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Whatcom Hospice Volunteer Newsletter A Prog ram of PeaceHealth St. Joseph Medica l Center

VOLUNTEER VOICES Whatcom Hospice Volunteer Newsletter—

A Prog ram of PeaceHealth St. Joseph Medica l Center

Whatcom Hospice, 2800 Douglas Ave., Bellingham, WA

98225 360.733.5877 Fax: 360.788.6884

Editor/Volunteer Coordinator: Dianne Gillespie

360.788.6892 dgillespie@peacehealth.org

Hospice House Volunteer Associates: 360.788.6885.

Noreen Fassler: nfassler@peacehealth.org

Amie Carr: acarr@peacehealth.org

Whatcom Hospice Manager: Patricia MacDonald

pmacdonald@peacehealth.org

September 2016

Mark Your Calendars for the November Volunteer Education

Avoid a Meltdown at our Sock Snowman Workshop! November 9th, 4:00—6:00 p.m.

Hospice Lower Level Conference Room “Sock snowmen?” you ask. No, we’re not kidding. Michelle Walsh will show us how to make these fun and fluffy snowmen as a stress reliever. She says even men love making them. They’re easy (even Michelle who is not crafty can make them!). Supplies will be provided, or bring your own socks (clean, of course! Baby or child’s socks for hats). Design your own snow-people! Just in time for the holidays! Kids and grandkids are welcome too. Contact Dianne if you plan to attend.

September Volunteer Education

Doodles & Zentangles:

Making Cards for Hospice Friday, September 9th, 3:00—5:00

Hospice Lower Level Conference Room

Have you ever thought of making a simple handmade card for your hospice patient or family? Or anyone, really? Whether you feel artistic or not, we can show you some simple and fun ways to express your thoughts and feelings on handmade cards.

Last month, our featured article discussed the joys and relaxation of doodling. We will also show you the Zentangle Method which is an easy-to-learn, relaxing, and fun way to create beautiful images by drawing structured patterns. Almost anyone can create beautiful images. Drawing zentangles have been shown to increase one’s focus and creativity, provide artistic satisfaction, and enhance one’s sense of personal well being—especially when doing it for someone else.

We will provide the cardstock, pencils, erasers, black drawing pens, and colored felt tips, but if you bring your own, we will be sure to have enough for everyone.

Contact Dianne if you’d like to attend.

Volunteer Help is Needed for the

Celebration of Light Service

Sunday, November 13, 2016 Volunteer help is needed for Cookie Baking, Hosting, Setting

Up, and Packing Up. Contact Dianne if you can help.

The service will be held on Sunday, November 13, 2016, from 3:00-4:00PM at St. Luke’s Health Education Center, 3333 Squalicum Parkway, Bellingham, 98225.

A memory table will be displayed and attendees are invited to bring pictures or a meaningful objects to place on the table for the duration of the program. Feel free to invite your friends and family. All are welcome.

For more information on the Service, contact Michelle Walsh, Bereavement Coordinator, at (360) 733-5877 or mwalsh3@peacehealth.org

Are You Having Trouble Sending Us Emails?

PeaceHealth has made changes in the computer

system, and one volunteer is having trouble sending

Dianne her reports. They are returned as not

deliverable. Though the volunteer has made the

changes recommended by the IT department

(remove us from your email, turn off/on your

computer), the emails still aren’t going through.

Please let us know if you are having trouble too.

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A REVIEW OF BOUNDARIES

“A healthy boundary is like a fence with a gate with the handle on the inside

where we control what comes in.” --Anonymous

THE NHPCO STANDARD OF PRACTICE

Each member of the hospice interdisciplinary team recognizes and demonstrates a fiduciary relationship [A relationship of

trust], maintains professional boundaries and understands that it is his/her personal responsibility to maintain appropri-

ate relationships with the patient, family and caregiver.

MAINTAINING PERSONAL BOUNDARIES

You are an individual with particular needs and boundaries. We respect that and need to know what those boundaries

are. If you are asked to do something that you cannot do--physically, emotionally, or ethically--we expect you to say

“no.” We want to keep you as a volunteer for as long as possible, so we want to make sure your boundaries are respect-

ed and you aren’t burning-out from overwork. Try to keep your 4-hour/week boundaries as much as possible and main-

tain good communication with your hospice supervisors. This will help everyone.

Please don’t talk about mutual friends with patients or families. Although this is a wonderful way to connect with a pa-

tient, (“Gee, we know the same person!”) you must be extremely careful you are not divulging personal information

about your friend, or later talk to your friend about the hospice patient you just met and what the patient shared with

you. In their attempt to be “friendly,” volunteers have lost friendships and broken confidentiality regulations because of

sharing too much information. Remember: LISTEN MORE; TALK LESS. WHAT HAPPENS HERE STAYS HERE.

When volunteering in the community, It is always recommended that you CALL BEFORE YOU GO to someone’s home to

provide assistance. Hospice is a world of sudden changes. You may have made arrangements with the family the day

before, but the patient’s condition may have changed overnight. It is always a good idea to call ahead just to be sure.

Are they expecting you? (They may have forgotten!) Do they still need you? Is there anything you can pick up on the

way? The patient may have suddenly gone to the hospital, to the Hospice House, or even died. Sometimes volunteers

are upset that no one called to tell them their patient died before they arrived or expect staff to call them if a patient is

close to dying. We apologize for that. We will notify you as soon as we are able, but that may not be right away. Some-

times a patient dies (in the community) and the family doesn’t even notify hospice right away! Bottom line is you need to

be flexible and understanding and prepared for some surprises.

ADHERING TO PROFESSIONAL BOUNDARIES

When you walk through the door of the hospice house or a patient’s home or facility, you put on your

“Volunteer Hat.” This means there are limits to what you are allowed to do. We all work together to pro-

vide hospice patients and their families the best of care, yet we each have our “professional boundaries.”

