Wow! Observing and learning the tough stuff.

This morning I had a particularly moving experience as I observed/participated in a hospice nurse's visit with a woman my own age who has advanced cancer and isn't expected to live more than a couple of weeks.  Tough stuff to see/experience, but the nurse did a wonderful job of communicating with the patient.  Made me truly appreciate the important role of these caregivers in helping patients deal with their impending death and all the emotions surrounding this.  I'm getting more and more comfortable in my role as an ethnographer.  I think I can even pronounce it correctly now!

IRB process --Acronym for Irritating Reseach Bumps (or Bruises)??

Well, this week has been a good learning experience regarding all the "hoops" to be jumped through for the IRB application approval.  Whew!  I appreciate, though, that the university takes this process so seriously and I am assured that whatever research is being done will be done with the utmost safety and concern for those involved in the experiments or observation. 

Also made some headway on my first paper--the one analyzing an article.  I hope to finish it later today after reviewing Dr. Howard's suggested website.

Enlightening Observation

Last week, I was able to actually observe, and found it really enlightening!  My biggest challenge is I'm choosing to not take notes during the actual process, (due to my perception that it will possibly change the dynamic of such a personal communication context).  Thus, I'm having to race back to my office and take notes on everything I've observed and heard.  I'm writing so fast and furiously that I've again developed a pad on my middle finger.  With use of keboards, I thought this baby was gone for good!  I may decide to change this tactic, depnding on how it's going. 

I appreciate the comments from my classmates. Amy, I regret that I'll not be able to attend the presentation on Oct. 5--I have class that night, sadly.  I do intend to get the audio book, though.  Great suggestion!

I've also made progress on several other fronts.  I found a great scholarly article to review and attended a scholarly lecture that I LOVED!  (Sally Roth out at New Harmony.)  I was excited that Jenny had also chosen this presentation.  Apparently, we're kindred naturalist spirits  I'm excited about everything seeming to come together and am cautiously optimistic about my progress.  I'm learning so much, but admit that the time since my undergraduate studies is becoming apparent in so many ways!  Not only have I forgotten so much, but the majority of the communication theories we're reading about weren't even presented when I was an undergrad!  I guess that shows how much this field has grown and developed in such a (relatively speaking) short amount of time. 

Narrowing Focus

Since class on Saturday, and after receiving the input on my IRB application and proposal, I've been working on narrowing my focus to make my project more workable and one that will be suited for participation/observation.  I've decided to now study "Communication Skills in Talking About Death."  This topic will incorporate some elements of physician/patient communication, but will also allow me the opportunity to observe other hospice caregivers communicating with patients and their families.  I hope to learn about how death is discussed (terms, spiritual elements, broadly, specifically, sensitively, etc.) In addition, I hope to explore variables such as whether family members are communicated with differently regarding the patient's impending death when in the presence of the patient or not.  As part of my research, I will explore training received for this skill set and whether it is viewed as adequate.  My interviews will be with health care providers to the terminally ill, including physicians, nurses, hospice spiritual care providers.

I have also sought and obtained approval from my employer to conduct this participation/observation. 

I feel better about my project, and look forward to beginning my participation observation in the next day or two!  I realize this may sound "odd"--looking forward to observing people talking about death, but I am passionate about promoting quality end-of-life experiences.  When one has seen the extremes of this first-hand, it becomes an important value, and one you want to share with others.  I hope all of my classmates will learn something from my research!

Now to get to the revision of my IRB and the Library assignment. . . ONWARD!! 

Change of heart

I decided to do an about face on my research topic.  After reading more on how to approach this project, I thought:  why not look at what's right under my nose and what is close to my heart?  I came to work at VNA due to the wonderful hospice care my own Mother received.  Yet, it took my family asking the physician to determine that she was near the end of her life, and then later to get the referral to a quality hospice program.  Why is this?  How many other patients are told too late or not at all about their terminal diagnosis and what impact does this have on the quality of the remainder of their lives? 

With my position in fund development, I've had the wonderful opportunity to meet many people who are family members of previous hospice patients.  These people could provide substantial qualitative content to my research.  In addition, I've developed a professional relationship with a well known author on the topic, who would most likely grant an interview via email or telephone.

My hope will be that my research will have an impact of reaching more involved in this vital communication and thus, impact the quality of end-of-life experiences for the patients involved.