August 4, 2016

New initiative pairs volunteers with palliative care patients

As a nurse working with critically ill patients with orders to not resuscitate, Rebecca Hixson, R.N., has often lingered in a patient’s room to complete her routine charting if she felt they were nearing death and no family or friends were around. But Hixson now hopes a new volunteer program at Vanderbilt University Medical Center (VUMC) will mean these patients will always have someone by their side at the end of life.

The palliative care team behind the Vigil Volunteer program includes, from left, Mohana Karlekar, M.D., Rebecca Hixson, R.N., Andy Peterson, M.Div., and Matt Frierdich, M.Div. (photo by Anne Rayner)
The palliative care team behind the Vigil Volunteer program includes, from left, Mohana Karlekar, M.D., Rebecca Hixson, R.N., Andy Peterson, M.Div., and Matt Frierdich, M.Div. (photo by Anne Rayner)

As a nurse working with critically ill patients with orders to not resuscitate, Rebecca Hixson, R.N., has often lingered in a patient’s room to complete her routine charting if she felt they were nearing death and no family or friends were around. But Hixson now hopes a new volunteer program at Vanderbilt University Medical Center (VUMC) will mean these patients will always have someone by their side at the end of life.

“Since we are a major trauma center, we might get people who have been picked up off the side of a road, and sometimes their family doesn’t even know they’re here,” said Hixson, who works in the Palliative Care Unit. “Sometimes people just don’t have any family. When I sent an email out to our physicians to see if there was interest in creating a program to address this, the response was immediate, and it was exciting. Everyone wanted to know what they could do to make this happen.”

The 16-bed Palliative Care Unit, serving patients facing life-threatening or life-limiting illness or injury, will soon be the pilot home for Vanderbilt Vigil Volunteers (or V3).

The V3 program will bring a volunteer into the room of a patient who either has no known family or friends, or whose family and friends are away from the hospital as the patient nears the end of his or her life. Hixson; Palliative Care Unit Medical Director Mohana Karlekar, M.D.; Vanderbilt Chaplain Matt Frierdich, M.Div.; and Director of Pastoral Care & Volunteer Services Andy Peterson have been working together since January to develop the program, modeling a national program that began in Oregon called No One Dies Alone.

“We have patients who come into our hospital because we try to bring in whomever needs our services from all over the place, Alabama, Virginia, Kentucky, Arkansas, Indiana — all over,” said Karlekar.

“We’ve had instances where families live far away and they can’t come here as often as they like. The patient is dying alone, and that’s incredibly hard on the families because they feel guilty, even though they shouldn’t. We have patients who, for whatever reason, have ended up in a situation where they just don’t have anybody. Then, we have family members who are exhausted because they haven’t left the bedside for five days. The impetus is to fill that space.”

Volunteers for the V3 program will be recruited from a pool of existing Vanderbilt volunteers who have already been screened and trained to provide services at VUMC, but organizers are also hoping to find volunteers among VUMC employees.

In the past, many non-clinical VUMC employees have asked for ways to contribute in a meaningful way to the well-being of patients, and now this is a way they can, said Peterson.

Similar national programs provide volunteer service only for patients who have absolutely no family or friends available, but the V3 program has been tailored to meet the needs of Vanderbilt’s particular patient population, Frierdich said.

“We’re seeing a lot of families that are just stretched thin — financially, physically, emotionally,” Peterson said. “We want to offer a program that lets families know there is someone here with their loved one continually, even when they can’t be here. The nurses and other members of the care team are here, but they are increasingly busy caring for complex patients. This program will help patients and their families, but it will also help our staff. This program is really intended to be a presence of peace and acknowledgement of this life, of this person who we are caring for and to ensure that they are not alone.”

Program organizers aren’t looking for a special resume when it comes to a Vanderbilt Vigil Volunteer, Karlekar said. There are no religious expectations and there is no need to have a medical background, as that isn’t the program’s purpose. The main requirement is the capacity for compassion and the ability to be a reassuring presence.

“You don’t have to have a specific skill set to be a good fit for this,” Karlekar said. “What you’re doing is going into a room and just being. You don’t have to be a craft expert and run them through a craft project. You don’t have to be a great public speaker and share a sermon. This is just you going in there and sharing a part of yourself at whatever level you feel comfortable, and in that way bringing them some comfort with your presence.

“I was raised Hindu; I’m at best agnostic now,” she said. “But I am very spiritual and I respect people who have faith. To me, this is not about religion. When my children were born, there was a magic to that. There is something about the moment of birth that is just incredible. There is something magical about the end of life as well. It can be beautiful and serene, and it can sometimes be difficult and serene. Sometimes it can be just awful. There is definitely a range, but to be able to help in that place, I don’t think someone has to be reciting scripture.”

Individuals must wait at least a year after the death of someone close to them to volunteer with V3.

Volunteers will receive training specific to end-of-life issues, and program staff will meet with volunteers after they sit with a patient so they can talk about their experience.

Vanderbilt employees interested in becoming a V3 volunteer can apply at: https://www.volgistics.com/ex/portal.dll/ap?ap=5047327 .

The first orientation will be at the end of August, and V3 volunteers should begin work in early September.

If you have questions, contact Hixson at rebecca.j.hixson@vanderbilt.edu or Frierdich at matthew.d.frierdich@vanderbilt.edu.