2011 05 25 hpm tweetchat transcript
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This document contains a transcript of tweets from a Twitter chat about healthcare and palliative medicine using the hashtag #hpm. Various participants introduced themselves and their locations and backgrounds. They then discussed definitions of suffering, with suggestions that suffering is subjective and unique to each individual's experience, and is caused by anything that causes distress including diseases, treatments, and impacts on one's life. The importance of determining the source of suffering from the patient's perspective was emphasized.
2011 05 25 hpm tweetchat transcript
- 1. #hpm Healthcare Hashtag Twitter Transcript From: Wed May 25 18:00:00 PDT 2011 To: Wed May 25 19:00:00 PDT 2011 Customize transcript dates and layout Learn more about #hpm at The Healthcare Hashtag Project Kaviraj2 RT @renee_berry: hey everyone, won't be able to make #hpm tonight, hope you have a great chat! Wed May 25 18:00:19 PDT 2011 EOLnavigator We will be tweeting about hospice & palliative care topics relevant to caregivers for the next hour. #hpm Wed May 25 18:00:31 PDT 2011 jfclearywisc Jim cleary from Madison WI #hpm Wed May 25 18:00:45 PDT 2011 aliciabloom MSW, LSW focusing on #palliative care program development & increasing #hospice access through clinical education at @VITASHospice #hpm Wed May 25 18:01:43 PDT 2011 MarksPhone Mark from NYC #hpm Wed May 25 18:01:43 PDT 2011 EOLnavigator Hey there! @jfclearywisc, @Kaviraj2, @MeredithGould #hpm Wed May 25 18:01:56 PDT 2011 dockj Kevin from Wilmington NC #hpm and family med Ed. Tweets are my own opinion. Wed May 25 18:02:35 PDT 2011 EOLnavigator Hi! Glad you made it. @aliciabloom, @marksphone #hpm Wed May 25 18:02:36 PDT 2011 doctatum Paul in Columbia MO (and another day with tornados just cleared out) #hpm Wed May 25 18:03:07 PDT 2011 MarksPhone it was a real learning experience last week wanted to return and learn more #hpm
- 2. MarksPhone Wed May 25 18:03:10 PDT 2011 EOLnavigator Hi Kevin @dockj #hpm Wed May 25 18:03:13 PDT 2011 dockj Next hour tweets tagged #hpm part of palliative medicine and hospice tweetchat Wed May 25 18:03:20 PDT 2011 EOLnavigator Topic 1 coming soon.... #hpm Wed May 25 18:03:30 PDT 2011 EOLnavigator Glad it was! RT @MarksPhone: it was a real learning experience last week wanted to return and learn more #hpm Wed May 25 18:03:46 PDT 2011 revdoc Pam Harris, MD w/KC Hospice, ordained minister; joining HPM tweetchat; opinions are my own #hpm Wed May 25 18:03:47 PDT 2011 KathyKastner health blogger, with (it seems increasing) interest in all things #hpm (hence recent post abt dying)http://tinyurl.com/3oqam2v Wed May 25 18:03:56 PDT 2011 dockj @doctatum glad you are safe. Hope everyone there is OK. #hpm Wed May 25 18:04:07 PDT 2011 EOLnavigator Hi @doctatum, @revdoc #hpm Wed May 25 18:04:12 PDT 2011 EOLnavigator T1: As a caregiver, how do you define "suffering" & what influences your beliefs about suffering? #hpm Wed May 25 18:04:24 PDT 2011 PracticalWisdom HI Lisa Speaker/Trainer Myers-Briggs/Leadership/Creativity/Presentation/Adult Educ. Morph the ho-hum into compelling. Curious/Connector #HPM Wed May 25 18:04:37 PDT 2011 PracticalWisdom Yes, I forgot if you were close. Sorry for Mo folks! RT @dockj: @doctatum glad you are safe. Hope everyone there is OK. #HPM Wed May 25 18:05:22 PDT 2011 EOLnavigator @practicalwisdom Glad you made it! #hpm Wed May 25 18:05:57 PDT 2011 revdoc T1 Suffering is pain/fear/sadness w/o meaning #hpm Wed May 25 18:05:58 PDT 2011 jfclearywisc Are we talking clinical or family caregivers? #hpm
- 3. jfclearywisc Wed May 25 18:06:29 PDT 2011 doctatum @PracticalWisdom @dockj @doctatum Thanks. RedCross doing a good job. More bad new in Sedalia today. #hpm Wed May 25 18:06:32 PDT 2011 MarksPhone T1 Do we project what feel and believe, or as observers do we alter what we observe or do we apply society beliefs? #hpm Wed May 25 18:06:34 PDT 2011 SheyontheBay Hello all - hospice/palliative nurse NY #hpm Wed May 25 18:06:43 PDT 2011 aliciabloom suffering is: anything causing distress, multifaceted (physical, emotional, spiritual) and unique to the individual experiencing it #hpm Wed May 25 18:06:46 PDT 2011 EOLnavigator Interesting. Why w/o meaning? RT @revdoc: T1 Suffering is pain/fear/sadness w/o meaning #hpm Wed May 25 18:06:49 PDT 2011 GailZahtz Trying to participate in #HPM -my first love medical chat- yet it's been hard to show-up lately. Intro- patient, care-giver, etc Wed May 25 18:07:04 PDT 2011 PracticalWisdom So Sorry. RT @doctatum: @PracticalWisdom @dockj @doctatum Thanks. RedCross doing a good job. More bad new in Sedalia today. #HPM Wed May 25 18:07:19 PDT 2011 EOLnavigator Our thoughts are with our friends affected by the tornado. Anyone here tonight? #hpm Wed May 25 18:07:20 PDT 2011 PracticalWisdom RT @MarksPhone: T1 Do we project what feel and believe, or as observers do we alter what we observe or do we apply society beliefs? #HPM Wed May 25 18:07:30 PDT 2011 SheyontheBay If there's meaning, does it mean there's no suffering? #hpm Wed May 25 18:07:38 PDT 2011 EOLnavigator @GailZahtz Thanks for coming! #hpm Wed May 25 18:07:47 PDT 2011 KathyKastner RT @aliciabloom: suffering is: anything causing distress, multifaceted (physical, emotional, spiritual) and unique to the individual experiencing it #hpm Wed May 25 18:07:51 PDT 2011 PracticalWisdom @GailZahtz: So Glad you could come. #HPM Wed May 25 18:08:10 PDT 2011
