Changes

I am thrilled to announce the release of my second book, Resilient Hearts. It is a collection of experiences I had caring for the dying and their families consolidated into a continuous story that follows a Palliative Care team in a hospital setting. I wanted to share what an honor and privilege it is to be accepted into a family's world at such an emotional and intimate time, and how Palliative Care team members can help patients and families focus on the journey and make what time remains as special and as loving as possible.

Death can become a celebration of life when we focus on the journey. The humor, the love, and the true joy is often a surprise for many and rarely equated with the dying process. Resilient Hearts attempts to share this joy and to instruct about the importance of  being genuine, compassionate, and remembering the importance of self-care.

I am amazed how few people know what Palliative Care is yet alone what a Palliative Care team can provide. It is my hope that Resilient Hearts will both help to educate and entertain.

Thought I would take some time to catch up. My second book is due in the bookstores after October 13th. I was able to purchase advance copies and so far friends and family have been very supportive and kind. The true test will come when strangers read it. The book is called Resilient Hearts. It follows a Palliative Care team as they work with terminally ill patients and their families in a suburban hospital. I wanted to give a working example of some of the communication that occurs and show how essential team work is when working with this patient population. My hope was to present the story with compassion and humor. Time will tell if I succeeded. You can read about the book on Tate Publishing's web site at:
   https://www.tatepublishing.com/bookstore/book.php?w=9781681647302

I am still hoping to make a movie version of the book to reach a wider audience and to give a clearer understanding of the kind of people who provide Palliative Care. I finished the movie script now I just have to get someone to commit to making the film.

On a brighter note the Pediatric Unit at City of Hope will finish training their first core group of nurses on the CARES Tool. The plan is that they will then act as an example and help others in the unit to learn. I hope to chat with them and put together an interview to share with other nurses to encourage them to learn more about the CARES Tool.

It all seems so slow. I am grateful for the interest shown so far, but it still feels like we have so much to do. Well, I guess I need to just keep trying.

Take Care

Lecturing on Self-Care

One of the problems I encounter when I am asked to lecture about the CARES Tool is I never seem to have enough time to really address all the things I want to say on the importance of self-care. I end up spending way to much time on the other sections of the CARES Tool and often find I have little time to devote to the last section "S" self-care. HPNA asked me to speak at their Leadership Conference that was just held for their Board of Directors and their regional chapter leaders this past weekend in Pittsburg, PA.

It was great fun meeting everyone and HPNA gave me a chance to sell some of my reference books on the CARES Tool published by Springer. It went well and I was thrilled how many people found my talk helpful. I am planning to post the Power Point I used on this website for others to download and use in their presentations about the CARES Tool. There is even a good chance that the CARES Tool will be picked up by HPNA. I love the thought of being able to reach even more nurses and health care providers and get the word out about the CARES Tool. I have such respect for the HPNA organization and their very approachable and down to earth staff and administrators.

A final topic I want to cover is about my second book Resilient Hearts. I placed an order today to receive 100 advance copies. The book will be on Amazon and hopefully at bookstores after October 13th. So if you are counting, I had 2 books published in 2015!! I think I need a nap! Anyway, I will have books available for early sale by mid-August. I hope to get them into Universities and do a few book signings- so we will see what happens. I am also nearing completion of the final edits for a movie script I wrote based on Resilient Hearts. My husband Allen, is going to be making an independent film based on my script. He knows numerous film people that want to help and I will be talking to Azusa Pacific University to see if the School of Nursing wants to get involved. It all seems like everything is falling into place so keep your fingers crossed for me.
Bonnie

When ever I get the opportunity to help the bedside nurse with end of life care I feel I am actually doing what I was intended to do with my career. I am so honored that the nurse feels comfortable calling me. My latest request occurred last Friday. The nurse was just given a consult for EOL care with my group. She wanted me to stop by and see if there was anything else I could suggest. The patient was a 28 year old man with ALL who developed a fungal infection in his sinuses that spread to his brain and was now actively dying. The family agreed to a DNR status and seemed to be coping well. I was able to adjust the current orders and write for  some back-up orders in case they would be needed over later. I love asking the nurse what other orders they want. They always look so surprised and they seem to enjoy being part of the decision process. We settled on adjusting the Morphine drip, adding orders for Glycopyrrolate, and increasing the Ativan order to 0.5mg q 2 hours prn. I spoke to the family and answered their questions. I taught them what to expect to see when their son's death was eminent, the importance for them to get their rest, the fact that the dying chose their time and to not take it as a failure if he dies when they are not there, and that the family was in charge and could dictate when their son was to be turned and if they want him bathed. I emphasized that this was their time with their son and it was precious. We talked about the use of music and familiar sounds. At this point their son was hypersensitive and rested better with silence. The family liked the idea of aroma therapy and went to the gift shop to purchase some lavender scented lotion. I went over some additional teaching points with the nurses and earned some Brownie points with my Docs for starting a consult for them. It is interesting how I need to be needed as much as the nurse and family needed me.

