Thursday, January 6, 2011

hospice vs technolgy.

I wonder how we remember the why in medicine while changing the how?

I wonder if there is anything that will keep us connected to our calling, to remember the reason we chose this profession at all

"I'm just a robot" my primary doc complained, the last time I was in his office.... and I would have to agree. We are all becoming a slave to the computers or hand held devices that are running the world these days. Difficult to make eye contact when there is a screen between you and the person you are talking to. Difficult to stop and really hear what that person is saying

Medicine is an art, as well as a science.... how do we keep the art without becoming a slave to the technology?

Computers invaded the world of hospice some years ago. Neat little laptops that we can carry into each person's home to find and record all necessary information. Pretty neat trick, if you can do it. I think that all of us -everywhere- were resistant to the idea. People who are drawn to the world of hospice are generally more tuned in to people's emotions, able to hear the heart cry. It is nearly impossible to teach a person who is drowning in grief or rage about the proper medication and treatments without first reaching out a hand into the pit of despair. Most of us have found ways around it..... sitting in homes listening with a pen and paper to jot on, then charting in driveways or on street corners- or at home on our own time in the evenings.

I don't think that anyone wants me sitting in their living room or at their kitchen table (usually covered with piles of bills and boxes of medicine, with food stuffs jammed to the side-evidence of life interrupted) diligently creating and recording plans of care and listing goals and interventions.

Yet, I want to be sure that the goals I am recording are Their goals... Is it more important to them to be pain free or to get to another soccer game?

I've spent the last month learning about our new computer system. Our latest upgrade. Sitting round a table with others, making sure that there is a way to document that will satisfy every regulatory body, will be complete and thorough, will address individualized needs, and will make sure every bodily process and medication has complete and thorough documentation.
The screens are bright and flashy. Different colors mean different things. So many little boxes to fill in and drop downs to check off. More things to pull my eyes from that patient and their family and onto a screen.

Hospice..... the word that originally meant rest and respite. Hospice..... where, if anywhere, one should/could practice the art of presence. Hospice..... where the sum of a person's life is often being recalled Hospice.... where a family is making decisions that will determine how they will go on, how they will honor, how they will mourn, how they will triumph, how they will remember..

Hospice.... and technology.....
I just don't know....

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  1. I disagree. Have done hospice for 10 years in Seattle and easily balance the laptop charting in the home. there is a time to chart and a time to keep it in your visit bag. You should not be charting at home in the evening on your own time. pts are very accomodating, how much of the resistance to laptops is imposed belief of our pts and families I wonder? change. pts already experience computer charting in the clinic. I feel that my hospice practice is very deep and connected. The gifts we bring, the listening with the heart, the companioning and presence are diminished because a laptop comes out. if anything it says "I will care for you on the deepest level, but I will also make sure you get care in our system by communicating your condition on this computer to those taking your call when I am off duty.
    good luck with the change

  2. thank you again... just found this comment also..

    My computer and I have started to establish a peaceful co existence and you have some excellent points...
    I am very appreciative of your comments...