- 4. EOLnavigator @SheyontheBay Hey there! #hpm Wed May 25 18:08:14 PDT 2011 GailZahtz T1- Suffering is only without meaning if we don't look for and find meaning in our pain and challenges #HPM Wed May 25 18:08:14 PDT 2011 revdoc Going through pain or other adverse situations can be brave, redemptive, or a growth experience; w/o meaning, it is just cruel #hpm Wed May 25 18:08:16 PDT 2011 GailZahtz @PracticalWisdom Thanks! I really miss you and everyone else. #HPM was my first home. Always in my heart, even if I'm not here! Wed May 25 18:08:50 PDT 2011 aliciabloom suffering can result not only from a disease, but its treatment and the impact it has on a person's life #hpm Wed May 25 18:09:04 PDT 2011 SheyontheBay @revdoc But there'/ still suffering, yes? #hpm Wed May 25 18:09:11 PDT 2011 GailZahtz @EOLnavigator Thank you for the welcome. are you moderating #HPM Wed May 25 18:09:12 PDT 2011 EOLnavigator RT @aliciabloom: suffering is: anything causing distress, multifaceted & unique 2 the individ experiencing it #hpm Wed May 25 18:09:22 PDT 2011 revdoc Meaning does not erase all pain, but I think it takes things from the realm of suffering to other experiences #hpm Wed May 25 18:09:22 PDT 2011 KathyKastner RT @aliciabloom: suffering can result not only from a disease, but its treatment and the impact it has on a person's life #hpm Wed May 25 18:09:38 PDT 2011 EOLnavigator @GailZahtz Yes I am! #hpm Wed May 25 18:09:53 PDT 2011 MeredithGould T1 Isn't suffering totally subjective? And don't we need to go with the definition of the person who claims to be suffering? #hpm Wed May 25 18:09:58 PDT 2011 dockj RT @aliciabloom: suffering can result not only from a disease, but its treatment and the impact it has on a person's life #hpm Wed May 25 18:10:00 PDT 2011 GailZahtz @revdoc We MUST give the pain and adversity meaning- otherwise it makes life unbearable. #HPM Wed May 25 18:10:15 PDT 2011
- 5. KathyKastner #hpm For a family caregiver, I think suffering includes seeing/perceving loved one 'giving up.' Wed May 25 18:10:15 PDT 2011 EOLnavigator @GailZahtz Do you find it easy to know the source? #hpm Wed May 25 18:10:43 PDT 2011 PracticalWisdom RT @MeredithGould: T1 Isnt suffering totally subjective? dont we need 2 go w/the definition of the person who claims to be suffering? #HPM Wed May 25 18:10:46 PDT 2011 MeredithGould @SheyontheBay My standard line is "not all suffering is redemptive." #hpm Wed May 25 18:10:46 PDT 2011 aliciabloom as clinicians, we should always ask patients about the sources of their suffering so that we can adequately address it & support them #hpm Wed May 25 18:10:48 PDT 2011 SheyontheBay RT @MeredithGould: T1Isnt suffering totally subjective?dont we need to go with the definition of the person who claims to be suffering? #hpm Wed May 25 18:10:57 PDT 2011 MarksPhone @MeredithGould I agree it is the person suffering who defines it but as with all language etc how is that communicated to the HCP? #hpm Wed May 25 18:11:00 PDT 2011 EOLnavigator RT @aliciabloom: suffering can result not only from a disease, but its treatment and the impact it has on a persons life #hpm Wed May 25 18:11:24 PDT 2011 EOLnavigator RT @revdoc: Meaning does not erase all pain, but I think it takes things from the realm of suffering to other experiences #hpm Wed May 25 18:11:40 PDT 2011 GailZahtz @EOLnavigator To know the source for suffering? Some is easy- like a DX. Some hard, like emotional impact. #HPM Wed May 25 18:11:41 PDT 2011 MarksPhone @EOLnavigator agree it is multi-deminisonal and each is treated differently #hpm Wed May 25 18:12:05 PDT 2011 KathyKastner RT @MeredithGould: T1 Isn't suffering totally subjective? And don't we need to go with the definition of the person who claims to be suffering? #hpm Wed May 25 18:12:19 PDT 2011 MeredithGould @MarksPhone We need to find out how the pt communicates, what language system, nonverbal signals, etc. #hpm Wed May 25 18:12:20 PDT 2011 MarksPhone RT @GailZahtz: @EOLnavigator To know the source for suffering? Some is easy- like a DX. Some hard, like emotional impact. #HPM
- 6. Wed May 25 18:12:27 PDT 2011 PracticalWisdom T1: My Tweets are my own. Does anybody else want to Give this information? #HPM Wed May 25 18:12:29 PDT 2011 EOLnavigator RT @MeredithGould +1: Isnt suffering totally subjective? dont we need 2 go w/the definition of the person who claims to be suffering? #hpm Wed May 25 18:12:29 PDT 2011 KathyKastner RT @MeredithGould: @MarksPhone We need to find out how the pt communicates, what language system, nonverbal signals, etc. #hpm Wed May 25 18:12:46 PDT 2011 GailZahtz @PracticalWisdom Yes, tweets are my own...trust me, with the fabulous groups I represent, each have their own very strong opinions! :) #HPM Wed May 25 18:13:27 PDT 2011 dockj T2 suffering is what the patient experiences when they are in distress they cannot cope with. Regardless of the source. #hpm Wed May 25 18:13:30 PDT 2011 EOLnavigator RT @aliciabloom: as clinicians, we always ask pts about the sources of suffering so that we can adequately address it & support them #hpm Wed May 25 18:13:31 PDT 2011 KathyKastner @MeredithGould I think I need to tell you I love you (for your mind of course) #hpm Wed May 25 18:13:42 PDT 2011 aliciabloom asking open ended questions ("what is distressing you?" "tell me what troubles you?") gives patients an opportunity to speak freely #hpm Wed May 25 18:13:50 PDT 2011 PracticalWisdom RT @dockj: T2 suffering is what the patient experiences when they are in distress they cannot cope with. Regardless of the source. #HPM Wed May 25 18:14:01 PDT 2011 SheyontheBay @EOLnavigator @revdoc It can take things to another realm, but if it doesn't, there's still suffering-be it physical, spiritual... #hpm Wed May 25 18:14:03 PDT 2011 GLakesCaring RT @dockj: T2 suffering is what the patient experiences when they are in distress they cannot cope with. Regardless of the source. #hpm Wed May 25 18:14:04 PDT 2011 KathyKastner RT @dockj: T2 suffering is what the patient experiences when they are in distress they cannot cope with. Regardless of the source. #hpm Wed May 25 18:14:18 PDT 2011 dockj RT @aliciabloom: asking open ended questions ("what is distressing you?" "tell me what troubles you?") gives patients an opportunity to speak freely #hpm Wed May 25 18:14:23 PDT 2011
