Captain Ron’s VIEW FROM THE BRIDGE:

July2009

It sounds crazy but it’s not.  Tell me what you don’t like about me.  Tell me what I’m doing wrong.  Tell me what I could be doing better.  No, I admit I don’t want to hear what you have to say but I need to hear it.  We all do.  There is always room for improvement and the only to know what improvement looks like is to hear about it when expectations aren’t met or the results weren’t what we desired.

Feedback is necessary but difficult.  Separating constructive criticism from the plain old garden variety of criticism can be difficult.  Constructive criticism comes from those who genuinely want to provide necessary information to help me or this vessel SS Hospice stay on course.  The other kind is often referred to as dumping.  Then again, dumping comes from people who are angry, and I’m willing to admit that sometimes people have a righteousness to their anger.  It represents their passion, their caring, their hurt.  I like to offer listening to general criticism in order to earn the right to also hear the constructive critique.

Ships today have sophisticated navigational systems that help them plot their course to within a few feet.  We’ve improved things since Christopher Columbus set sail in 1492, hoping that he’d run into some kind of land before the crew mutinied.  For 56 of those 57 days they could only guess where they were with no land in sight.  Now we have GPS to guide us and Radar to know who else is out there sharing the high seas with us.

One month following the passing of a Hospice patient our ship’s navigator, Lyla, sends out surveys to the families of our patients.  She then goes through an elaborate ritual that I can only assume involves magic or at least mathematics because when she gives me the report, it allows me to see clearly what obstacles lie in our path.  The surveys contain 5 questions that ask the respondent to rate us on a scale of 1 to 10.  The questions ask if we provided emotional support to the family, respected the patient’s wishes, ensured patient’s needs were met quickly, helped the patient to die on his or her own terms and provided the family with the information they wanted to understand what was going on.

If you’ve watched the weather report on the evening news during a storm you’re familiar with Doppler Radar showing green on the map where rain is actively falling.  In Florida it shows yellow and red too, indicating far more rain than we ever get.  White is for snow and purple is for lots of snow.  We get purple sometimes.  When the map shows nothing it means we have clear weather.
When I look at surveys and summaries and see nothing but 9s and 10s it’s like watching a boring weather report.  Oh, I don’t mean to minimize the fact.  I praise the wonderful people with whom I work.  When I see an 8 it’s like green on the Doppler.  Time to pay attention.  I don’t want it to get to the point where I’m seeing yellow or red.  There were two 8s on two different questions in the last bunch.  Not bad out of a dozen surveys.  Still, ignoring them is like Captain Edward John Smith of the Titanic saying to himself, “We only hit a little bit of the iceberg…and this is an unsinkable ship!”

Did we provide emotional support to patient’s family?  Apparently we could have done better.  Part of what makes Hospice such a blessing for people is that the nurse, social worker, aid, volunteer and chaplain become well-known to the patient and families.  In the case of the two families who gave us an 8 both patients were on our service for only a matter of days.  How can we encourage people to invite us in sooner so that we can provide the support?  How can we encourage physicians to talk with patients about the benefits of having Hospice earlier?  When 1 out of 8 patients receive three days of Hospice or less it is very hard for our whole team to do our best work.

Rev. Ron Jetter, Executive Director
Lower Valley Hospice and Palliative Care

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