By Amy Bartlett
Hospice Care of the Lowcountry and Technical College of the Lowcountry have a partnership that’s broadening perspectives on end-of-life care.
“It’s not about dying,” says James Dismond, CEO and Executive Director of Hospice Care of the Lowcountry. “It’s about living.”
That’s not only the hospice’s motto, it’s the concept that motivated their partnership with the nursing program at the Technical College of the Lowcountry, where each nursing class gets clinical hours with HCL staff.
Dismond said the students rotate through a two-day cycle, spending each day with one of two main disciplines: shadowing the social services team (Bereavement Coordinator, Chaplin, Social Worker) and second, being with a Registered Nurse Case Manager.
“The two-day approach is for students to experience how the psychosocial aspect of hospice care pairs with the clinical aspect in a day-to-day view of how registered nurses in hospice are clinically and emotionally unique,” he said.
Vandy Amason, TCL’s Nursing Program Director and Instructor, says the two-day rotation is invaluable to TCL’s nursing students.
“It gives our students the opportunity to see an aspect of nursing that is very unique,” she said. “It’s a community-based service, so it helps students understand how healthcare is managed at home and in other community settings rather than just hospitals and outpatient facilities. It also lets them see a holistic approach to patient care rather than just the disease process.”
Amason added: “It looks at everything about the patient – what resources are available and their support system – and really brings it all together. It emphasizes that nurses care for patients from beginning to end, however long or short that journey may be.”
The relationship between HCL and TCL teaches caregivers how to provide this level of care and influences a still developing perspective shift.
This process of discovery works in both directions as HCL reports from an organizational standpoint that the one-on-one time with students has opened the teaching staff’s eyes and worked to lessen the supply gap for workers.
“In the past,” Dismond said, “recruiting an RN directly out of school was unheard of. We preferred seasoned, well-rounded RNs. Now, recent graduates have already acquired the passion and drive to directly enter the field of hospice.”
HCL provides care-based training in a uniquely relational and human way, striving to learn what each person needs before passing away and providing it where possible.
“More times than not, it’s not even about medicine,” said Dismond, noting stories of parents who reconciled with children, or couples who exchanged vows moments before one of them passed away.
That’s what HCL is teaching TCL’s nursing students —that it’s about the time you do have and preparing for the “absolutes” before there’s a medical crisis.
“(Recently) we had students on site, and one of the students stated on day one that she was eager to get a job in the emergency department or the ICU,” Dismond said. “By day two she said that watching the RN case manager hands-on made her realize that position is the nucleus of the care team, managing and coordinating care at a high level. Before she left, she shared that hospice was now at the top of her career list.”
Dismond said it’s also important to note that the staff does a “well-rounded job” at immersing the students in all aspects of hospice to see how the case management aspect is many moving pieces.
“They see the many different hats it takes to care for the dying patient: RN, LPN, CNA, NP, Physician, Chaplin, social worker, bereavement coordinator, patient family volunteers and other contract therapists,” he said.
This variety of careers translates to a variety of care.
“Families are different than they were 40 years ago when hospice was developing in the U.S.,” says Dismond. “It’s not always children or descendants making decisions – the decision makers are often the patients themselves. If you don’t know what that climate looks like for your own end-of-life care, don’t avoid the discovery process. Start the conversation that can make the difference between just dying and learning how to live well until your dying day.”