- 7. EOLnavigator RT @KathyKastner: @MeredithGould I think I need to tell you I love you (for your mind of course) #hpm Wed May 25 18:14:30 PDT 2011 MeredithGould Is there a T2? #hpm Wed May 25 18:14:35 PDT 2011 GailZahtz T2 IMO opinion we need to add in people's cultural perspective to the event and the relative suffering and communication of it. #HPM Wed May 25 18:14:41 PDT 2011 PracticalWisdom RT @aliciabloom: asking open ended (?)'s ("what is distressing U?" "tell me what troubles U?") gives patients an oppor. 2 speak freely #HPM Wed May 25 18:14:44 PDT 2011 MeredithGould @KathyKastner So does that mean you do NOT love my hair, too? #hpm Wed May 25 18:15:00 PDT 2011 EOLnavigator Suffering always spurs me to action as a clinician. #hpm Wed May 25 18:15:16 PDT 2011 dockj Sorry mine was a miss answer. LoL should be T 1. #hpm Wed May 25 18:15:19 PDT 2011 MarksPhone some patients want to put on a good face for the HCP show they are succeeding in tx and making progress while outside HC they hurt #hpm Wed May 25 18:15:20 PDT 2011 KathyKastner I covet your hair. RT @MeredithGould: @KathyKastner So does that mean you do NOT love my hair, too? #hpm Wed May 25 18:15:29 PDT 2011 dockj RT @EOLnavigator: Suffering always spurs me to action as a clinician. #hpm Wed May 25 18:15:43 PDT 2011 EOLnavigator @MeredithGould No T2 yet....still on T1 #hpm Wed May 25 18:15:54 PDT 2011 PracticalWisdom Yup, Not Blond. RT @KathyKastner: I covet your hair. RT @MeredithGould: @KathyKastner So does that mean you do NOT love my hair, too? #HPM Wed May 25 18:16:09 PDT 2011 GailZahtz @dockj T2 I don't think that suffering is distress that someone can't cope with. I think that you may be coping- but it's hard! #HPM Wed May 25 18:16:13 PDT 2011 MeredithGould @EOLnavigator Ok, thanks. #hpm Wed May 25 18:16:21 PDT 2011
- 8. EOLnavigator Do you think culture or religion influences suffering? #hpm Wed May 25 18:16:36 PDT 2011 MeredithGould BTW, @bentleystewart has a great post at http://healthfaith.com today re: communicatng w/pts. #hpm Wed May 25 18:16:59 PDT 2011 GailZahtz @MarksPhone In my experience, both hcp's and outsiders WANT us to be strong, stoic, "brave" and that minimizes the reality of the pain #HPM Wed May 25 18:17:16 PDT 2011 SheyontheBay @EOLnavigator Yes #hpm Wed May 25 18:17:27 PDT 2011 KathyKastner A big yessrree bob to that RT @EOLnavigator: Do you think culture or religion influences suffering? #hpm Wed May 25 18:17:31 PDT 2011 revdoc I think culture and religion can teach us patterns of coping, give us resources to stand up under adversity #hpm Wed May 25 18:17:55 PDT 2011 EOLnavigator RT @dockj: T2 suffering is what the patient experiences when they are in distress they cannot cope with. Regardless of the source. #hpm Wed May 25 18:18:01 PDT 2011 KathyKastner Nice! RT @revdoc: I think culture and religion can teach us patterns of coping, give us resources to stand up under adversity #hpm Wed May 25 18:18:16 PDT 2011 aliciabloom "@EOLnavigator: Do u think culture/religion influences suffering?" yes. patient perception & values are impacted by culture & religion #hpm Wed May 25 18:18:36 PDT 2011 hollyby Hello all! At Upaya this week, so only lurking tonight! Have a great chat! #hpm Wed May 25 18:18:41 PDT 2011 GailZahtz @dockj What is coping? In the face of tragedy- it's just getting up and dong the next right thing. May not be pretty or clean... #HPM Wed May 25 18:18:50 PDT 2011 SusanCadell I was very pleased to present research about caregiving parents in peds #palliative care today @sickkids via @OTNtelemedicine #hpm #growth Wed May 25 18:19:00 PDT 2011 MeredithGould Culture shapes the ways suffering is perceived and expressed, sure. #hpm Wed May 25 18:19:03 PDT 2011 EOLnavigator @hollyby Thanks for coming! #hpm Wed May 25 18:19:04 PDT 2011
- 9. revdoc Unfortunately, culture and religion can also provide NEGATIVE examples of coping #hpm Wed May 25 18:19:23 PDT 2011 jfclearywisc I actually find the question "are you suffering?" to be very powerful and revealing. Or to ask it of family #hpm Wed May 25 18:19:45 PDT 2011 GailZahtz @aliciabloom @EOLnavigator Yes, definitely said earlier, culture, religions, belief system completely impact what and how we suffer #HPM Wed May 25 18:19:47 PDT 2011 dockj Culture/ religion give us constructs to help us decode suffering in the context of society, but it is still and individual experience. #hpm Wed May 25 18:20:02 PDT 2011 PracticalWisdom Hey Meredith,“I’m hoping for a miracle soon. Quote in Blog RT@MeredithGould.@bentleystewart has a great post at http://healthfaith.com #HPM Wed May 25 18:20:14 PDT 2011 EOLnavigator RT @GailZahtz +1What is coping? In the face of tragedy- its just getting up & doing the next right thing. May not be pretty or clean... #hpm Wed May 25 18:20:28 PDT 2011 EOLnavigator Topic 2 coming in a jiffy..... #hpm Wed May 25 18:20:41 PDT 2011 GailZahtz The book on the Hunan and their experience with medicine in the U.S. is a beautiful example of the impact of culture on getting care. #HPM Wed May 25 18:20:41 PDT 2011 MarksPhone America is death phobic this is the over arching driver of this discussion we do not accept it therefore we dont want to mitigate it #hpm Wed May 25 18:20:47 PDT 2011 MeredithGould RT @dockj: Culture/ religion give us constructs to help us decode suffering in the context of society, #hpm Wed May 25 18:21:00 PDT 2011 jfclearywisc "What do you mean by a miracle?" #hpm Wed May 25 18:21:12 PDT 2011 EOLnavigator RT @jfclearywisc: I actually find the question "are you suffering?" to be very powerful and revealing. Or to ask it of family #hpm Wed May 25 18:21:20 PDT 2011 doctatum I think it reframes things for the family in conflctRT @jfclearywisc: the question "are you suffering?" = very powerful and revealing. #hpm Wed May 25 18:21:29 PDT 2011 culture and religion can be protective factors & sources of strength, but they can also