I will be doing a webinar for NCCN about evidence-based care of the dying and will be show casing the CARES Tool. The webinar is called Optimizing Nursing Care at End of Life. It will be available through NCCN until late June go to http://education.nccn.org/node/64447 to check it out.

I am also continuing to chat with HPNA to sponsor and post the CARES Tool. I am hopeful that I can make the CARES Tool more available to help all of us provide better end of life care. So all positive thought will be appreciated.

I am working on a screenplay based on my novel Resilient Hearts. The novel follows a Palliative Care team and how they care for their patients and each other. My husband loved it so much he is organizing an independent film production company to make it into a movie. This has been a goal of mine since I finished the book. I feel a movie would be a great teaching tool and reach many more individuals. It shows how important setting goals of care and having open communication is to promoting a peaceful and loving death, how very important it is to have self-care.

I also had the pleasure to talk to a nurse practitioner who decided she needed to learn more about palliative care. I was able to help her see how as a nurse we are already focused on providing palliative care and we talked about the difference between providing primary and specialty Palliative Care. Nurses need to become experts in primary palliative care. I think I found a kindred spirit in this NP and I hope to help her appreciate the special gifts she can bring to he patients by providing primary palliative care.

So thanks for checking out this blog. I will continue to stay busy.
Take care,
Bonnie

Had a great experience attending a conference through City of Hope that explored how to establish and develop an effective Palliative Care program. Dr. Ira Byock was there and gave a very inspirational speech. He identified that the medical model is inadequate when caring for the terminally ill and dying because the care must be personal. What a great way to explain the difference in care that must be provided, and personal includes not just the patient but their family and the care givers involved with care. The whole concept addresses the need for listening, compassion, empathy and the importance of personalizing care.

I sincerely believe nurses must step up in their role as patient advocates and function in a primary palliative care provider role which differs from the Primary Care Specialist. Nurses must become well trained and compassionate primary Palliative Care providers. We have our work cut out for us.

Had a great time at the Nursing Symposium at Azusa Pacific University. The attendees enjoyed my talk about the CARES Tool and I had some very lively discussions. I enjoy the enthusiasm of the students and I look forward to the opportunity to talk to them more. With each of my lectures I am reminded of the work that needs to be done to educate about compassionate care of the dying. I am  hoping to have an established organization pick up and promote the CARES Tool so it can be shared with even a broader audience. Wish me luck!

I am getting ready to do my first book signing at the yearly research symposium put on by Azusa Pacific University where I graduated with a DNP in 2013. They very kindly asked me to talk about the CARES Tool and share how it was developed and what is happening with it, all in 30 minutes. For me that will be a challenge. I look forward to seeing the faculty again, and I love being around the students with all of their energy. I am just trying to get organized and deciding what to emphasize during my talk. This is usually a lost cause as I just go off into some  tangent no matter how I plan.

I am making cover submissions to my publisher for my next book Resilient Hearts. I am really hoping it will help bring a better understanding of what goes on with a Palliative Care Team. I am proud of the results and can't wait for others to read it.

So my writing has slowed down and I am trying to adjust. I need to focus on keeping my web site current and doing some research for a possible third book. I hope any one reading this is doing well and I look forward to sharing more thoughts with you.

Take Care

NCCN Conference

Here in Hollywood Florida for the NCCN conference. I had a surprising number of participants stay to hear me give the last lecture of the day. I understand the general scheme of a conference is to go with new things and progress through out the day and end with dying, but just once I would like to be in the middle of a conference so people can stay focused. They won't be tired, or worried about traffic, and could absorb what I have to say.

