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15/12 #hpm Healthcare Social Media Transcript

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#hpm transcript

Healthcare Social Media Transcript

From: Wed Aug 08 18:00:00 PDT 2012

To: Wed Aug 08 19:15:00 PDT 2012

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aliciabloom let's get started with introductions. . . #hpmWed Aug 8 18:01:01 PDT 2012

best_endings #hpm Evening all @KathyKastner (reporting live from new avatar!) Gr8 topic gr8 host@aliciabloomWed Aug 8 18:03:42 PDT 2012

kilani19 @aliciabloom hey! #hpmWed Aug 8 18:04:50 PDT 2012

aliciabloom @best_endings hi kathy! thanks for joining. who else do we have here tonight? #hpmWed Aug 8 18:05:01 PDT 2012

aliciabloom @kilani19 hello! glad you're here. #hpmWed Aug 8 18:05:44 PDT 2012

aliciabloom reading for Topic 1: "At the end of life, talk helps bridge a racial divide"(http://t.co/aUJcKkfx)#hpm

Wed Aug 8 18:06:53 PDT 2012

hollyby Hi there! Holly Yang, #hospice and #palliative medicine doc with@SanDiegoHospice. All tweets are my own #hpm

Wed Aug 8 18:07:08 PDT 2012

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_lizzy_ Hi all! I'm here but sleepy so I'll be in & out. Lizzy Miles, researcher, social worker,writer & passionate advocate for #hpm

Wed Aug 8 18:07:32 PDT 2012

hollyby For the next hour I am tweeting from the #hospice and #palliative medicine tweetchat.Feel free to join in ! #hpm

Wed Aug 8 18:07:58 PDT 2012

aliciabloom hi @_lizzy_ & @hollyby. so glad you're both here! #hpmWed Aug 8 18:09:05 PDT 2012

anetto I'm here and interested to see what the differences are #hpmWed Aug 8 18:09:16 PDT 2012

nursefriendly RT @aliciabloom: welcome to #hpm chat! i'll be your host tonight & we will talk aboutthe role of race & religion in end of life decision making.

Wed Aug 8 18:09:21 PDT 2012

nursefriendly Wednesday, August 8,2012: #Healthcare#Tweetchats (all EDT): 9p #dsma 9p #hpm9p #mhealth 9p #premeded - #nurseup#nursefriendly#s4pm

Wed Aug 8 18:09:55 PDT 2012

aliciabloom welcome @anetto! glad you're joining us. #hpmWed Aug 8 18:10:12 PDT 2012

aliciabloom here is our reading for T1: "At the end of life, talk helps bridge a racial divide"(http://t.co/aUJcKkfx)#hpm

Wed Aug 8 18:10:44 PDT 2012

nursefriendly RT @aliciabloom: reading for Topic 1: "At the end of life, talk helps bridge a racialdivide" (http://t.co/aUJcKkfx) #hpm

Wed Aug 8 18:11:46 PDT 2012

nursefriendly Hello Everyone, Andrew Lopez, RN from #newJersey, winding down from #s4pm :)#hpm

Wed Aug 8 18:12:19 PDT 2012

Kamiyamay RT @aliciabloom: here is our reading for T1: "At the end of life, talk helps bridge aracial divide" (http://t.co/aUJcKkfx) #hpmWed Aug 8 18:12:25 PDT 2012

best_endings Greetings!#hpm-ers! @hollyby@_lizzy_@anetto@nursefriendly@kilani19Wed Aug 8 18:12:32 PDT 2012

aliciabloom T1 (part 1): please share initial thoughts from the @nytimes piece. . . #hpmWed Aug 8 18:13:16 PDT 2012

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_lizzy_ T1: I enjoyed that article and I found that it paralleled my personal SW experience#hpm

Wed Aug 8 18:13:34 PDT 2012

hollyby I'm having tweetchat issues. It won't let me retweet. I know @ctsinclair told me how tofix this once... Sigh! #hpm

Wed Aug 8 18:14:05 PDT 2012

aliciabloom @_lizzy_ you've seen this in your work? #hpmWed Aug 8 18:14:27 PDT 2012

aliciabloom @hollyby i think you have to refresh. . .? #hpmWed Aug 8 18:14:44 PDT 2012

Kamiyamay #hpm T1-Excellent observation - pertinent topic!Wed Aug 8 18:14:51 PDT 2012

