Eleven-year-old Jack sobbed uncontrollably. The laceration on his hand had stopped bleeding, thanks to Candice Alper, RN, ED nurse at Northern Westchester Hospital (NWH), Mt. Kisco, but staying still to wait for sutures was too much to bear. Then a Cavalier King Charles Spaniel, named Kobys Karma, licked Jacks face and dried his tears.
When I heard the page, Pet Therapy Dog to the ED STAT I realized that the Planetree philosophy had indeed permeated our hospital, said Maria Hale, vice president, Patient Advocacy and Service Excellence.
Last year, NWH became the first hospital in New York to become a designated Planetree Patient-Centered Hospital. We chose to apply to Planetree because it fit in with our culture and philosophy of nursing, which emphasizes clinical competence and provision of care with warmth, caring, and compassion, says CNO Lauraine Szekely, RN, MBA, senior vice president, Patient Care Services. Planetree allows us more tools and comfort measures to care for the whole patient, including his or her spiritual and intellectual needs.
Planetree, named for the sycamore (or plane tree) under which Hippocrates sat as he taught tenets of holistic medicine to students in ancient Greece, aims to refocus Western medicine on patient-centeredness. In 1978, Angelica Thieriot, dismayed at the lack of personalized care after several traumatic hospital experiences, founded Planetree. It was later reorganized by Griffin Hospital, a nonprofit institution in Derby, Connecticut, where the Planetree Alliance is now based. The alliance totals more than 100 hospitals and other healthcare affiliated institutions across the country, in the Netherlands, and in Canada.
The journey begins
At the start of its journey with Planetree in 2001, NWH became an affiliate and began a dialogue with Planetree members who were like-minded in forming a healing partnership with patients. Hale says NWH began to break down typical regulations; for example, changing set visiting times to open hours.
NWH applied for designation, a one-year process that involved making an initial self-assessment and then submitting documentation. Planetree scheduled a site visit to verify the hospitals implementation of programs that meet the spirit and intent of the designation criteria for patient-centered care.
A review team toured the facility, met with hospital leadership, and conducted detailed focus groups and interviews with patients, physicians, and staff to evaluate whether the Planetree philosophy had taken root. A designation committee of national healthcare experts made the final determination.
Rather than a prescriptive template, Planetree provides principles to demystify, humanize, and personalize health care for patients and families, says Hale. This enables the hospitals creative energy to take over, she says.
Staff learns the Planetree philosophy at retreats with interactive, hands-on sessions designed to bring to conscious awareness the feelings and needs not only of patients but coworkers as well. The retreat also emphasizes teamwork, nurturing one another, and being aware of and alleviating stress for each other, says Hale.
Integrative therapies, considered by NWH as a nursing standard of care, are enmeshed in the hospital culture and are offered free of charge, says Karen Maier, RN, clinical coordinator, Integrative Medicine Program. These include Reiki, guided imagery, acupuncture, aromatherapy, and massage, music, and art therapies.
Nurses throughout NWH are trained in integrative therapies to support patient care in all settings. For example, nurses in the ED help to reduce patient anxiety. In Labor and Delivery, they help to ensure positive delivery experiences, and on units such as Oncology, the nurses help create a peaceful setting for patients and families who are coping with end-of-life issues, Maier says. Not only do the therapies benefit the patients and staff, but the caregiver and family as well.
Maier recounts the story of a young mother with end-stage cancer, whose four-
year-old daughter sat silently watching while Maier provided therapeutic touch to her mother. Maier engaged the child in the process by teaching her a simple, gentle touch therapy. Each day, when Maier entered the room, the little girl would jump up and smile at the opportunity to relate to her mom through touch.
This scenario shows how the family is a cultural norm at NWH, says Szekely. Even during a code, family is present, she adds.
NWHs patient-centered programs foster comfort, healing, and wellness.
The Ken Hamilton Caregivers Center contains a library and meeting rooms and is equipped with computers to provide access to health information for patients and families.
A social worker and 12 caregiver coaches, who are trained community member volunteers and who have been caregivers themselves, offer emotional support and counseling. The success of the Caregiver Support Program was recognized by Planetrees National Spirit of Caring Award for Best Program for Family, Friends, and Social Support in 2006.
At shift report, nurses learn patients clinical plan of care and then elicit from patients their priorities and arrange the clinical plan accordingly. It is crucial that patients have input into their individual plans of care and feel comfortable about articulating their personal needs. This philosophy ensures that patients feel actively involved, says Hale. Allowing patients to have input into their care is a great way for them to be involved, says Hale.
Planetree is employee empowerment giving the team ways to do their jobs better and creating partnerships with patients. Its about patient empowerment enabling patients to be active participants in their care, says Hale. Planetree gives us the framework to put these two groups together to form the perfect relationship between professional caregiver and patient, she adds. What Planetree does for nurses is to pull the art of nursing in with the science of nursing to care for the whole patient, says Szekely.