I have to admit being the last lecture wasn't bad this time. The audience was very responsive and I got some nice comments after. I just wish I brought more CARES Tools and book marks. I hope they check out my web site. Time will tell.

Update 3/1/2015

I received copies of my reference book Compassionate Person-Centered Care of the Dying: An Evidence Based Palliative care Guide for Nurses. It provides additional information and insight into the CARES Tool from Springer Publishing. It is an amazing feeling to hold a years worth of work in your hands. I am very proud of the end result and am looking forward to using the book to help educate staff at City of Hope on care of the dying.

I completed my second book that is actually a novel called Resilient Hearts and signed a contract with Tate Publishing. Resilient Hearts follows a fictional Palliative Care team as they work with terminally ill and dying patients and their families. The novel also focuses on how the team members provide self-care through the central character of Michael Lafata, a doctorate prepared palliative care nurse practitioner.  The story line includes a patient who opts for palliative sedation, providing last wishes for a gentleman dying of heart failure, and arranging special closure activities for a five year old and a retired army officer. The story combines multiple actual events and demonstrates the importance of laughter, compassion, empathy, and understanding. The need for music and joy is explored and shared with the reader. (I don't want to give away everything) I am hoping Resilient Hearts will be available before Christmas.

I want to encourage any of my readers to ask questions about my postings or the CARES Tool. I want this blog to provide further understanding of the use of the CARES Tool and to encourage nurse advocacy and promote communication.

Take Care

Lots of activity. My Husband Allen has been busy getting my CARES website up and functional. I had laproscopic knee surgery and now know what 10 out of 10 pain feels like, and I finished my second book Resilient Hearts. I am learning all about working with publishers and literary agents. It all can get pretty overwhelming. I was also told my CARES Tool reference book is ahead of schedule and I should be getting my copies in about a week. This will time well with my EOL teaching plans at City of Hope. I am still most excited about my novel Resilient Hearts. I think it will be a helpful teaching tool and I can't get the idea of making it into a movie out of my head. Time will tell.

I am excited about this Blog. If anything it will be good therapy for me. I just hope I don't bore my readers. I am in the process of finishing a second book called Resilient Hearts. It is a story about a Palliative Care Team and what they encounter as part of their job, how they interact with patients, families, and each other; and how they are able to find the emotional energy to continue working with the dying and terminally ill.

My greatest hope is that it will one day be made into a movie. It would be a very helpful teaching tool because healthcare staff need to know that when you care for the dying you often get more out of it than you give, and it is one of the rare moments in life when you are in the presence of truly unselfish love.

I think some nurses shy away from caring for the dying because they have seen too many horror movies. Death should not occur in a dark room at the end of the hall. It should be bright, loving, and the tears should be mixed with laughter. The life of that dying individual should be celebrated.

There will never be a better time to make a difference in the lives of a family whose loved one is dying than when you show you value and respect their loved one, and it is often as easy a just placing a wash cloth on their forehead. I encourage any nurse to "Never underestimate the value of a wash cloth."

Well gotta work on my book.

Introduction

I wanted to start a Blog to add additional experiences and lessons I have learned as I progress getting the word out about my CARES Tool. It is my hope that I can reach nurses and health care providers that work with the terminally ill and dying. I want to help improve their skills, let them know how important the work we do for the dying is to patients, families, the community, and to our personal and professional growth.

I am launching a new website, and a book called: Compassionate Person-Centered Care of the Dying: An Evidence Based Palliative Care Guide for Nurses, it will be available through Springer Publishing the end of February. I plan to use these resources to promote and further explain use of the CARES Tool, which by-the-way, is an acronym (Comfort, Airway, Restlessness and delirium, Emotional and spiritual support, and Self-care) organized pocket reference guide that addresses the most common symptom management needs of the dying.

The CARES Tool is expanding to include versions for supportive personnel, friends and family, and pediatrics. I will continue to make digital templates available to anyone interested in printing their own copies of the tool, and I am in the process of providing the option to purchase pre-printed versions of the CARES Tool through my web site. I was made aware the template I send out electronically requires the use of a professional printing service. So, I wanted to simplify things by making a heavy card stock version available through the store on my web site. Once my book is released there will be a link made available through Springer to down load the CARES Tool as a phone app.

This is a real growth time for me and for the CARES Tool. I hope you will find my blog helpful.