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Conversations around death and dying might sound morbid. However, no one lives forever. So if you knew you were dying, what type of care would you want to receive in your final days? Each year, thousands of individuals who have a life-limiting illness consider that question and choose hospice, a specialized home care service that offers support during the dying process. Conversely, so many terminally ill individuals do not opt for hospice. Is hospice care dismissed or delayed because we live in a death-denying society and entry into hospice requires the acceptance of death?

For those who are ready to accept the finality of their disease, hospice providers are available to assist patients with attaining the best quality of life throughout the dying process. Of course, individuals who are dying should be able to die with dignity and free from pain. But do all individuals receive high quality care throughout the entire length of service? During the last two days of life when organs start to fail and functional disabilities increase, some individuals and their families might not receive the hospice support they need.

One national study found that individuals who either lived in a rural area, were African American/Black or resided in a nursing home, were less likely to receive a visit during the last two days of life. What should you expect from hospice and what can you do to ensure that you or your loved one receives the high quality service that is so critical during the last two days of life? Dr. Joan Teno, a physician at the Cambia Palliative Care Center of Excellence and the author of Examining Variations by Professional Staff in the Last 2 Days of Life, joins me on Healthstyles to respond to those critical questions and provide valuable patient advocacy resources.

Tune in to WBAI or listen to the interview with Dr. Joan Teno by clicking the link below.

the-last-two-days-of-life

Conversations around death and dying might sound

trump

The election of Donald Trump and the Republican dominance in both houses of Congress and state governorships and legislatures and possibly a majority of the Supreme Court means that major changes are coming that will affect the health and health care of people.

Not the least of these is an escalation in harassment and bullying against people of color, women, LGBTs, and Muslims. This week on HealthCetera radio, Senior Fellow and radio co-producer Kenya Beard, RN, EdD, joins producer and moderator Diana Mason, PhD, RN, FAAN, in discussing implicit and explicit bias and its effects on the health and well-being of people and what people can do to create safe places for those being bullied.

The Safety Pin Brigade provides a visual symbol of safety and willingness to intercede to stop the bullying. People simply attach a safety pin to their coats or jackets or blouses to send the message to those who don’t feel safe that the person is a safe harbor. Drs. Beard and Mason also discuss a strategy to stop the bullying and harassment that was developed specifically for Islamaphobic attacks but is relevant to all situations of bullying. It includes calmly sitting down with or standing next to the person being bullied and initiating a conversation with them about something other than the incident of bullying. The intervening person ignores the bully and avoids eye contact with the bully. Instead, the person maintains eye contact with the person being bullied and continues to talk calmly with them. The expectation is that the bully will eventually leave, after which the person should escort the person being bullied to a safe place.

They also discuss expected federal policy changes that include crippling the Affordable Care Act or Obamacare in ways that will see the nation returning to almost 50 million uninsured people; privatization of Medicare; scaling back Medicaid by turning it into a block grant to states; failing to reauthorize the Child Health Insurance Program that has been responsible for ensuring that poor children have health insurance coverage even if their parents do not; removing protections against environmental degradation, including from climate change; and attempting to reverse Roe v. Wade and other changes to restrict women’s reproductive rights and health. You can listen to this interview here in two parts:

The program ends with a brief interview with Elie Kindisi Kabulululu, a nurse and deputry president of the Democratic Republic of Congo Nurses Association and Coordinator of an NGO working in the challenging and insecure circulstances of the East Congo at Beni North Kivu. Last week, rebels based in Uganda attached a village and health center 30 kilometers from Mr. Kabulululu’s village. He shares what happened and the priority of finding ways to help the roaming children who are homeless after the death of their parents. You can listen to this interview here:

So tune in on Thursday, November 17, 2016, at 1:00 to WBAI, 99.5FM in New York City or streaming online at www.wbai.org.

 

 

 

 

The election of Donald Trump and the

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Christina Carpenter

This guest post is by Christina Carpenter, RN, a nurse and writer. She’s pursuing her master’s degree at the Hunter-Bellevue School of Nursing in New York City, where she was a student last year in CHMP senior fellow Joy Jacobson’s narrative writing class for graduate nursing students. She writes poetry, fiction, and books for children. View her writings at her blog, The Key To Faith.

 

Magnet status is a coveted designation for many hospitals today. It means that they give excellent nursing care and demonstrate excellence in many areas, including lower patient mortality rates. At a recent visit I learned that St. Jude Children’s Research Hospital in Memphis, Tennessee, earned its magnet status in August of 2015.

 

Along with a few fellow nurses from the National Black Nurses Association and other esteemed guests, I had the privilege of experiencing this magnificent place last July. I got to witness first-hand the beauty of the building, feel the pride of the staff who work there, and catch the highlights of the good things this facility is doing. We were given an exclusive tour to the most widely known children’s cancer hospital in the country.

 

St. Jude, started by Danny Thomas in 1962, is a name that’s recognized all over the country. And this hospital is leading the way to change the prognosis of in children with a life-altering diagnosis of cancer.

 

I was impressed by the pristine beauty—the clean, modern radiance of the facility with its expansive manicured lawn at the front of the campus. The careening sidewalks are lined with flowers. Upon our arrival inside, we were greeted with a complementary lunch of pulled pork and chicken BBQ sandwiches, lemonade, and banana pudding. We were seated in a moderately sized auditorium with its red plush seats and movable writing desks.

 

We listened as one nurse gave an impassioned speech on the excellent working conditions at St. Jude. She called the facility “the closest thing to being the ivory tower for nurses because they go by the book.” The nurse to patient ratio there, she said, is averaging 1:3. “You actually have time for yourself, to eat your lunch, unlike other hospitals.”

 

She spoke of the people who come to the facility for treatment, only to be disappointed that they have to have a referral from their physician. But St. Jude strives to give hope to each family and make them feel welcomed there. The facility understands how precious time is to families when a child is sick and does not bill for treatment; 75% of revenue into the hospital comes from public funding.

 

Another nurse spoke of the goals of research at the institution—simply to find cures and make a better life for cancer patients. They want to help others, more than to get credit.

 

The world at St. Jude is highly secured to maintain patient confidentiality, so cameras are prohibited in certain areas. Though I didn’t take pictures, I can say that the feeling you get as you walk along is a cheerful one. Around every turn there is hope. Maybe it’s the high ceilings, the Starbucks cafes, and the artwork that give hope and encouragement.

 

My favorite parts were the artwork and photographs lining the corridors and the thought-provoking quotes on the walls. Especially moving were the artwork by patients and the photos of adult survivors holding black-and-white pictures of themselves as childhood cancer patients at St. Jude. Every survivor looked so healthy and happy compared to his or her sicker days. Young patients have access to an Xbox center, with a Nintendo game center. A play area features a big plastic tree spread out like an umbrella for children to play under.

 

If you have never been to St. Jude I suggest you visit it. However, if you never visit Tennessee, at least think of donating to the cause. Every dollar counts. I saw how St. Jude is a beacon of hope for so many. God bless those who work selflessly for and support the hospital’s research mission.

[caption id="attachment_11814" align="alignleft" width="225"] Christina Carpenter[/caption] This guest