January 2020 Newsletter
Director's Note, Upcoming Events, Community Events, Interview with Realities organizer Micki Jackson, and presenter Rebecca Culter, FCN, and Devotional.
Dear health ministries community,
Happy new year to you and yours! As we enter 2020, I hope you’ll support HMN’s new year’s resolution to expand the reach of health ministries in our community. The more I learn about the power of faith community nurses and health ministers, the more I know how important it is for more folks to have this support in their faith community.
As part of this, we are inviting faith community leaders to a breakfast on Wednesday, January 22. Please help us spread the word to bring together a diverse array of faith communities! Thank you for partnering with us on this important work.
I hope you’ll read the full newsletter including an interview Micki and Rebecca, who generously give their time to help folks plan for medical care decisions. Their motivations and plans for the future are truly inspiring.
Thank you to Rev. Cindy Bauleke for sharing inspiration as well in the form of this month’s beautiful devotion.
Amelia Vader Executive Director email@example.com
Friday, Jan 17, 11:00 AM – 1:00 PM
First Congregational Church, 2401 Cornwall Ave, Bellingham
Please join us for a for our January meeting, where FCNs and HMs network, lunch, and learn. Program TBA. This meeting is free and all are welcome, especially those interested in health ministry! A light lunch will be provided.
Faith Community Leader Breakfast
Wednesday, Jan 22, 2020, 8:00 AM – 10:00 AM
First Congregational Church, 2401 Cornwall Ave, Bellingham
Join us to learn how faith community nursing can support you and your congregation. Whether you have an established health ministry or are interested in learning more, we hope you'll join us! Open to clergy, pastors, rabbi, and anyone interested in health ministry.
April 3 - May 31
Online and in-person at First Congregational Church, 2401 Cornwall Ave, Bellingham
Prepares state licensed RNs for faith community nurse ministry and other caring individuals for health minister service in their respective congregation or faith community.
In an effort to connect our volunteers with relevant resources, we publish community events in our monthly newsletter and on our website. Email firstname.lastname@example.org to add your own.
Webinar: American Society on Aging: Innovative Approaches to Reach Underserved Populations Living with Dementia
Wednesday, January 8th, 10 AM PT
This webinar will provide examples of community-based programs that strive to meet the needs of specific underserved groups, including the Hispanic/Latino population and persons with intellectual and developmental disabilities and dementia.
Micki Jackson (right)
Realities Organizer, Community Advocate for Outpatient Palliative Care
Rebecca Cutler (left)
Realities Presenter, FCN for Unity Spiritual Center
What is “Realities of Advanced Medical Interventions” (Realities) and why is it important?
Rebecca: "Realities of Advanced Medical Interventions" (Realities) is a talk for the public to learn how you will be treated, for example, if you have a cardiac arrest. It covers what advanced medical interventions could be used if you make it to the hospital.
I also talk about the statistics of the outcomes: How many people survive and what their level of functioning is. A lot of times we hear the numbers and think, ‘oh, that’s pretty good’ (although they're actually not that great), but the thing that's not always mentioned is quality of life. People need to know they may survive an advanced medical intervention but may not have the same quality of life as they did before. There's a high number, like over 50 percent, of people who have cognitive functioning issues after these treatments.
It's really important that people have informed consent and you can't have informed consent if you don't know what's real and what's not. We have so many television shows where somebody has a cardiac arrest, they get coded and then it shows them walking down the aisle the next day getting married, and that's not real life.
What do advance directives have to do with Realities? Why do they matter?
Rebecca: The Realities presentation provides the knowledge of what an advanced directive is and why you need it, usually followed a week later by an advance directive workshop where participants can be helped with the document and have it notarized. We talk about the difference between an advanced directive and a POLST, and information about the importance of choosing your own surrogate.
Washington state law says that if you don't have anything in writing naming someone to speak for you about medical treatment, when you cannot speak for yourself, your spouse, parents, or siblings make the decisions. A lot of people don't realize a consensus is required among your surrogates.
Say you don't have parents, adult children or a spouse but you have siblings. I have five older brothers, and without a surrogate named in writing they would all have to agree about what treatments I receive. Without consensus, medical professionals are legally obligated to do everything they can to keep you alive.
Realities informs people that full treatment is default, even if it’s extremely painful, unlikely to succeed, and in the event of success, very unlikely to return you to a similar quality of life. And some of these treatments can be more than uncomfortable, appearing to professional care providers, physicians, and nurses to feel like torture.
Micki: One PeaceHealth employee said, 'I am a non-medical person. I hear all the time from medical professionals about the necessity for advance directives, but they don't give complete context for why. This talk is the important missing piece of the puzzle that puts all of it into perspective. I wish all of our patients and their families could see this presentation. It would make life better and easier for all of us.'
Should you attend Realities even if you already have your living will or advance directive completed?
Micki: Advance directives are important in addition to a will. Many people who attend Realities already have their advance directive filled out. Once they've heard the presentation they say, 'Whoa, I didn't understand what I picked and now I know and have to redo my advance directive.'
How do you think Realities presentations impact the community?
Rebecca: It's providing a huge opportunity for people to get questions answered, questions they might not be able to ask elsewhere. The presentations can last anywhere from an hour and a half to two hours because folks have a lot of questions and I don't cut people short; I answer their questions if I can.
Micki: For a long time, doctors weren't reimbursed for having these conversations. On January 1st of 2016, a billing code was implemented that allowed doctors to be reimbursed $86 for a 30-minute discussion, but you can't do it in 30 minutes. So, Realities is a needed layer of education.
Another way that this impacts the community is that more and more young people are becoming aware of the need for this kind of discussion. I actually think that the Realities model, not to inflate our importance, has now gotten attention throughout the state. In fact, there is a hospice nurse from Seattle, who came to one of Rebecca's presentations because she wanted to see what it was all about and now, she presents Realities in her area, with her iteration.
How do these presentations and workshops relate to Faith Community Nursing?
Rebecca: I look at being a faith community nurse (FCN) a little bit more broadly than just my congregation at Unity Spiritual Center, I see it as serving Whatcom County. Presenting Realities to the larger community is part of my health ministry.
Micki: One of the things that I have found in collaborating with Health Ministries Network is that because of who FCNs and health ministers (HMs) are, their grounding, they are able to share this message really effectively.
In working with the FCNs and HMs that I have, I’ve felt that the conversations they have about advance care planning are more poignant, they're deeper, and I think it’s because of their faith.
Rebecca: Working with faith community nurses in this project has been very beneficial. They’ve organized a time for us to come and talk, hosting the presentation and advance directive workshop in their churches.
What motivates the Realities team?
Rebecca: When my mother in law was diagnosed with pancreatic cancer she said, “I want hospice. I don't want any treatment.” She was in her 80's, she had heart failure and COPD. She knew treatment would probably be futile and she embraced the fact that she wanted the time she had left to be as good as it can be, and it was. It was really wonderful. My family members all took turns going to visit her, I cooked for her.
Her goal was to live to Thanksgiving and her doctor came to visit her a couple of weeks before and said, “I don't think she will make it to Thanksgiving.” So, we moved Thanksgiving up and we were all there with her.
As far as deaths go, it was a really good death. We all got to say goodbye. We got to have that last Thanksgiving dinner with her. All of her kids and grand-kids were with her.
That's what I wish for everybody, that they have the best death that they can have. We plan for the best party, the best wedding, the best vacation. Why can't we plan for the best death? Because it's all going to happen to all of us, 100 percent.