_lizzy_ T1: To clarify, when I say "enjoy" I mean that I felt the subject was well-reported #hpmWed Aug 8 18:14:57 PDT 2012

hollyby You are right. Thx. :) RT @aliciabloom: @hollyby i think you have to refresh. . .? #hpmWed Aug 8 18:15:38 PDT 2012

anetto It sounds as though the difference is in the information provided more than thebackground of the patient #hpm

Wed Aug 8 18:15:41 PDT 2012

aliciabloom how to always frame decision making: "Living or dying is not at issue. The questionthis family confronts is how the patient will die." #hpm

Wed Aug 8 18:16:02 PDT 2012

aliciabloom @anetto how the information is provided is critically important, but more than that, it'sabout being aware of the patient framework #hpm

Wed Aug 8 18:16:54 PDT 2012

anetto @hollyby If you find out I have had the same problem w Retweets #hpmWed Aug 8 18:17:15 PDT 2012

_lizzy_ @aliciabloom Yes - especially the point about the shared decision making. #hpmWed Aug 8 18:17:40 PDT 2012

aliciabloom refresh the page & it should work. RT @anetto: If you find out I have had the sameproblem w Retweets #hpm

Wed Aug 8 18:18:07 PDT 2012

hollyby T1: I think it is important to recognize that some concerns are specific to particular

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groups, so they can be asked about & addressed #hpm

Wed Aug 8 18:18:16 PDT 2012

aliciabloom @_lizzy_ and understanding that the shared decision making may include extendedfamily members, clergy and others. #hpm

Wed Aug 8 18:19:00 PDT 2012

_lizzy_ T1 In a few cases, we had to do a lot of work to determine the decision-maker

because of the family dynamics and deferences #hpmWed Aug 8 18:19:44 PDT 2012

aliciabloom we should be reminded not to make assumptions about patient/family preferences &always engage in honest, compassionate discussion #hpm

Wed Aug 8 18:19:57 PDT 2012

nursefriendly @aliciabloom T1 They make very valid points on how #patients have come to distrustthe sytem that has discriminated in the past #hpm

Wed Aug 8 18:20:06 PDT 2012

Kamiyamay #hpm@aliciabloom hpm message needs to be shared - we have large multiculturaldiversity -some large populations are non-numbers or outliers

Wed Aug 8 18:20:43 PDT 2012

nursefriendly @aliciabloom T1 Old habits, traditions, cultural beliefs die hard, change slowly. Is adaunting task to convince #patients, #families#hpm

Wed Aug 8 18:21:01 PDT 2012

_lizzy_ @aliciabloom Yes! That's just what I was trying to say... the "official" decision-makermay defer to othr fam members w/diff opinions #hpm

Wed Aug 8 18:21:02 PDT 2012

aliciabloom legal/ethical issues--> MT @_lizzy_: in cases, had to do work to determine thedecision-maker because of family dynamics & deferences #hpm

Wed Aug 8 18:21:22 PDT 2012

hollyby MT @aliciabloom: we should be reminded not to make assumptions abt pt/familyprefs & always engage in honest, compassionate discussion #hpm

Wed Aug 8 18:21:23 PDT 2012

kilani19 @aliciabloom keeping the focus on the individual & not the cultural background iswhat's important. Also start the conversation early #hpmWed Aug 8 18:21:24 PDT 2012

aliciabloom @_lizzy_ i thought so :) #hpmWed Aug 8 18:21:53 PDT 2012

aliciabloom !!RT @kilani19: keeping the focus on the individual & not the cultural background iswhats important. Also start the conversation early #hpm

Wed Aug 8 18:22:18 PDT 2012

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_lizzy_ @aliciabloom If I have learned anything i ts that I know nothing. Always start fromscratch. #hpm

Wed Aug 8 18:22:52 PDT 2012

nursefriendly Yes, some cultures are very resistant to #EOL options, #hospice RT @aliciabloom:@_lizzy_ you've seen this in your work? #hpm

Wed Aug 8 18:23:16 PDT 2012

aliciabloom T1 (part 2): #hpm intervention impacts EoL decision making in minority patients. whatcan we teach the greater health care community?

