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October 18, 2012 // By Jessica Mikulski // Comments

Early Observations: A Hospice Volunteer’s Journey

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Family Room at the Inpatient Hospice Unit at Penn
Family Room at the Inpatient Hospice Unit at Penn
Last month, I wrote a post in anticipation of starting the training necessary to become a volunteer with Penn Wissahickon Hospice. Since that time, I’ve completed training to become an inpatient hospice greeter and actually volunteered twice. Although it’s still very early on in my experience, I think I’ve gleaned a few insights that I wanted to share.

Perhaps the most important thing I’ve learned in this short time is just how extensive and intensive the training process is – and needs to be – to become a hospice volunteer.

It’s no easy assignment and volunteers need to be fully prepared for a variety of issues in their new roles. Research has revealed that hospice volunteers face ethical issues, including dilemmas about gifts, patient care and family concerns, issues related to volunteer roles and boundaries.

Other studies have looked at how the stress of volunteering can take a toll on the individuals, with some studies (although there are few) finding attrition rates as high as 43 percent. There is very little research that has focused on volunteers, but stress plays a major role (both personal and while volunteering) in why some people choose to stop.

These issues, and many that go unreported due to the dearth of research in this area, compel hospice programs to spend a lot of time and resources to train their volunteers.

At Penn, the process is broken up into multiple training sessions. I have only completed the most introductory orientation to help as a greeter in our inpatient facility.  This means that I help greet and direct patient’s families and friends as they come into visit their loved one and answer the phone.

For this, I had to apply to the program, I was interviewed by our hospice volunteer coordinator, and I had to provide personal references to make sure I would be an appropriate candidate. I completed a two-hour educational session and because I’d be working in the inpatient unit, I needed a series of vaccinations (which thankfully I already had from working in the Department of Communications).

The next level of training is much more involved because it will allow me to volunteer in direct patient contact programs. To be ready to interact with a patient one-on-one, a volunteer must complete two days of intensive workshops to prepare for anything from psycho-social issues that patients and their families are facing at the end of life to the importance of verbal and non-verbal communication while interacting with patients who may be unable to speak.                

Other areas of focus revolve around the role of the hospice chaplain and spirituality in end-of-life care, the boundaries of volunteerism, national patient safety goals, and bereavement counseling for families. Volunteers that work directly with patients may be deployed to clients in a private home setting, nursing homes, hospitals, assisted living facilities and group homes. Penn Wissahickon Hospice attends to patients wherever they live. The complete training is suggested for everyone so all volunteers have the overall understanding of the hospice philosophy.

Even in just my first two shifts, I understand why the comprehensive training is necessary. On my first night, I greeted a family that had just learned their mother had been transferred to the inpatient unit. They were flustered, not knowing where to go and how their loved one was doing. As I had been instructed, I asked them to sign-in, so that we can keep an accurate record of people in the unit in case of fire or emergency and to know who is with the patients at any given time. I could tell by their pained expressions that they just wanted to get to the room and my administrative request was wasting precious seconds.

The urgency of that moment for them was so palpable it made my stomach twist. They signed in as I told them what room their mother was in and they ran down the hall. It was my first “moment” of knowing how emotionally charged this experience will be at times. As the night went on, I signed several more patient families in and directed them to their loved ones’ rooms. Many had been to visit multiple times and nodded knowingly when I stopped them.

During my second shift, a large group of visitors made use of the cozy family area in the unit, designed to offer patients and their families a beautiful and comfortable atmosphere to relax. A fire was burning in the fireplace and the visitors, family and friends of a patient, were laughing and chatting as they each took turns in the patient’s room. For a moment, it almost felt like I was in the living room of their house, experiencing a family party. Not at all what most people might imagine a hospice unit to feel like. A few moments later, a somber visitor for another patient asked if he was allowed to stay all night. He explained that he didn’t want to leave his loved one’s side. At the end of my shift, a visitor emerged from a room with an adorable Corgi (patients are allowed to have their pets visit depending on their current condition), bringing smiles to everyone’s’ faces as he trotted down the hall and out to the elevators.

These examples lead to my second observation, which I’m sure I will continue to grow and refine, involving the sweeping range of emotions that course through the hospice care experience. Everything from sadness, fear, stress, and anger to love, solidarity, patience, and yes sometimes, joy.  Even though I’m not experiencing these emotions due to a direct connection with a patient, I’ll bear witness to them and internalize the feelings of those around me.

I think this is one of the things that I’m most excited and apprehensive about.

 

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