- 10. culture and religion can be protective factors & sources of strength, but they can also aliciabloom create unique challenges and barriers #hpm Wed May 25 18:21:38 PDT 2011 KathyKastner #hpm Religion caused my best pal great suffering when she felt baby's death was god's punishment Wed May 25 18:21:46 PDT 2011 EOLnavigator T2: How does your perspective on suffering affect how you care for someone who is terminally ill? #hpm Wed May 25 18:21:53 PDT 2011 revdoc @EOLnavigator @GailZahtz Up and dressed is a fine goal if that is the only place you can be at the time #hpm Wed May 25 18:22:08 PDT 2011 dockj RT @MarksPhone: America is death phobic this is the over arching driver of this discussion we do not accept it therefore we dont want to mitigate it #hpm Wed May 25 18:22:32 PDT 2011 DrSnit #hpm oh hai! Been watching hockey. Now I'm here!!! How goes cats? Xx missed you! Wed May 25 18:22:35 PDT 2011 GailZahtz @MeredithGould @dockj @revdoc The real question isn't does culture/religion work- how does it work for the individual patient and family #HPM Wed May 25 18:22:43 PDT 2011 DoctorFisher @jfclearywisc Or even better "In what way are you suffering?" gives patient the open door to talk #hpm Wed May 25 18:22:45 PDT 2011 PracticalWisdom Sigh, how terrible.RT @KathyKastner: #hpm Religion caused my best pal great suffering when she felt babys death was gods punishment #HPM Wed May 25 18:22:51 PDT 2011 EOLnavigator @aliciabloom Irish Catholic (my background) always equate suffering with payment for sins! #hpm Wed May 25 18:22:52 PDT 2011 GLakesCaring RT @EOLnavigator: T2: How does your perspective on suffering affect how you care for someone who is terminally ill? #hpm Wed May 25 18:22:53 PDT 2011 EOLnavigator @DrSnit Hai there to you too! #hpm Wed May 25 18:23:12 PDT 2011 PracticalWisdom So Glad you are Here. Like Superman but GirlRT @DrSnit: #hpm oh hai! Been watching hockey. Now Im here!!! How goes cats? Xx missed you! #HPM Wed May 25 18:23:20 PDT 2011 MarksPhone T2 my vision or the caregivers vision will effect the patient if the patient allows it and then the battle of wills begins #hpm Wed May 25 18:23:24 PDT 2011
- 11. SheyontheBay RT @GailZahtz: The real question isnt does culture/religion work-how does it work for the individual patient and family #hpm Wed May 25 18:23:27 PDT 2011 MeredithGould T2 Takes a lot of consciousness to not project/superimpose one's own stuff onto patients & caregivers. #hpm Wed May 25 18:23:47 PDT 2011 GailZahtz @revdoc @EOLnavigator Succeeding 51% of the time- especially during trauma- is 100% success. #HPM Wed May 25 18:23:55 PDT 2011 DoctorFisher Hi just arrived #hpm Wed May 25 18:24:00 PDT 2011 EOLnavigator RT @doctorfisher: @jfclearywisc Or even better "In what way are you suffering?" gives patient the open door to talk #hpm Wed May 25 18:24:05 PDT 2011 KathyKastner RT @MeredithGould: T2 Takes a lot of consciousness to not project/superimpose one's own stuff onto patients & caregivers. #hpm Wed May 25 18:24:16 PDT 2011 aliciabloom @EOLnavigator i'm part italian catholic and part eastern european jew-- i hear you! #hpm Wed May 25 18:24:20 PDT 2011 revdoc @GailZahtz @revdoc @EOLnavigator Amen, sister! #hpm Wed May 25 18:24:30 PDT 2011 EOLnavigator @PracticalWisdom @KathyKastner So sorry! That happens alot. Makes you suffer too. #hpm Wed May 25 18:24:44 PDT 2011 MeredithGould @aliciabloom We should talk! #hpm Wed May 25 18:24:51 PDT 2011 DoctorFisher @MeredithGould agree, try not to project, yet my patients find it comforting when I share what gives me hope #hpm Wed May 25 18:25:05 PDT 2011 PracticalWisdom Welcome, so glad you come tonight. RT @doctorfisher: Hi just arrived #HPM Wed May 25 18:25:12 PDT 2011 SheyontheBay @EOLnavigator @aliciabloom i heard suffering bought time off in purgatory, now there's no more purgatory->what to do withmy suffering? #hpm Wed May 25 18:25:20 PDT 2011 KathyKastner Basta. Oy. RT @aliciabloom: @EOLnavigator i'm part italian catholic and part eastern european jew-- i hear you! #hpm
- 12. european jew-- i hear you! #hpm Wed May 25 18:25:32 PDT 2011 revdoc T2 risk that caregivers push pt to find meaning pt is not ready to investigate; caregivers are successful if pt finds "closure" #hpm Wed May 25 18:25:46 PDT 2011 MeredithGould @doctorfisher Right and that's not projecting, that's sharing! #hpm Wed May 25 18:25:51 PDT 2011 DrSnit Belief in punishment or Suffering certainly changes both caregiver & patient EOL / illness experiences. #hpm Wed May 25 18:26:01 PDT 2011 GailZahtz Also, neither the outsider nor the person "suffering" knows which even will cause the most pain. We need to be gentle in judgment. #HPM Wed May 25 18:26:09 PDT 2011 EOLnavigator @doctorfisher Thanks for making it! #hpm Wed May 25 18:26:12 PDT 2011 doctorfisher @PracticalWisdom thanks it's always great to 'be' here #hpm Wed May 25 18:26:30 PDT 2011 EOLnavigator RT @doctorfisher: @MeredithGould agree, try not to project, yet my patients find it comforting when I share what gives me hope #hpm Wed May 