Wed Aug 8 18:23:41 PDT 2012

Kamiyamay RT @_lizzy_: @aliciabloom If I have learned anything its that I know nothing. Alwaysstart from scratch. #hpm

Wed Aug 8 18:23:46 PDT 2012

hollyby Beginner's mind. :) RT @_lizzy_: @aliciabloom If I have learned anything its that Iknow nothing. Always start from scratch. #hpm

Wed Aug 8 18:23:57 PDT 2012

kilani19 @aliciabloom@_lizzy_ with icu pts it's important to jump on board for support earlyso if things don't improve, u have been there #hpm

Wed Aug 8 18:24:14 PDT 2012

nursefriendly T1 I'm not shy about bringing up Code status, #DNRs, #ComfortCare or #Hospice.Some discussions much more difficult to start. #hpm

Wed Aug 8 18:24:29 PDT 2012

aliciabloom yes! patients & families are experts, too RT @_lizzy_: If I have learned anything itsthat I know nothing. Always start from scratch. #hpmWed Aug 8 18:24:32 PDT 2012

kilani19 @nursefriendly@aliciabloom@_lizzy_ a lot of cultures that way - Asian cultures likeKorean or Filipino #hpm Hispanic to some degree.

Wed Aug 8 18:25:20 PDT 2012

aliciabloom @kilani19 building rapport, offering continuity. both lead to trust. it definitely matters.#hpm

Wed Aug 8 18:25:22 PDT 2012

hollyby @_lizzy_ I mean that in a good "keeping a beginner's mind" kind of way. I totallyagree with you. #hpm

Wed Aug 8 18:25:28 PDT 2012

nursefriendly @_lizzy_ T1 The article spelled out why a culture of #distrust and #suspicion haspersisted and can make #EOL decisions difficult #hpm

Wed Aug 8 18:26:01 PDT 2012

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kilani19 @aliciabloom yes. It really doesn't matter which culture. Start afresh each pt andfamily and be sincere. That's what works. #hpm

Wed Aug 8 18:26:36 PDT 2012

_lizzy_ T2 It is helpful to know why 'no' to hospice. I was surprised once 2 hear man say famdid not want extra people in HH. valid concern. #hpm

Wed Aug 8 18:26:51 PDT 2012

Kamiyamay @kilani19@nursefriendly@aliciabloom@_lizzy_#hpm and some must only speakto head of house for all decisions and sometimes gender matters

Wed Aug 8 18:27:14 PDT 2012

aliciabloom the article reminds us of the historical context & it's impact on the patient/familyexperience in the health care system #hpm

Wed Aug 8 18:27:23 PDT 2012

_lizzy_ @hollyby No worries. I started thinking I knew everything. Now the more I learn, themore I know I do no know. Every family is differnt #hpm

Wed Aug 8 18:27:46 PDT 2012

Kamiyamay @kilani19@aliciabloom#hpm Excellent and never assume!Wed Aug 8 18:28:07 PDT 2012

aliciabloom key component of #hpm intervention: meet patient/family where they are. understandconcerns, barriers & address through supportive education

Wed Aug 8 18:28:59 PDT 2012

H_O_G_ @nursefriendly@aliciabloom@_lizzy_ I agree. Many people are unable to discussEOL options,feeling as if its somehow disrespectful #hpm

Wed Aug 8 18:29:01 PDT 2012

nursefriendly RT @kilani19: @nursefriendly@aliciabloom@_lizzy_ a lot of cultures that way -Asian cultures like Korean or Filipino #hpm Hispanic to ...

Wed Aug 8 18:29:36 PDT 2012

Kamiyamay RT @aliciabloom: key component of #hpm intervention: meet patient/family wherethey are. understand concerns, barriers & address thr ...

Wed Aug 8 18:29:44 PDT 2012

aliciabloom lots of great thoughts and ideas coming from the @nytimes article and our T1. pleaseshare closing thoughts & we'll move to T2. #hpmWed Aug 8 18:29:58 PDT 2012

nursefriendly @kilani19 T1 You need to feel each person, family out in having the discussion,understand but do not assume there is Bias #hpm

Wed Aug 8 18:30:22 PDT 2012

nursefriendly RT @Kamiyamay: @kilani19@nursefriendly@aliciabloom@_lizzy_#hpm andsome must only speak to head of house for all decisions and somet ...

