Alyssa Pace-Patterson is on her way to becoming a Doctor and recently completed a rotation with Covenant Care Hospice. She presented this speech to our Covenant Care staff following the conclusion of her rotation.
"This rotation was different than any other rotation I have experienced in my journey to becoming a physician. We are often so focused on expanding the length of life that we forget that it is sometimes necessary to switch focus to improving the quality of what life remains. When we forget to shift that focus, patients can miss out on final moments they may have otherwise been able to experience, potentially a trip to see family or a walk on the beach they always dreamed of, or even a chance to say goodbye.
This rotation taught me the potential diagnoses one needs to be able to qualify for hospice but when to make this referral requires a significant amount more knowledge and wisdom that in time, I hope to understand. I hope to know when what I am going to do has the likelihood of doing more harm than good. I hope to have the communication skills to give my patients autonomy to make those very difficult decisions but with a true understanding of what each option means and what their final days could look like with each. This rotation made me far more comfortable with initiating that conversation because I now understand what it looks like and the peace it can bring not just to the individual but the ongoing support that it can provide to their loved ones following their passing.
Hospice proved to be much more than what I had previously understood it as:
From the navigation team who comforted the grieving family and provided such elegant explanations for the goals of care, to the nurses who could comfort a late-stage dementia patient simply by holding her hand, to the chaplain whose music and prayers brought tears of joy and a moment of relief, to the hospice aid that was so methodical in the way she approached the most challenging part of patient care that she made it look easy and the patients so comfortable in their very vulnerable moments, to the pharmacist who I am convinced never stops working, to the social worker who was an advocate for fighting for what her patient needed and always involving the family, to the bereavement counselor who followed people for months/years and provided them a safe place to share the feelings they hide from everyone else, to the nurse practitioners that were so knowledgeable and willing to teach, to the administration team that does all the back end work that no one sees but is so vital in keeping everything running and the many people I had the pleasure of working with in between.
In my future practice, I hope that there are few patients that I have to send to hospice, but this rotation has taught me what that referral will mean and given me comfort with it. Instead of fighting through the final moments, I have seen the peace that can be brought in those moments. When I am confident that the procedure or treatment plan I have in place would ultimately do more harm than good, I will shift my focus from quantity to quality and engage hospice much sooner than I would have had I not spent my last four weeks with the team at Covenant Care.
Thank you to the hospice team at covenant care for being so welcoming and full of knowledge and wisdom. I am so impressed by what you all do, your job is incredibly difficult, but you do it with such grace. The experiences I had with you will be brought with me as I continue to progress in my career and will positively impact my future patients."