25 18:26:36 PDT 2011 MeredithGould @aliciabloom Oy vey, Maria...as my mother would say. #hpm Wed May 25 18:26:51 PDT 2011 aliciabloom @MeredithGould love it! #hpm Wed May 25 18:27:14 PDT 2011 EOLnavigator I find, when I can identify with pt.'s suffering & they realize we have common understanding, their suffering decreases. #hpm Wed May 25 18:27:15 PDT 2011 RossJeanette Hi all I'm joining in late. I'll lurk u til I can figure out what we are talking about #HPM Wed May 25 18:27:37 PDT 2011 doctorfisher @MeredithGould yes and I think sharing my own views makes me more 'human' plus if we disagree, it's on the table #hpm Wed May 25 18:27:38 PDT 2011 EOLnavigator Hope is definitely an important part of relief from suffering. #hpm Wed May 25 18:27:56 PDT 2011 DrSnit @MeredithGould yes. Also to not be offended or annoyed by seemingly outlandish beliefs. Oy. "what did you do to make god mad?" #hpm
- 13. beliefs. Oy. "what did you do to make god mad?" #hpm Wed May 25 18:28:04 PDT 2011 doctorfisher RT @EOLnavigator: I find, when I can identify with pt.'s suffering & they realize we have common understanding, their suffering decreases. #hpm Wed May 25 18:28:07 PDT 2011 EOLnavigator @RossJeanette Glad you made it! #hpm Wed May 25 18:28:13 PDT 2011 GailZahtz @EOLnavigator I think the key with connecting and identifying with other's suffering is validating their own perceptions of it. #HPM Wed May 25 18:28:18 PDT 2011 MeredithGould @RossJeanette We're talking about suffering. LOL. #hpm Wed May 25 18:28:21 PDT 2011 dockj I think the concept of total pain which accounts for all sources of suffering is a useful construct. #hpm Wed May 25 18:28:29 PDT 2011 aliciabloom what we perceive as suffering should be left outside the patient's room, so that we can fully understand their unique suffering #hpm Wed May 25 18:28:29 PDT 2011 DoctorFisher RT @EOLnavigator: Hope is definitely an important part of relief from suffering. #hpm Wed May 25 18:28:34 PDT 2011 EOLnavigator @rossjeanette "Suffering" #hpm Wed May 25 18:28:37 PDT 2011 MeredithGould RT @dockj: I think the concept of total pain which accounts for all sources of suffering is a useful construct. #hpm Wed May 25 18:29:07 PDT 2011 dockj Physical/family dysfunction / relationships/ religious/ cultural. #hpm Wed May 25 18:29:15 PDT 2011 doctorfisher RT @GailZahtz: @EOLnavigator I think the key with connecting and identifying with other's suffering is validating their own perceptions of it. #HPM Wed May 25 18:29:21 PDT 2011 EOLnavigator RT @DrSnit: @MeredithGould yes. Also 2 not be offended or annoyed by outlandish beliefs. Oy. "what did you do 2 make god mad?" #hpm Wed May 25 18:29:24 PDT 2011 MeredithGould @dockj Total pain as in physical, mental and spiritual, right? #hpm Wed May 25 18:29:25 PDT 2011 MeredithGould And, gee, what the heck...also total pain as in familial?1? #hpm
- 14. MeredithGould And, gee, what the heck...also total pain as in familial?1? #hpm Wed May 25 18:30:20 PDT 2011 dockj Any or all can be the biggest source of suffering at any one time #hpm Wed May 25 18:30:22 PDT 2011 KathyKastner #hpm I know this is a serious discussion, but 2nite I'm suffering cuz I have piles of reading for QA committee meeting in the am. Wed May 25 18:30:27 PDT 2011 EOLnavigator RT @DrSnit: Belief in punishment or Suffering certainly changes both caregiver & patient EOL / illness experiences. #hpm Wed May 25 18:30:32 PDT 2011 aliciabloom hope is important, but often hope = cure, which isn't always reality. sometimes we need to help patients/families reframe hope. #hpm Wed May 25 18:30:43 PDT 2011 revdoc Should we question pts about distress we see in them even if they do not report they are suffering? #hpm Wed May 25 18:30:54 PDT 2011 GailZahtz No offense, but making fun of other people's belief's (which may seem silly or destructive to you) is the exact opposite of support #HPM Wed May 25 18:31:04 PDT 2011 PracticalWisdom MD told Wife/Patient Don't ask a (?) right now if U don't want truth. Arc of Life & Love, Unbent by Treatment http://nyti.ms/kJ7Sr2 #HPM Wed May 25 18:31:10 PDT 2011 doctorfisher RT @aliciabloom: hope is important, but often hope = cure, which isn't always reality. sometimes we need to help patients/families reframe hope. #hpm Wed May 25 18:31:20 PDT 2011 EOLnavigator @aliciabloom Do you think that you have to have suffered yourself to understand someone else's suffering? #hpm Wed May 25 18:31:23 PDT 2011 GailZahtz @revdoc Absolutely, may people suffer the most in silence, and won't discuss or heal if not directly asked. #HPM Wed May 25 18:31:54 PDT 2011 PracticalWisdom RT @GailZahtz: Making fun of other peoples beliefs (which may seem silly or destructive to you) is the exact opposite of support #HPM Wed May 25 18:31:57 PDT 2011 SheyontheBay @aliciabloom often to facilitate change in what they are hoping for...a peaceful passing, instead of cure #hpm Wed May 25 18:31:59 PDT 2011 KathyKastner RT @SheyontheBay: @aliciabloom often to facilitate change in what they are hoping for...a peaceful passing, instead of cure #hpm Wed May 25 18:32:17 PDT 2011
