent exercise session. “I really depend on this program. It’s a very, very nice program. It’s not only for people who need to exercise but it’s a chance to communicate with people.”

Just how much Stan enjoys the program is also borne out by the numbers. Phase three of the cardiac rehab program opened its doors on Feb. 7, 2012 and Stan was the first person to join. Since then, he has not missed a twice-a-week class unless it was canceled due to the weather. He has been at 121 exercise sessions.

Phase 3 is a maintenance program with the goal of getting participants to push themselves to exercise regularly and effectively in a setting where they feel safe.

The start of last’s year Cardiac Rehab 5K

On Monday, November 26, from 5 to 6:30 p.m., Ruth Charne, who has diabetes herself, understands the challenges diabetics face and will present a free program entitled, “Take Control and Live Well with Diabetes.”

She will talk about some of the ways to control your blood sugar, which may help reduce your risk of diabetes-related complications.   “It is worth the effort to keep your blood sugar in control,” Charne says.

Charne is a A1C Champions®. They are people who have diabetes and have learned to successfully manage it. They have walked in your shoes and understand what it’s like living day-to-day with diabetes – and they want you to know that you are not alone in your journey with diabetes. Champions share personal diabetes stories, provide support and give practical advice to help motivate you to make healthy lifestyle choices and strive to reach your blood sugar goals.

This is a free presentation, including a buffet dinner, but space is limited so please pre-register by calling Sumer Higgins at 930-2650, or e-mail her at shiggins@wcgh.org.

 The presentation will take place at Waldo County General Hospital’ sEducation Center.

By quitting, smokers will be taking an important step towards a healthier life – one that can lead to reducing cancer risk. Tobacco use remains the single largest preventable cause of disease and premature death in theUnited States.

Quitting is difficult, but chances for success are increased by getting help. On Monday, Nov. 5, from 5 p.m. to 6 p.m. and again on Thursday, Nov. 8, from 11:30 a.m. to 12:30 p.m., WCGH pharmacist Nancy Nystrom will discuss medication options for quitting while Barbara CrowleyRN will talk about coming up with a quit plan and will offer some quit tips.

The Nov. 5 session will be held in the Education Center, beside the hospital, while the Nov. 8 workshop will be in the hospital’s classroom on the bottom floor.

For more information, call Barbara Crowley at 930-2650.

The screening provides a full lipid profile and glucose level and requires fasting (with only water allowed). The screening cannot be done if you have not fasted for 10 hours.

Following the finger stick screening, your results will be explained to you and can be sent to your doctor if you request.

The screening take approximately 10 minutes each so pre-registration is required. Call Barbara Crowley at 930-2650 to pre-register.

The screenings will take place in Conference Room 125, which is located on the second floor of the new building across the street from the hospital.

The hospital’s highest positive score was in the area of the staff discussing the help patients would need and giving them written information about their recovery as they were being discharged. For over a year, the hospital has been working on a MaineHealth collaborative, Transitions of Care Task Force. The goal of this initiative is to “help patients, who are going home, to understand what they need to do, so they won’t have to return to the hospital,” said Carolyn Leach, RN, who is on that Task Force.

This includes such things as clear instructions to follow as far as their medication schedules, seeing their doctor within seven days of discharge, their plan of care, and educating the patients and their families on what to expect. If a patient is going to another facility upon discharge, the goal is to communicate clearly with caregivers at the next level of care. The work of this task force should not only improve patient care, but should also positively impact patient satisfaction questions.

The hospital’s second highest score was in keeping patients’ rooms and bathrooms clean. Ruth Shute, the housekeeping manager, said she was at a meeting in Portland and some of the other managers in the room were comparing their scores. They asked her if she wanted to see hers and when they saw the 85% for the rooms and bathrooms being clean, they were shocked. “It was awesome. It was the highest score,” she said.

Waldo County’s lowest positive score was in the noise level at night in the hospital. When Rob Fowler was hired as the Director of Quality at the beginning of the year, he made reducing the noise level in the hospital, especially on the patient floor a priority. It is an ongoing effort that should be reflected in the next survey report.

This will be a fun event plus an opportunity to raise money to help those fighting cancer.

The day will start with a pancake breakfast, $6, from 8 a.m. to 10 a.m. at the Waldo County Shrine Club. The ride will take off at 11 a.m. and will return to the Shrine Club around 1 p.m. From 1 p.m. to 3 p.m., there will be a live band, food and beverages available.

The registration fee for the ride is $20 for a motorcycle and driver. That pays for the ride, lunch, a goodie bag and the live music. Riders and the general public can get lunch and enjoy the music for $20 as well.

To pre-register, go to www.wcgh.org/rideforoncology. For more information, call Gary at 322-8675.

Proceeds will go to the Oncology Patient Assistance Fund at the hospital.