Nurses don’t do Social Work; Social Workers don’t nurse. Volunteers, even if they are trained as an RN

or MSW, do not function in those roles. Volunteers don’t discuss medications with the patient (other than, Did you take

it? Or Did you ask your nurse about that?) or the RN (“Shouldn’t she be on X medicine?”), nor do they function in place of

a Social Worker (like call estranged family) or Chaplain (call the patient’s minister). You are welcome to contact the RN,

Social Worker, or Chaplain to report information, gain information, or ask for support. However, please be mindful of

your boundaries as a volunteer. Your job description clearly spells out your duties.

Volunteers do not practice medicine. Never give patients recommendations for medications or alternative medical treat-

ments--even if it seems harmless! Cider vinegar, asparagus, probiotics, or coffee enemas might work for you, and you

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may share this with a friend, but you don’t share these therapies with a hospice patient. You don’t want to give false hope

or anger the patient’s doctor!

Hospice volunteers no longer toilet, move, or lift patients. Washington State law says that if volunteers function in this ca-

pacity, they must be supervised by a professional caregiver and pass yearly competency in this field. This is just not possi-

ble for us to do. None of these activities are in your job description, so you are not allowed to do them without direct su-

pervision from the RN.

You are a member of the hospice team. Frustrations can and do occur for a variety of reasons between volunteers and a

patient, a nurse, a family member, or another team member. Although the patient’s needs are first priority, be mindful

that sometimes patients (or family members) triangulate or try to turn one team member against another. This is just who

they are. Don’t be too quick to judge a team member as wrong. Also, please recognize that some patients will complain to

you—because they can. Staff may have addressed the issue with the person, but some folks either don’t hear or don’t want

any help; they just want something to complain about (they call them “help declining complainers.”) Do contact your su-

pervisor to discuss your concerns—we are here to help you do your job as well as provide the best care for the pa-

tient/family as possible.

“THEY’RE NOT YOUR NEW BEST FRIEND”—HOSPICE PATIENTS, FAMILY MEMBERS, OR BE-

REAVEMENT CLIENTS

When performing your duties as a hospice volunteer—anything from delivering medication to res-

pite sitting or leading a class for the bereaved—you may have a great bonding experience. Perhaps

you both grew up in the same town or state, you’re both Seahawks fans, or you are neighbors.

Whatever brought you closer, you may feel you now have a new friend. Perhaps you want to socialize, get together for a

drink or party, become even closer. You must do your best to not cross over the “Client-Caregiver” boundary. Remember

your “Volunteer Hat”? In all your hospice and bereavement relationships you wear that hat. Hospice brought you to-

gether, therefore, you have that “fiduciary responsibility” (see the beginning of this article) to hospice clients. It’s your

JOB to maintain a professional relationship until you are no longer a hospice volunteer. Of course this excludes clients

who were friends or relatives prior to hospice.

KEEPING PATIENT AND FAMILY BOUNDARIES

Observe the suffering and remain compassionate, but don’t immerse yourself.

Avoid thinking you can solve other people’s problems.

Be on the lookout for patient and family dependency on you.

Learn to say, “No.”

Be aware of your own unfinished business…the things you think and feel about dying. Your own experience with

death/dying could negatively affect your work with the family if you’re not careful.

Avoid becoming the family’s therapist/best friend/only one who can help.

Try not to turn your own family and friends into your therapist.

Ask yourself…

Am I losing objectivity?

Has my stress increased?

Am I thinking about the patient/family too frequently?

Do I feel like I want/need to take over?

Do I feel like the patient is my responsibility? That they can’t function without me?

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The hospice staff does its best to provide the family some general understanding of your role as a volunteer as well as

help you identify your role in the patient’s plan of care. They will outline the family’s needs and expectations for you--

with the understanding that these duties may very well change as the patient’s condition changes. Whether you help

in the community or the Hospice House, families are under stress and often forget what they have been told. They

will need you to explain how you might be of help—making food, providing respite, etc. Be as clear as possible what

you can and can’t offer in terms of your roles, boundaries, abilities and availability.

Patients/families seek our services at a time of intense need. The relationship is not equal. This goes for bereavement

support as well. We insert ourselves into their lives very quickly, yet we all go away when the death occurs. It is up to

us to prepare for that transition. We want to help them in their time of need while at the same time respect their

autonomy and competence. They may not do things the way we think they should, but it’s best to not get in the mid-

dle and to respect their path.

On the other hand, keep in mind that in the Hospice House, families may not realize that you are there to help them.

They often think you have other more important duties to attend to. Offer to help where you can. Be a good listener.

ASK YOURSELF…

Would I tell a colleague about this activity or behavior? Would I tell my coordinator?

Would other team members find my behavior acceptable?

Could my actions with the patient be misunderstood (by family, observers)?

Will my actions change the patient’s expectations for care?

Will these actions bias my clinical decision making?

Am I losing objectivity?

Has my stress increased?

Am I turning my own family and friends into my therapist?

BOUNDARY BUSTERS!

Personal business relationship with patient/family Accepting gifts for self or family Sharing personal concerns or work concerns with clients Addressing issues outside your discipline Offering medical or other advice (RNs excluded)

Asking clients to do you a personal favor Making extra accommodations for some clients because they are cute or special Making special accommodations for some clients because you feel sorry for them or fear they may get angry at

you, complain or be destructive Asking staff to make special accommodations for the patient

ESTABLISHING BOUNDARIES

Clarify where you stand in the relationship Understand your position, role and territory Give clear messages Say “no” when you need to

Sort out the sources of your confusion, guilt, fear, lack of confidence, or pity and seek solutions for them. Consult the hospice team.