- 15. MeredithGould @EOLnavigator Great question. Probably everyone suffers but some have denial so thick they don't cop to it. #hpm Wed May 25 18:32:21 PDT 2011 GailZahtz @PracticalWisdom Thanks Lisa! #HPM Wed May 25 18:32:41 PDT 2011 MarksPhone I wonder, do HCP have the wear with all to identify all the issues surrounding the patient and family and navigate a path? #hpm Wed May 25 18:32:53 PDT 2011 DoctorFisher @aliciabloom Yes, I never let my patients "give up hope", I help them shift their hope to realistic goals #hpm Wed May 25 18:32:55 PDT 2011 GailZahtz @DoctorFisher For some reason, we haven't crossed paths. Nice to meet you, and get to know you, and hope to meet again :) #HPM Wed May 25 18:33:10 PDT 2011 KathyKastner Yep. My hubRT @MeredithGould: @EOLnavigator Great Q. Probably everyone suffers but some have denial so thick they don't cop to it. #hpm Wed May 25 18:33:17 PDT 2011 RossJeanette The physical suffering may be "easier" to identify. #HPM Wed May 25 18:33:26 PDT 2011 EOLnavigator Sometimes they don't know RT @revdoc: Should we question pts about distress we C in them even if they do not report they are suffering? #hpm Wed May 25 18:33:28 PDT 2011 GailZahtz @DoctorFisher @aliciabloom Is there an appropriate time and place when a patient is entitled to give up hope? Question, not sure. #HPM Wed May 25 18:33:47 PDT 2011 KathyKastner How wonderful of you RT @DoctorFisher: @aliciabloom I never let my pts "give up hope", I help them shift their hope 2 realistic goals #hpm Wed May 25 18:34:00 PDT 2011 aliciabloom @EOLnavigator think suffering is something we all experience in life, regardless of the source. it's part of being human. #hpm Wed May 25 18:34:09 PDT 2011 DoctorFisher @GailZahtz You as well! #hpm Wed May 25 18:34:10 PDT 2011 EldrcareConsult Hey guys so sorry i am late! #hpm Wed May 25 18:34:10 PDT 2011 revdoc @EOLnavigator @revdoc But is that my deciding the pt is suffering? #hpm Wed May 25 18:34:25 PDT 2011
- 16. EOLnavigator @EldrcareConsult Hey there! We are talking about suffering #hpm Wed May 25 18:34:39 PDT 2011 EOLnavigator RT @doctorfisher: @aliciabloom Yes, I never let my patients "give up hope", I help them shift their hope to realistic goals #hpm Wed May 25 18:35:04 PDT 2011 MeredithGould Great post about hope and communicating w/pts: http://bit.ly/lHaS1l #hpm Wed May 25 18:35:04 PDT 2011 KathyKastner Good Q. RT @revdoc: @EOLnavigator @revdoc But is that my deciding the pt is suffering? #hpm Wed May 25 18:35:06 PDT 2011 EOLnavigator RT @RossJeanette: The physical suffering may be "easier" to identify. #hpm Wed May 25 18:35:10 PDT 2011 DrSnit @GailZahtz have you ever watched a mother ask her daughter what she did to anger god? It is hard to deal with their needs fully #hpm Wed May 25 18:35:35 PDT 2011 MeredithGould RT @DrSnit: Belief in punishment or Suffering certainly changes both caregiver & patient EOL / illness experiences. #hpm Wed May 25 18:35:40 PDT 2011 EOLnavigator RT @KathyKastner RT @MeredithGould Probably everyone suffers but some have denial so thick they dont cop to it. #hpm Wed May 25 18:35:44 PDT 2011 PracticalWisdom Great To See You. RT @EldrcareConsult: Hey guys so sorry i am late! #HPM Wed May 25 18:35:59 PDT 2011 aliciabloom @GailZahtz- i agree with @DoctorFisher in that we have to help people find hope & meaning all the time, even if it means reframing it. #hpm Wed May 25 18:36:13 PDT 2011 doctorfisher @GailZahtz sure, we need to let patients grieve loss. But I don't want to leave them hopeless so must offer some form of help #hpm Wed May 25 18:36:47 PDT 2011 whole_patients RT @MeredithGould: Great post about hope and communicating w/pts: http://bit.ly/lHaS1l #hpm Wed May 25 18:36:53 PDT 2011 KathyKastner Is it only #hpm-ers who are trained to re-frame? Wed May 25 18:36:58 PDT 2011 EOLnavigator Never! Hope to die well. RT @GailZahtz: @DoctorFisher @aliciabloom Is there an
- 17. EOLnavigator Never! Hope to die well. RT @GailZahtz: @DoctorFisher @aliciabloom Is there an appropriate time & place when a pt can give up hope? #hpm Wed May 25 18:36:59 PDT 2011 GailZahtz @DrSnit I've been told that either in this life or a former life I did something that I'm doing "teshuvah" for. (need to go to a 2nd..) #HPM Wed May 25 18:37:12 PDT 2011 MarksPhone http://bit.ly/jt92nj Jimmie Holland the Human Side of Cancer #hpm Wed May 25 18:37:15 PDT 2011 MeredithGould RT @KathyKastner: Is it only #hpm-ers who are trained to re-frame?<--my guess is yes Wed May 25 18:37:23 PDT 2011 EOLnavigator Ur only frame of reference tho RT @KathyKastner: Good Q. RT @revdoc: @EOLnavigator @revdoc But is that my deciding the pt is suffering? #hpm Wed May 25 18:38:05 PDT 2011 GailZahtz @DrSnit On one hand, very hard to hear, process, benefit. On another, my personal belief system from where it comes, helps me cope. #HPM Wed May 25 18:38:17 PDT 2011 EOLnavigator Topic 3 is almost upon us.... #hpm Wed May 25 18:38:19 PDT 2011 revdoc @MeredithGould @KathyKastner Reframing not a big part of my medical education... #hpm Wed May 25 18:38:24 PDT 2011 jfclearywisc Said it b4; Tulsky (Hope or Hubris, JPM) Hope=trust. However bad, things will work out. #hpm Wed May 25 18:38:32 PDT 2011 DoctorFisher @KathyKastner I was trained to re-frame during #geriatrics fellowship #hpm Wed May 25 18:38:42 PDT 2011 EOLnavigator Different topic...we've suffered enough! #hpm Wed May 25 18:38:59 PDT 2011 MeredithGould @revdoc Because it's too "soft" and not "science," right? #hpm Wed May 25 18:39:01 PDT 2011 MeredithGould @EOLnavigator LOLOL...good one #hpm Wed May 25 18:39:09 PDT 2011 GailZahtz @DrSnit I want to strangle people who say "it's all for the best" or "we're not given more than we can handle" others benefit from that #HPM Wed May 25 18:39:19 PDT 2011 revdoc @MeredithGould @revdoc Yep #hpm