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Wed Aug 8 18:30:37 PDT 2012

kilani19 @nursefriendly yup! Each experience is a rewarding one! #hpmWed Aug 8 18:31:18 PDT 2012

nursefriendly Feeling out who is the decision maker is a challenge :( @Kamiyamay: @kilani19@nursefriendly@aliciabloom@_lizzy_#hpm

Wed Aug 8 18:31:20 PDT 2012

_lizzy_ T1 As SW, my biggest challenge is when official decision mkr is not the real decisionmkr & fam disagrees...helping them to sort out #hpm

Wed Aug 8 18:31:30 PDT 2012

Kamiyamay @H_O_G_@nursefriendly@aliciabloom@_lizzy_#hpm You are right, happens,again as was mentioned must be aware of who & how to communicate

Wed Aug 8 18:32:04 PDT 2012

aliciabloom my final thought- we can bridge gaps with honest, compassionate communicationabout the reality of the disease process & options #hpm

Wed Aug 8 18:32:16 PDT 2012

nursefriendly @H_O_G_ T1 That is one of the points made in the article, discussing #DNR or#hospice can be equated to witholding needed care #hpm

Wed Aug 8 18:33:04 PDT 2012

Kamiyamay @_lizzy_#hpm Would love to discuss that as #hpm topic! Firetrucks to firearms -family not in agreement while patient in middle!

Wed Aug 8 18:33:40 PDT 2012

aliciabloom reading for T2, courtesy of @GeriPalBlog: When religious beliefs are at odds with anatural death (http://t.co/tF6Js1Ic) #hpm

Wed Aug 8 18:34:29 PDT 2012

nursefriendly RT @Kamiyamay: #hpm@aliciabloom hpm message needs to be shared - we havelarge multicultural diversity -some large populations are non- ...

Wed Aug 8 18:35:03 PDT 2012

_lizzy_ @Kamiyamay I would love to hear ideas of how to bring people together. I've beenwitness to screaming. It can get ugly. #hpm

Wed Aug 8 18:35:41 PDT 2012

timbigfish I'm lurking as @nursefriendly@kilani19@kamiyamay tweet & RT #hpm chat. I'mlearning from smart ppl who share my values #hcsm#ff them

Wed Aug 8 18:36:12 PDT 2012

Kamiyamay @nursefriendly@H_O_G_#hpm or the opposite, that we are on scene to rush things.Wed Aug 8 18:36:19 PDT 2012

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RannPatterson RT @nursefriendly: Wednesday, August 8,2012: #Healthcare#Tweetchats (all EDT):9p #dsma 9p #hpm 9p #mhealth 9p #premeded - #nurseup#nu ...

Wed Aug 8 18:36:23 PDT 2012

DeathwDignity End of day reminder: #DWDchat tomorrow w/guest @MarksPhone - How can we useexperiences w/#hospice to educate others? Tell us 6p ET. #hpm

Wed Aug 8 18:37:01 PDT 2012

nursefriendly RT @aliciabloom: T1 (part 2): #hpm intervention impacts EoL decision making inminority patients. what can we teach the greater health c ...

Wed Aug 8 18:37:11 PDT 2012

aliciabloom @_lizzy_@Kamiyamay i think it's critically important to keep the patient at the center.remind family why we are all around the table. #hpm

Wed Aug 8 18:37:15 PDT 2012

EWidera Talking about the OncoTalk Legacy: IntensiveTalk and GeriTalk http://t.co/NWnnnlFJ#hpm

Wed Aug 8 18:37:21 PDT 2012

_lizzy_ @timbigfish join us - we don't bite : ) #hpmWed Aug 8 18:38:02 PDT 2012

aliciabloom T1 has run a little longer than expected, but i definitely think the discussion has beengreat. please share final thoughts before T2. #hpm

Wed Aug 8 18:38:20 PDT 2012

nursefriendly @aliciabloom T1 Normalize the conversation, have #doctors, #nurses#HCPSdiscuss #EOL, Living Wills long before a crisis emerges #hpm

Wed Aug 8 18:38:28 PDT 2012

kilani19 @timbigfish@nursefriendly@kamiyamay hi Tim! #hpmWed Aug 8 18:38:30 PDT 2012

Kamiyamay #hpm T2 Very important topic - we spent half IDT time today talking about religious,ethical, what is quality

Wed Aug 8 18:38:52 PDT 2012

aliciabloom it's true. we don't. AND we l ike making new friends :) RT @_lizzy_: @timbigfish join us

