One of Capital Caring’s core values is that we are all learners and teachers. It is in that spirit that we partner with Walter Reed National Medical Center and Fort Belvoir Community Hospital to teach medical residents about hospice care. These internal medicine and family medicine residents rotate for a week, observing patient care in home/long-term care settings and at Capital Caring’s inpatient hospice centers. The goal of the rotation is to help participants increase their skills in effectively managing physical, emotional, and spiritual pain, while also supporting Capital Caring’s core values and our mission to simply improve care.
One recent rotation participant, Dr. Jenner Gibson, was so impressed with the time he spent with us that he wrote the following reflection about the knowledge and insights he gained while with Capital Caring’s clinical staff. Thank you, Dr. Gibson!
As a medical resident, I rely on my training to identify ways to treat patients and attempt to heal them of whatever condition they might face. During a week-long rotation last month with Capital Caring (a well-respected hospice provider in Maryland, Washington DC, and Virginia), I learned the value of patient-centered care focused on those whose advanced illness will not improve.
During my few days shadowing members of Capital Caring’s interdisciplinary teams, I came to better understand how doctors, nurses, social workers, chaplains, and others work with each other to help identify what matters most to those in hospice care. I watched Dan, one of Capital Caring’s nurses, interact with a 70-year-old self-described “hermit” with terminal esophageal cancer. Dan’s calm and patient demeanor with his patient was a reminder for me – and all of us – to take time to better understand each other, especially our neighbors who might be suffering. By the time we left our appointment with the patient, Dan had aptly negotiated one small intervention after another, all meant to alleviate suffering and keep the patient mobile as long as was safe and possible.
My second day was spent with Linda, a social worker, who took me to visit a retired Colonel suffering from advanced Parkinson’s and blindness. He had been coughing for several days, with his wife of 70 years concerned for pneumonia. I was able to listen to his lungs at the bedside, which were clear. Despite the simple nature of my exam, the wife’s reassurance at this news greatly rewarded my split second decision to bring my stethoscope that day. I found lingering at the bedside of a very ill patient, with his family in close proximity, to be the greatest salve for the inevitable suffering of the dying process.
Finally, on Friday I worked with a chaplain, Helen. We visited a retirement community together. She spent 40 minutes talking with me one-on-one before we ever saw one of her patients. She got to know me, and she shared her background. I learned of her late call to seminary, after a business career and home-schooling three children. She gave me some advice regarding providing comfort to those who are dying, as well as how to approach discussions of advanced directives and other medical treatments patients might select or refuse. Her gentle comfort and propensity to pray with her patients was genuine and kind. Her patients lit up when they saw her coming.
Ultimately, during my week with Capital Caring, I was reminded of the necessity of taking time with patients to understand their concerns and the many ways we can support those whose days are limited. As a physician, my goal is often to find ways to improve my patients’ lives; what my time with hospice taught me is that improving lives does not always mean seeking treatments and extending life at all costs. We can improve the lives of those with advanced illness by addressing what matters most to each of them and ensuring that they are comfortable, surrounded by friends, family, and loved ones.
Lieutenant Jenner Gibson
Lieutenant Gibson is a 2nd-year medical resident at Fort Belvoir Community Hospital. He attended Wake Forest Medical School, and is originally from Gardners, Pennsylvania.