- 18. revdoc @MeredithGould @revdoc Yep #hpm Wed May 25 18:39:30 PDT 2011 KathyKastner I have pondered hope and false hope http://tinyurl.com/3yzvexh #hpm Wed May 25 18:39:35 PDT 2011 KathyKastner Ha! RT @EOLnavigator: Different topic...we've suffered enough! #hpm Wed May 25 18:39:57 PDT 2011 PracticalWisdom RT @KathyKastner: Ha! RT @EOLnavigator: Different topic...weve suffered enough! #HPM Wed May 25 18:40:25 PDT 2011 aliciabloom i often feel like #hospice & #palliative care is as much an art as it is a science #hpm Wed May 25 18:40:30 PDT 2011 EOLnavigator T3: When you search for information about end of life care online, what kind of information are you looking for & do you find it? #hpm Wed May 25 18:40:48 PDT 2011 DrSnit @GailZahtz not the same as watching it as a provider but you get it from an advocacy perspective. #hpm Wed May 25 18:40:54 PDT 2011 KathyKastner Hope and aging.Gr8 combo RT @DoctorFisher: @KathyKastner I was trained to re- frame during #geriatrics fellowship #hpm Wed May 25 18:41:06 PDT 2011 GailZahtz @aliciabloom @DoctorFisher @EOLnavigator Studies show that outcomes of same surgeries affected by hope. #HPM Wed May 25 18:41:07 PDT 2011 PracticalWisdom Great Truth 2 That. Thank you! RT @aliciabloom: i often feel like #hospice & #palliative care is as much an art as it is a science #HPM Wed May 25 18:41:11 PDT 2011 revdoc @aliciabloom Absolutely! #hpm Wed May 25 18:41:12 PDT 2011 dockj RT @aliciabloom: i often feel like #hospice & #palliative care is as much an art as it is a science #hpm Wed May 25 18:41:19 PDT 2011 DrSnit RT @EOLnavigator: T3: When you search for information about end of life care online, what kind of information are you looking for & do you find it? #hpm Wed May 25 18:41:25 PDT 2011 MarksPhone Finding it is one thing, wanting to know what it says is another there is a gap in acquiring this knowledge to the problem at hand #hpm Wed May 25 18:42:00 PDT 2011
- 19. Wed May 25 18:42:00 PDT 2011 revdoc T3 More research is being done, but too much old literature was anecdotal; I'm looking for best practices #hpm Wed May 25 18:42:14 PDT 2011 EOLnavigator It makes me feel defeated when I hear that. RT @GailZahtz: @DrSnit #hpm Wed May 25 18:42:21 PDT 2011 dockj RT @EOLnavigator: T3: When you search for information about end of life care online, what kind of information are you looking for & do you find it? #hpm Wed May 25 18:42:22 PDT 2011 DebErupts RT @aliciabloom I often feel like #hospice & #palliative care is as much an art as it is a science #hpm | Absolutely Wed May 25 18:42:34 PDT 2011 MeredithGould @MarksPhone Brilliant...wanted to RT but it was too long. :-( #hpm Wed May 25 18:42:39 PDT 2011 dockj RT @revdoc: T3 More research is being done, but too much old literature was anecdotal; I'm looking for best practices #hpm Wed May 25 18:42:42 PDT 2011 EOLnavigator RT @PracticalWisdom: Great Truth 2 That. RT @aliciabloom: i often feel like #hospice & #palliative care is as much art as it is science #hpm Wed May 25 18:43:00 PDT 2011 GLakesCaring RT @EOLnavigator: T3: When you search for info about end of life care online, what kind of info are you looking for & do you find it? #hpm Wed May 25 18:43:13 PDT 2011 EOLnavigator RT @dockj: RT @revdoc: T3 More research is being done, but too much old literature was anecdotal; Im looking for best practices #hpm Wed May 25 18:43:28 PDT 2011 dockj I spend more time hard searching NLM for #hpm questions than any other clinical questions I have. Wed May 25 18:43:50 PDT 2011 GailZahtz @DrSnit @EOLnavigator The juggle is for pt, caregiver, provider, family, allowing some kind of freedom of perspective allowing dignity #HPM Wed May 25 18:44:02 PDT 2011 PracticalWisdom RT @MarksPhone: Finding it is 1thing, wanting 2 know what it says is another. A gap in acquiring this knowledge to the problem at hand #HPM Wed May 25 18:44:17 PDT 2011 EOLnavigator Best practices in EOL care is pandora's box IMO! #hpm Wed May 25 18:44:28 PDT 2011
- 20. dockj RT @EOLnavigator: Best practices in EOL care is pandora's box IMO! #hpm Wed May 25 18:45:26 PDT 2011 PracticalWisdom @MarksPhone: Sincerely think/Feel you are one of the sharpest Crayons in the Box. #HPM Wed May 25 18:45:37 PDT 2011 MarksPhone the real issue is getting the seeking of a this knowledge to want to apply it. In a death phobic society we want to survial DFS etc #hpm Wed May 25 18:45:38 PDT 2011 GailZahtz We should be allowed to rage, or find irrational comfort, or even to control our hope if that empowers us, yes? #HPM @EOLnavigator @DrSnit Wed May 25 18:45:41 PDT 2011 revdoc @EOLnavigator We can use good information to help find most effective, least toxic, cost-effective regimens though #hpm Wed May 25 18:45:42 PDT 2011 DoctorFisher T3 sometimes my search is less about info and more about finding people with similar mission (like you fine people) #hpm Wed May 25 18:45:47 PDT 2011 DrSnit There is too much separation between provider, patient, caregiver and "what next" in palliative and hospice care right now. #hpm Wed May 25 18:45:47 PDT 2011 MeredithGould RT @DrSnit: There is too much separation between provider, patient, caregiver and "what next" in palliative and hospice care right now. #hpm Wed May 25 18:45:56 PDT 2011 KathyKastner Aren't best practices 'situational' in eol care?RT @EOLnavigator: Best practices in EOL care is pandora's box IMO! #hpm Wed May 25 18:46:04 PDT 2011 EOLnavigator I've noticed that alot of healthcare sites really shy away from EOL care topics #hpm Wed May 25 18:46:09 PDT 2011 aliciabloom political discourse about end of life care is frustrating ("death panels" "rationing"). fosters fear & creates barriers for patients #hpm Wed May 25 18:46:12 PDT 2011 GailZahtz Agree! MT @DrSnit: Too much separation between provider, patient, caregiver and "what next" in palliative and hospice care right now. #hpm Wed May 25 18:46:21 PDT 2011 PracticalWisdom RT @doctorfisher: T3 sometimes my search is less about info and more about finding people with similar mission (like you fine people) #HPM Wed May 25 18:46:28 PDT 2011 dockj The problems with research in #hpm that good outcomes = bad outcomes for most medical research.
