Three Women Working: Family-Centered Patient Care At Four Seasons

 

WNC Woman: What inspires you about your work?

 

Dr. Janet Bull, MD, Chief Medical Officer: Patients always inspire me, as they share their lives, the joys and difficulties that they are dealing with, and the courage they have to face overwhelming challenges. Hospice and Palliative Medicine are different from conventional medicine where the focus is on curing. Our care is delivered by an interdisciplinary team, consisting of doctors, nurse practitioners, physician assistants, social workers, nurses, music therapists, home aids and volunteers, and the focus is on improving quality of life and maintaining good symptom control. I am always inspired by the work of high functioning teams as they can offer so much more to patients and families. The patient and family is at the center of our care and it is important for us to gain a good understanding of what is important to each patient and each family so that we can help facilitate the kind of care they want. I am also inspired by the many people I work with – devoted to the same values of compassion, balance, respect, integrity, teamwork, and excellence. Working at Four Seasons is more than a job, it is a mission and those who serve alongside of me are so devoted to giving the best of themselves each and every day.

 

Dr. Janet Bull MD Chief Medical Officer

Dr. Janet Bull MD Chief Medical Officer

What is the biggest challenge you face each day in your career?

 

Some of the regulatory scrutiny the hospice industry is currently facing can be weary and time consuming. Also, with the recent cuts in Medicare there is a decrease in reimbursement which creates more pressure financially. We are fortunate to have a wonderful community that is generous with their donations. As a nonprofit organization it is important for us to put our dollars in improving quality and care so patients and families get the best of care.

 

What do you want to leave behind when you step away from Four Seasons?

 

Leave with a sense that my time made a difference in the lives of others and the organization is a stronger one because of my impact. I have no doubt Four Seasons will continue to thrive long after I am gone, although at this point I have no plans on leaving and will be one who is working well past the typical retirement age.

 

What lead you to work with hospice? Four Seasons?

 

I witnessed a very difficult death of a close colleague. She was one of our office staff when I was an OB-GYN physician and I saw how despite massive use of technology and the “best” at the time that medicine could offer that it was not good enough to save her, but actually increased her suffering and that of her family. She died in a small cubicle at a major teaching hospital with many machines whirring about, devoid of human touch and family closure. I knew there had to be a better way, so that is where my journey began. I had heard of hospice so when I moved to Asheville, I volunteered and fell in love with the organization and the field of hospice and palliative medicine.

 

I have been at Four Seasons for 14 years and continue to choose to work there because of its aspirations to offer the highest quality of care for patients and families. Four Seasons has a national reputation, known for its high quality care, educational offerings, and well-respected research department.

 

Where do you see the future of hospice in ten years? Twenty?

 

There is a tremendous amount of change occurring in the medical field today. Hospice and palliative care are part of the solution to a health system that spends twice as much as any other country, yet ranks low in quality. Many studies demonstrate that both hospice and palliative lead to high quality care, high patient and family satisfaction, and lower costs. The payment structure may change in the future with moving away from the fee for service model, but I believe hospice and palliative care will continue to thrive.

 

Was there a certain patient, experience or situation that made you know you were “right” for this position at Four Seasons Compassion for Life? If you feel comfortable, please explain.

 

There are so many it is difficult to pick out just one. However I will share a short story about a patient I cared for years ago. She faced her death with such grace and dignity. She had a “going away” party and raised thousands of dollars for her favorite charity. She selectively gave away her possessions with care and delight making sure she acknowledged the impact others had in her live. Even at the very end, she orchestrated the kind of death she wanted, and those of us who cared for her at Elizabeth House were truly inspired by her greatness and learned much from her examples.

 

What is the best part about waking up and coming to work every day providing palliative care and hospice care to patients all around WNC?

 

Every day is different and I never know in the mornings what will occur in the day. One day it may be working with the researchers at Duke, another it may be handing a crisis situation that is occurring, or helping the nurses manage a symptom need. Knowing the impact we have upon the many patients that we care for and always asking “how do we raise the bar?” And finally, working with a team of dedicated professionals who hold each other accountable to be the best we can be.

 

If you could tell us one thing we do not know about Four Seasons, what would it be?

 

Four Seasons has an active research department that is contributing to the field of hospice and palliative medicine so that we can understand best practices and ultimately improve patient outcomes. We work closely with Duke and UNC and have collaboratively developed a quality tool to help measure symptoms, advance care planning, psychosocial, and spiritual distress. Information is stored in a large database where we can analyze and gain a better understanding of the needs of our patients and families. We are currently developing educational interventions and will test the impact of these on patients who are dealing with symptoms such as pain and shortness of breath. We are continuing to ask the question, “how can we improve care for those suffering with serious illnesses?”

 


 

Joyce Mason, RN

Joyce Mason, RN

WNC Woman: What inspires you about your work?

 

Joyce Mason, RN, Clinical Director of Elizabeth House: The incredible honor to serve patients and their families at one of the most difficult times in their lives.

