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Pacific College and Hospice Providing Beneficial Experiences For Both Students and Patients

By Lauri Howell

For the past seven years, Pacific College of Oriental Medicine students have been provided the unique opportunity of working with terminally ill patients in collaboration with physicians, nurses, social workers, chaplains and bereavement counselors through an externship program with San Diego Hospice. Students use various healing modalities, providing a positive and rewarding experience for those who are terminally ill.

Hospice is focused on preventing and relieving suffering, promoting quality of life at every stage of life, through patient and family care, education, research and advocacy . Patients who receive care from Hospice, come to the facility for pain management, or because they are at the end of life. On average a patient stay at the facility is six days, after which the patient will either have control of their pain and return home, or will have passed away.

Students who participate in this externship program find the work at Hospice to be both challenging and uplifting. While working at a slow and relaxed pace, emphasis is placed on the quality of time spent with each patient. Students often see the benefits of their treatments immediately, as well as learning different techniques in treating a bed-ridden patient.

"I was given the opportunity to really see what acupuncture alone is capable of. I have seen the simple profoundness of a three or four needle treatment and the power of auricular points used alone," said Lornae Hinson, former student intern. "I have been challenged to think differently about Chinese medicine. At hospice , we are not always able to treat as we do in the clinic. Our treatment tables are their beds, and the patient's position is never changed. Their clothes may not even be acu-friendly. So, the challenge becomes to fit the medicine to the patient and not the patient to the medicine."

When Pacific College 's externship program first began Spring term 1998, there were four interns that came three times a week. The students received intensive training to prepare for working in this type of setting. Initially the students were guided as to what patients to see by the Medical Director of Inpatient Care Center and Integrative Medicine Program, Dr. Charles Lewis. However, by the second week, the students had been granted the ability to go into any room they wanted, proving they could become an integral part of the Hospice team.

"At first we didn't really know what we could do for the patients, because there is not a lot of literature in Oriental medicine on how to treat the terminally ill," said Ana de Vedia, Clinic Supervisor and Pacific College Board Member. "And after all these years in this successful program, we still go with the premise that we may not know. It is about going in there and being of service, if at all possible at the moment of death. In what ways can we assist to make the transition as comfortable and as conscious as possible?"

In order to provide the best type of care for Hospice patients , various types of modalities are used. Everything from aromatherapy, touch for healing techniques, acupuncture, seeds, hydrotherapy and massage are available as a part of treatment. Each student has their own portable tray complete with everything they would need from swabs and cotton balls to needles. Students are responsible for setting up their own appointments with patients in a way they would not have to do in a regular clinic. They go room by room to see what patients would be open for treatment, and often times offer treatments to family members who are feeling the strain of watching their loved one deteriorate.

"At Hospice, you learn how to help patients and their families during a time of need and vulnerability. You offer caring, compassion, and healing touch to patients who are in excruciating pain," said Alfred Russo, former intern. "Often, the patient uses the relief you provide as an opportunity to say good bye to their loved ones. You become intimately involved in patients' lives very quickly, not knowing if they will still be there when you return for your next shift."

During the course of an externship, students will be in rotation three times a week for seven weeks. As they visit each patient throughout their shift, students must use evaluation forms to track the effectiveness of their treatment on their patients. They will monitor how their patient feels, how much pain they are in, if they are nauseous, tired, how their appetite is, and their feelings of wellbeing before treatment. They also do the same evaluation after treatment. Most often results are immediate, as a patient may no longer being feeling nauseous, or their level of pain has reduced soon after treatment.

"My experience at Hospice has reinforced my understanding of the depth and power of acupuncture," said Jeff Silver, former intern. "I have used acupuncture alone to completely eliminate phantom leg pain, repeatedly seen medication become more effective following application of the NADA auricular protocol, and utilized this medicine to anchor and transform families struggling with rapidly changing circumstances."

While this program enables students to make a difference in the lives of their patients and the families, it also becomes a transformative experience for each intern , as they learn to grow on both personal and professional levels.

"When I first began, I knew in my heart that these people had come to die, but my mind and ego wanted to cure," said Hinson. "I took time to be comfortable that my purpose was of a palliative nature and not a curative one. Healing here does not mean that patients are cured or even that they can go home. Healing comes in a flickering second when the hearts clarity enables the patient to say one last "I Love You," or even "Goodbye." If this is the pearl that comes perhaps only once from working at Hospice, then it is a work worth doing."