- we dont bite : ) #hpmWed Aug 8 18:38:57 PDT 2012

WaywardChad I'm here, too....better late than never. G'evening, wonderful tweeps! :) #hpmWed Aug 8 18:39:04 PDT 2012

aliciabloom welcome back! RT @WaywardChad: Im here, too....better late than never. Gevening,wonderful tweeps! :) #hpm

Wed Aug 8 18:39:32 PDT 2012

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nursefriendly T1 We need to make #EOL part of the normal #healthcare#discussion, not only bringit up when #patients take a turn for the worst #hpm

Wed Aug 8 18:39:32 PDT 2012

hollyby MT @aliciabloom: reading for T2, via @GeriPalBlog: When religious beliefs are atodds with a natural death http://t.co/qgCP4TmK#hpm

Wed Aug 8 18:39:44 PDT 2012

nursefriendly RT @timbigfish: I'm lurking as @nursefriendly@kilani19@kamiyamay tweet & RT#hpm chat. I'm learning from smart ppl who share my values #hcsm#ff them

Wed Aug 8 18:39:50 PDT 2012

aliciabloom T2: When religious beliefs are at odds with a natural death (http://t.co/tF6Js1Ic)

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_lizzy_ @aliciabloom Curious where the law stands and if it will change with all of theinitiatives. Can fam request support they cannot pay 4? #hpm

Wed Aug 8 18:45:07 PDT 2012

aliciabloom @hollyby such a delicate balance. at what point can/should we say, this is not goingto be helpful so we are not going to do it? #hpm

Wed Aug 8 18:45:18 PDT 2012

nursefriendly RT @Kamiyamay: @H_O_G_@nursefriendly@aliciabloom@_lizzy_#hpm You areright, happens, again as was mentioned must be aware of who &am ...

Wed Aug 8 18:45:25 PDT 2012

WaywardChad RT @aliciabloom: key of #hpm intervention: meet patient/fam where they are.understand concerns, barriers & address w/ supportive educ #hpm

Wed Aug 8 18:46:03 PDT 2012

Kamiyamay #hpm T2 who determines qualify of life, who decides- enough is enough, life/deathweighty matter some fear eternal consequence.

Wed Aug 8 18:46:26 PDT 2012

_lizzy_ @aliciabloom It's all so politically charged right now and gets reframed in the worstways... #hpm

Wed Aug 8 18:46:51 PDT 2012

Kamiyamay @_lizzy_@aliciabloom#hpm Yes but non-insured on rise for some reason!Wed Aug 8 18:47:25 PDT 2012

aliciabloom @_lizzy_ financial implications are real, plus the ethics...non-maleficence (do noharm), social justice (resource utilization) #hpm

Wed Aug 8 18:47:55 PDT 2012

anetto MT@Kamiyamay:T2 who determines qualify of life, who decides- enough . life/deathweighty matter some fear eternal consequence. #hpm

Wed Aug 8 18:48:14 PDT 2012

aliciabloom important to remember that a natural, peaceful death is uniquely defined by eachindividual & impacted by many factors #hpm

Wed Aug 8 18:48:59 PDT 2012

_lizzy_I expect there will be another situation like Terri Schiavo/Nancy Cruzan that will forcethe issue into lawmaking #hpm

Wed Aug 8 18:49:21 PDT 2012

aliciabloom struggle sometimes with the incongruence of leaving things "in God's hands" butwanting all o f the man made medical intervention. . . #hpm

Wed Aug 8 18:49:53 PDT 2012

kilani19 @anetto@Kamiyamay only the individual can determine what is qol #hpm mix ofethics and understanding who your pt is.

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Wed Aug 8 18:50:17 PDT 2012

hollyby @aliciabloom It is rare that people go against family wishes. In extreme cases, ethicsconsultation is usually involved. #hpm

Wed Aug 8 18:50:57 PDT 2012

aliciabloom great point --> RT @kilani19: only the individual can determine what is qol, mix ofethics and understanding who your pt is #hpm

Wed Aug 8 18:51:21 PDT 2012

aliciabloom @hollyby it's true. i feel that clinicians are often challenged, feeling they're doingmore harm than good. difficult situations. #hpm

Wed Aug 8 18:52:24 PDT 2012

WaywardChad Excellent point! RT @kilani19: only the individual can determine what is qol #hpmmix of ethics and understanding who your pt is. #hpm

