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Develop strategies to improve communication
Child's community includes school
Good communication between hospice staff, patients, and families is a critical part of quality hospice care. The challenge for many hospice staff members is communication when the patient is a child.
Not only do nurses have to be able to communicate with the adults in a child's life, but he or she also must communicate on an appropriate level with the patient, siblings, friends, and classmates, says Mary Kay Tyler, CNP, MSN, director of pediatrics and clinical support teams at the Hospice of the Western Reserve in Cleveland, OH. Also, bereavement support goes beyond immediate family and friends and often extends to the child's school, she says.
To enhance the support her hospice can provide, Hospice of the Western Reserve offers two training sessions for school counselors each year. "These sessions are in addition to the one-on-one education we provide for counselors at schools our patients attend," says Tyler. The general training sessions cover issues such as how to discuss the topic of death, how to listen to children, and how to answer specific questions. "We intensify our efforts with the schools that our patients attend, and we are always available to consult with school counselors," Tyler says.
Developing a good rapport with parents is important, says Tyler. Parents can be a good source of information, especially if the child has an uncommon diagnosis, she says. "A hospice program that sees few children every year may encounter diagnoses that have not been seen before, so finding out how the condition will progress and what to expect in terms of clinical needs may not be easy," she says. "You can talk with the child's physician and care team for information, but don't forget to talk with the parents."
Because the family has been through the process of diagnosis, the parents often have specific knowledge, not only about the disease, but also about the child's particular symptoms, says Tyler. "Recognize their expertise and let them know you appreciate their knowledge," she says. Not only does this approach build a rapport with the parents, but it also increases their trust that you are taking steps to provide the best care for their child, Tyler adds.