nmda introduction 7-2015

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No one should die alone . . . Each human should die with the sight of a loving face ~ Mother Teresa of Calcutta

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Page 1: NMDA INTRODUCTION 7-2015

No one should die alone . . . Each human

should die with the sight of a loving face

~ Mother Teresa of Calcutta

Page 2: NMDA INTRODUCTION 7-2015

No Member Dies Alone

Page 3: NMDA INTRODUCTION 7-2015

NMDA Mission

THE GRAND RAPIDS HOME FOR VETERANS

IS COMMITTED TO PROVIDING

CARING SUPPORT AND COMPANIONSHIP

TO EVERY DYING MEMBER.

Page 4: NMDA INTRODUCTION 7-2015

NMDA VisionWHEN ONE OF OUR MEMBERS ENTERS THE FINAL STAGES OF

LIFE HAVING NO FAMILY OR FRIENDS

PRESENT, OR IF THOSE PRESENT NEED

RESPITE; GRHV WILL ENFOLD THAT

MEMBER WITH DIGNITY AND HONOR

BY CONTINUOUS SUPPORT AND COMPANIONSHIP,

ENSURING NO MEMBER DIES ALONE.

Page 5: NMDA INTRODUCTION 7-2015

staffing

Page 6: NMDA INTRODUCTION 7-2015

Volunteers selected for NMDA Care Team will learn:–how to relate to unit staff & family –how to protect a member’s privacy–what to do at the bedside–listening, observing & presence skills–self-care

STAFFING

Page 7: NMDA INTRODUCTION 7-2015

Support team

Page 8: NMDA INTRODUCTION 7-2015

Support team

You will be supported by a team chosen from our chaplains, nurses, recreational therapists, security, social workers and the volunteer

supervisor.

One member of this team will lead each mission and serve as your

primary contact for that mission.

Page 9: NMDA INTRODUCTION 7-2015

Support team

ESSENTIAL FLOOR STAFFPhysician

House Supervisor (3pm-7am + weekends)

Unit CoordinatorShift RN

Shift LPN(s)Unit Secretary (first shift)

Caregiver

Page 10: NMDA INTRODUCTION 7-2015

ACTIVATing

Page 11: NMDA INTRODUCTION 7-2015

1.The nursing staff from the unit where a member is actively dying will alert the NMDA on-call Mission Leader.

2.You will receive an e-mail and/or text and/or voicemail:

“We have been activated for a (m/f) member on (floor/unit). This mission may last (time frame). The member has (no/some) family involvement. Please go to Google Calendar and sign up with your name, phone number and mission (M##) for available times from today to (time frame). Questions? Call (mission ldr @ ###-###-####).

activating

Page 12: NMDA INTRODUCTION 7-2015

AcTivatING

More specific details about scheduling will be given to those volunteers who are selected to serve following their qualifying interview.

You will be given the opportunity to sign up for an interview following this introduction.

Page 13: NMDA INTRODUCTION 7-2015

SErvING

Page 14: NMDA INTRODUCTION 7-2015

servingON UNIT

STAY IN YOUR LANE!

Page 15: NMDA INTRODUCTION 7-2015

serving

DO COMMUNICATE with member’s nurse

When in doubt about what you can and cannot do

ON UNIT

Page 16: NMDA INTRODUCTION 7-2015

serving

• Any changes you observe in the member’s condition

• If you are concerned the member is worsening

• When a member dies while you are sitting bedside

ON UNITDO COMMUNICATE with member’s nurse

Page 17: NMDA INTRODUCTION 7-2015

servingBEDSIDE

STAY IN YOUR LANE!

Page 18: NMDA INTRODUCTION 7-2015

serving

• Move member in or out of bed• Put any type of restraint on the

member • Get food, water or ice for the

member• Communicate medical information

to the family

BEDSIDE(Do not…)

Page 19: NMDA INTRODUCTION 7-2015

serving

LISTEN

OBSERVE

BE PRESENT

Page 20: NMDA INTRODUCTION 7-2015

serving

LISTENINGIt’s more than simply hearing

• More than 80% of communication is non-verbal

• Be aware of eye contact, touch, body language

• Don’t change the subject they have chosen

• Encourage reminiscing• Empathize actively

Page 21: NMDA INTRODUCTION 7-2015

(SOME signs of impending death)

• Breathing slower, shallow, difficult, apnea;

• Increased secretions at mouth; • Increased restlessness (legs); • Hallucinations and altered reality; • Fingernails and lips become bluish; • Skin moist, “clammy,” mottled;• Noises increase in throat and upper chest.

OBSERVING

ServING

Page 22: NMDA INTRODUCTION 7-2015

ServingOBSERVINGTwo Roads to Death

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serving

• Let the member know you are there • (hearing and touch remain until death)

• Talk and read softly• Touch gently or hold hand• Play music• Sit silently

PRESENCE

Page 24: NMDA INTRODUCTION 7-2015

Those who have the strength and love to sit with a dying patient in the silence that goes beyond words will know that this moment is neither frightening or painful, but a peaceful cessation of the functioning of the body.

Watching a peaceful death of a human being reminds us of a falling star; one of a million lights in a vast sky that flares up for a moment only to disappear into the endless night forever.

~ Elizabeth Kubler-Ross

Page 25: NMDA INTRODUCTION 7-2015

SALUTE

Page 26: NMDA INTRODUCTION 7-2015

Salute Ceremony

Following preparation and washing of body, the nurses will transfer the deceased

member’s body to a draped cot for removal to the

morgue.

Page 27: NMDA INTRODUCTION 7-2015

Final salute

The following Friday @ 10:00 am, the member’s

name will be read over the house intercom while taps is played and a moment of

silence is observed.

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SELF CARE

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Self care

DEBRIEFING BEDSIDE EXPERIENCES

CHATS WITH A CHAPLAIN

QUARTERLY TRAINING

PERSONAL HABITS

Page 30: NMDA INTRODUCTION 7-2015

Self care

DEBRIEFING BEDSIDE EXPERIENCES

• Within 48 hours when a member has died in your presence• To review the bedside experience• Support staff will contact volunteer

Page 31: NMDA INTRODUCTION 7-2015

Self care

CHATS WITH A CHAPLAIN

• hosted as needed by Chaplain Kalish or another chaplain

• sharing with the rest of the NMDA group any thoughts and feelings about your experience bedside.

Page 32: NMDA INTRODUCTION 7-2015

Self care

QUARTERLY TRAINING

SECOND MONDAY of JANUARY, APRIL, JULY, OCTOBER at 7:00 pm in GRHV ALL PURPOSE

ROOM.

• To debrief the recent missions

• To develop the volunteer’s skills

• To discuss & evaluate key issues

Page 33: NMDA INTRODUCTION 7-2015

Self care

PERSONAL HABITS

•Hygiene – wash your hands•Maintain safe emotional boundaries•Manage stress well•Practice spiritual centeredness•Ask for help!

Page 34: NMDA INTRODUCTION 7-2015