Wed Aug 8 18:52:31 PDT 2012

Kamiyamay @aliciabloom@_lizzy_#hpm#hpm has diverse team, all R needed, #eol veryintimate, raw subject, that touches the core of humanity.Wed Aug 8 18:52:39 PDT 2012

_lizzy_ @hollyby But seriously, does that mean hospital or insurance company eats cost?People can b sustained on equip indefinitely right? #hpm

Wed Aug 8 18:53:00 PDT 2012

hollyby @aliciabloom re: feeling like they're doing more harm than good -> source of healthcare provider moral distress and burnout #hpm

Wed Aug 8 18:55:12 PDT 2012

nursefriendly RT @_lizzy_: @Kamiyamay I would love to hear ideas of how to bring peopletogether. I've been witness to screaming. It can get ugly. #hpm

Wed Aug 8 18:55:16 PDT 2012

_lizzy_ T2 This is why I would be challenged to work in a hospital environment. I admirethose of you who do. I have had few clients on equip. #hpm

Wed Aug 8 18:55:53 PDT 2012

Kamiyamay @kilani19@anetto#hpm U R right :-) There is no specific answer. Needs, cultures,beliefs, families vary, past experience matters too!

Wed Aug 8 18:55:54 PDT 2012

nursefriendly @_lizzy_ It can literally tear families apart when they cannot agree on end of lifedecisions #hpm

Wed Aug 8 18:55:59 PDT 2012

aliciabloom T2: in the case presented in the @GeriPalBlog piece, what do you think is the bestway to honor this familys religious bel iefs? #hpm

Wed Aug 8 18:56:12 PDT 2012

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nursefriendly It is easy for they to think that RT @Kamiyamay: @nursefriendly@H_O_G_#hpm orthe opposite, that we are on scene to rush things.

Wed Aug 8 18:56:39 PDT 2012

WaywardChad MT @aliciabloom: T2: in the case presented, what do you think is the best way tohonor this familys religious beliefs? #hpm

Wed Aug 8 18:57:15 PDT 2012

nursefriendly RT @Kamiyamay: #hpm T2 Very important topic - we spent half IDT time today talkingabout religious, ethical, what is quality

Wed Aug 8 18:58:05 PDT 2012

_lizzy_ @nursefriendly True! And sadly, some families r already torn *before* they face eol ofa loved one (& of course some come together). #hpm

Wed Aug 8 18:58:13 PDT 2012

nursefriendly RT @aliciabloom: it's true. we don't. AND we like making new friends :) RT @_lizzy_:@timbigfish join us - we dont bite : ) #hpm

Wed Aug 8 18:58:17 PDT 2012

ggramels "The goal of a peaceful death should be as much a part of the purpose of medicine asthe promotion of good health." D. Callahan #hpm

Wed Aug 8 18:59:13 PDT 2012

Kamiyamay @nursefriendly@H_O_G_#hpm Them (sorry tired & slow tonight)!Wed Aug 8 18:59:15 PDT 2012

nursefriendly RT @H_O_G_: @Kamiyamay@nursefriendly death, as in life, is individual. We needto be factual,w/out losing compassion. #hpm

Wed Aug 8 18:59:26 PDT 2012

nursefriendly No biggie, I'm not spell checking :) RT @Kamiyamay: @nursefriendly@H_O_G_#hpm Them (sorry tired & slow tonight)!

Wed Aug 8 19:00:06 PDT 2012

aliciabloom we're in the final few minutes of #hpm chat! please share final thoughts....Wed Aug 8 19:00:08 PDT 2012

RannPatterson RT @aliciabloom: key component of #hpm intervention: meet patient/family where

they are. understand concerns, barriers & address thr ...Wed Aug 8 19:00:34 PDT 2012

aliciabloom sorry if the topics weren't flowing as well tonight. my tweetchat was being a little slow,cumbersome. so glad you all joined in! #hpm

Wed Aug 8 19:01:17 PDT 2012

hollyby @_lizzy_ Not indefinitely. Yes, insurance, the patient, and the hospital in somecombination pays for the care. #hpm

Wed Aug 8 19:01:24 PDT 2012

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ggramels "....disease and death will have their day." D. Callahan in The Troubled Dream of Life#hpm

Wed Aug 8 19:01:47 PDT 2012

nursefriendly @aliciabloom Depends on the attitude of the doctor, the hospital, the insurance, verydifficult to abruptly halt care #hpm