 

What is the biggest challenge you face each day in your career?

 

Blending compassion, objectivity, professional knowledge in such a way that all of our patients, families and team members are served with the highest possible level of grace and competence.

 

What do you want to leave behind when you step away from Four Seasons?

 

A competent, compassionate team who will carry on the mission of Four Seasons.

 

What lead you to work with hospice? Four Seasons?

 

I worked with a Hospice organization in Indiana 25 years ago and loved the opportunity to serve the patients and their families. After that I worked in organ donation, community wellness and trauma. As I entered the last 10 of a 50-year career in nursing, I knew I wanted it to be with Hospice. Four Seasons is the leading end-of-life provider in the area, so here I am.

 

Where do you see the future of hospice in ten years? Twenty?

 

I truly believe that over the next 10 – 20 years Hospice will be utilized to the fullest extent possible. Currently, many of our patients come to us in the last few weeks or days of their lives, when they could have been receiving the extensive services and support of the Hospice Team for six months. As we learn, in America, to accept death, we will begin to have the critical conversations about our end of life choices with our physicians and loved ones. Once that happens, Hospice will become a natural and compassionate option for many more patients, much earlier in the course of their illness.

 

Was there a certain patient, experience or situation that made you know you were “right” for this position at Four Seasons Compassion for Life? If you feel comfortable, please explain.

 

A few years into my nursing career in the late 1970’s, I watched an elderly woman die alone in an emergency room, while her family was forced to wait in the reception area. I stayed with the patient, holding her hand as she took her last few breaths, so at the least, I could tell her family that she did not die alone. At that moment, I knew there had to be a better way to die, and a few years later, I became a Hospice nurse.
What is the best part about waking up and coming to work every day providing palliative care and hospice care to patients all around WNC?

 

That I will have a chance, in some small way, to make a difference in someone’s life.

 

If you could tell us one thing we do not know about Four Seasons, what would it be?

 

That Four Seasons is always here for you … it is never too early to call us to see if there is anything that we can do to help you. Anyone can call us and everything we do is centered around what the patient and family wants and needs – we provide true “Patient Centered Care.” Your Care. Your Way.

 


 

WNC Woman: What inspires you about your work?

 

Callie Walston and her Granddad

Callie Walston and her Granddad

Callie Walston, Philanthropy Coordinator: The most inspiring thing, I think, about the work we all do at Four Seasons Compassion for Life is that the mission, purpose and reach is far greater than you and I. The people we have the true pleasure of working with and for are the most inspirational part of what we do.

 

What lead you to work with hospice? Four Seasons?

 

After many challenging positions early in my career, it was like a domino effect of all the right things coming together when I “landed” at Four Seasons. With past experience in promotional marketing and then print marketing and business development it was eerily right when the job at Four Seasons surfaced. I now use the skill set I developed post college to succeed in philanthropy, marketing and brand consistency, relationship development and building, managing the agency’s print and promotional products, as well as coordinating exciting and profitable agency events.

 

Was there a certain patient, experience or situation that made you know you were “right” for this position at Four Seasons Compassion for Life? If you feel comfortable, please explain.

 

Though I am still a rookie in this industry there are a few people who did make me feel “right” for my position at Four Seasons. Those people I call my “Support Team” and they start with my sweet Grandad; he was able to show me, up to his dying day, that life is beautiful, not to be taken for granted and to never give up on your dreams. My grandmother who I believe taught me a great deal about how to develop and sustain relationships; she and my mother urged me to write notecards and thank you cards growing up and I now receive more compliments on my handwritten thoughtful notecards than you could imagine. Next there is a Four Seasons staff member who never lets a day go by without telling me how important I am, the value of my work and the impact it makes on our fellow staff, volunteers, patients and their families. Lastly, there is a hospice patient that I have had the true pleasure of getting to know since my employment began at Four Seasons. He has taught me a lifetime of knowledge in the past few months. He has taught me that a good smile and simple conversation can turn any bad day around. He has taught me to pick and choose what is important to me and put my focus and energy only on the things that matter. He has taught me that family, friends and the memories we create make life worthwhile. All of these things collaboratively make me feel right at home at Four Seasons.

 

If you could tell us one thing we do not know about Four Seasons, what would it be?

 

Four Seasons has many unique ways to offer support to not only our patients but our patients’ families as well. Music and pet therapy are both instrumental in the daily lives of our patients, both allowing the patient and family to connect on a non-traditional level which sometimes can be very healing. We also have our Heart Songs program that provides support and bereavement services to children and teens experiencing grief and pain. Furthermore, Four Seasons provides a seven-session program called LIFT, Life in Forward Transition, which offers an experience of shared camaraderie in a nurturing and positive environment for bereaved children, teens and families. Lastly, Four Seasons has a partnership with the country of Zambia where we provide education, support and service in the areas of hospice and palliative care to an area much in need.

 

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