Wed Aug 8 19:02:39 PDT 2012

hollyby It is one thing to address the information need of patients, but it is just as important toaddress the emotional and spiritual needs. #hpm

Wed Aug 8 19:02:50 PDT 2012

WaywardChad Anytime we get to share even a bit of dialogue, wld call that success, regardless oftechnical limitations.Taking away good things! :) #hpm

Wed Aug 8 19:03:30 PDT 2012

nursefriendly @aliciabloom The question comes up often in #oncology, with expensive#chemotherapy, little chance of success, no ability to pay #hpm

Wed Aug 8 19:03:43 PDT 2012

nursefriendly RT @Kamiyamay: #hpm T2 who determines qualify of life, who decides- enough isenough, life/death weighty matter some fear eternal conseq ...

Wed Aug 8 19:03:55 PDT 2012

aliciabloom important for patients to understand it isn't about the cost or withholding care, it'sabout providing appropriate, supportive care #hpm

Wed Aug 8 19:05:15 PDT 2012

nursefriendly RT @_lizzy_: I expect there will be another situation like Terri Schiavo/Nancy Cruzanthat will force the issue into lawmaking #hpm

Wed Aug 8 19:05:49 PDT 2012

Kamiyamay #hpm LT:Race, gender, color, creed, relig ion/lack of, family differences, pastexperience, geography. B aware! - Give all kindness & respect

Wed Aug 8 19:05:53 PDT 2012

nursefriendly RT @kilani19: @anetto@Kamiyamay only the individual can determine what is qol#hpm mix of ethics and understanding who your pt is.

Wed Aug 8 19:06:12 PDT 2012

nursefriendly RT @hollyby: @aliciabloom It is rare that people go against family wishes. In extremecases, ethics consultation is usually involved. #hpm

Wed Aug 8 19:06:22 PDT 2012

hollyby Thanks so much, @aliciabloom for moderating the chat! See you all next week! #hpmWed Aug 8 19:06:38 PDT 2012

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nursefriendly RT @Kamiyamay: @aliciabloom@_lizzy_#hpm#hpm has diverse team, all Rneeded, #eol very intimate, raw subject, that touches the core o ...

Wed Aug 8 19:06:57 PDT 2012

_lizzy_ MT @aliciabloom: impt for pts 2 understand it isnt about the cost or withholding care,its about providing appropriate, supportive care #hpm

Wed Aug 8 19:06:57 PDT 2012

aliciabloom thanks for joining @hollyby! looking forward to you running the show next week :)#hpmWed Aug 8 19:07:35 PDT 2012

nursefriendly RT @hollyby: @_lizzy_ Not indefinitely. Yes, insurance, the patient, and the hospitalin some combination pays for the care. #hpm

Wed Aug 8 19:08:41 PDT 2012

aliciabloom @WaywardChad thank you & glad you joined again. it's great to have new voices inthe conversation. #hpm

Wed Aug 8 19:08:54 PDT 2012

WaywardChad Last thought: Strive to meet patients/families where they are. We may be HCP, but notexperts of getting where people are w/o asking. #hpm

Wed Aug 8 19:08:55 PDT 2012

produceconsume RT @DeathwDignity: RT @schwartzbrown: Check out the #AssistedDeath in UStimeline on @timetoasthttp://t.co/oy7hn3oQ#eolchat#dwdchat#hpm

Wed Aug 8 19:09:53 PDT 2012

nursefriendly RT @Kamiyamay: #hpm LT:Race, gender, color, creed, religion/lack of, familydifferences, past experience, geography. B aware! - Give all ...

Wed Aug 8 19:10:11 PDT 2012

nursefriendly RT @hollyby: Thanks so much, @aliciabloom for moderating the chat! See you allnext week! #hpm

Wed Aug 8 19:10:25 PDT 2012

WaywardChad @aliciabloom Thank you! I'll try to be here on time next week. Mustremember....9...not 9:30. Gah! #hpm

Wed Aug 8 19:11:46 PDT 2012

kilani19 @aliciabloom@hollyby@_lizzy_@Kamiyamay thx again! #hpmWed Aug 8 19:13:40 PDT 2012

aliciabloom @kilani19@_lizzy_ thanks for joining...see you next week! #hpmWed Aug 8 19:14:42 PDT 2012

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8:8:12 #hpm