- 21. Wed May 25 18:46:38 PDT 2011 KathyKastner RT @GailZahtz: We should be allowed to rage, or find irrational comfort, or even to control our hope if that empowers us, yes? #HPM @EOL ... Wed May 25 18:46:54 PDT 2011 MarksPhone The edu issue at hand is changing the learners desire to uptake knowledge and apply, we dont know what the learners need to know #hpm Wed May 25 18:46:59 PDT 2011 EOLnavigator RT @revdoc: @EOLnavigator We can use good information to help find most effective, least toxic, cost-effective regimens though #hpm Wed May 25 18:47:02 PDT 2011 GLakesCaring T3: Trick is to find info that doesn't "scare" people away from using HPM. #hpm Wed May 25 18:47:05 PDT 2011 doctatum could you say more?RT @DrSnit: too much separation between provider, patient, caregiver and "what next" in palliative and hospice care #hpm Wed May 25 18:47:18 PDT 2011 GailZahtz IMO Palliative physicians, caregivers and providers are the most COURAGEOUS because they can't cure. #HPM Wed May 25 18:47:29 PDT 2011 MeredithGould RT @GailZahtz: IMO Palliative physicians, caregivers and providers are the most COURAGEOUS because they can't cure. #HPM Wed May 25 18:47:46 PDT 2011 dockj Even in the best of circumstances, there has to be subjectivity in most EOL research. #hpm Wed May 25 18:48:03 PDT 2011 EOLnavigator TY. RT @doctorfisher: T3 sometimes my search is less about info & more about finding people with similar mission (like you fine people) #hpm Wed May 25 18:48:05 PDT 2011 KathyKastner How about this http://tinyurl.com/4uphd7c @GLakesCaring: T3: Trick is to find info that doesn't "scare" people away from using HPM. #hpm Wed May 25 18:48:07 PDT 2011 PracticalWisdom T3: @doctorfisher Do you tell other MD's about finding people with similar mission? I think so few really understand the beneifts #HPM Wed May 25 18:48:12 PDT 2011 EOLnavigator Precisely! RT @KathyKastner: Arent best practices situational in eol care? Best practices in EOL care is pandoras box IMO! #hpm Wed May 25 18:48:44 PDT 2011 aliciabloom RT @GailZahtz: IMO Palliative physicians, caregivers and providers are the most COURAGEOUS because they cant cure. #hpm Wed May 25 18:48:45 PDT 2011
- 22. DrSnit Yes! RT @GailZahtz: IMO Palliative physicians, caregivers and providers are the most COURAGEOUS because they can't cure. #HPM Wed May 25 18:48:47 PDT 2011 MeredithGould @dockj There's subjectivity in all research -- we just pretend there isn't. #hpm Wed May 25 18:49:03 PDT 2011 MarksPhone @GLakesCaring That's the point what do learners want I believe a need assessment to understand caregivers and patients is critical #hpm Wed May 25 18:49:04 PDT 2011 PracticalWisdom RT @DrSnit: Yes! RT @GailZahtz: IMO Palliative physicians, caregivers and providers are the most COURAGEOUS because they cant cure. #HPM Wed May 25 18:49:20 PDT 2011 KathyKastner And practice, too, no? RT @dockj: Even in the best of circumstances, there has to be subjectivity in most EOL research. #hpm Wed May 25 18:49:24 PDT 2011 EOLnavigator @MarksPhone That's why I asked the Q. I see alot of what we think people want to know! #hpm Wed May 25 18:49:32 PDT 2011 GailZahtz T3: Especially in palliative information, it needs to have many formats and messages so that people can access it within their way. #HPM Wed May 25 18:49:58 PDT 2011 EOLnavigator RT @GLakesCaring: T3: Trick is to find info that doesnt "scare" people away from using HPM. #hpm Wed May 25 18:49:59 PDT 2011 revdoc I don't know about the rest of you...my treatment plans are ALWAYS the best! ;) #hpm Wed May 25 18:50:09 PDT 2011 SheyontheBay RT @KathyKastner: Arent best practices situational in eol care? Best practices in EOL care is pandoras box IMO! #hpm Wed May 25 18:50:21 PDT 2011 dockj @KathyKastner yes. #hpm Wed May 25 18:50:31 PDT 2011 PracticalWisdom Could you clarify RT @EOLnavigator: @MarksPhone Thats why I asked the Q. I see alot of what we think people want to know! #HPM Wed May 25 18:50:37 PDT 2011 MarksPhone EOL research should be paired with a study of knowledge translation How can what we learn in EOL be up took (LOL) better #hpm Wed May 25 18:50:49 PDT 2011 EOLnavigator @GailZahtz The value is in the relief of suffering & improvement in QOL without cure.
- 23. EOLnavigator @GailZahtz The value is in the relief of suffering & improvement in QOL without cure. #hpm Wed May 25 18:50:53 PDT 2011 TAFORU RT @DrSnit: There is too much separation between provider, patient, caregiver and "what next" in palliative and hospice care right now. #hpm Wed May 25 18:51:02 PDT 2011 MeredithGould Re: research methods & subjectivity, read @SusannahFox post: http://bit.ly/jHrnH4 #HPM Wed May 25 18:51:13 PDT 2011 Tanrita24 RT @DrSnit: There is too much separation between provider, patient, caregiver and "what next" in palliative and hospice care right now. #hpm Wed May 25 18:51:36 PDT 2011 DrSnit p value of what? RT @MeredithGould: @dockj There's subjectivity in all research -- we just pretend there isn't. #hpm Wed May 25 18:51:46 PDT 2011 MeredithGould @colleen_young Was just recommending folks at the #HPM chapt read that article. #hcsmca #hcsmeu Wed May 25 18:51:53 PDT 2011 SheyontheBay VERY cautious about sites I choose 4 research. Like with most "disease-specific" sites, can b fraught with misinformation #hpm Wed May 25 18:52:18 PDT 2011 KathyKastner Truth be told..RT @MeredithGould: @dockj There's subjectivity in all research -- we just pretend there isn't. #hpm Wed May 25 18:52:27 PDT 2011 doctorfisher T3 lots of 'subjective' research in social sciences and even #psych, can #hpm learn from them? Wed May 25 18:53:02 PDT 2011 GailZahtz Palliate: to ease (as a disease) without curing. Webster's Dictionary. I've always loved that. TO EASE- our goal. #HPM Wed May 25 18:53:11 PDT 2011 EOLnavigator @PracticalWisdom @marksphone The edu issue is that we dont know what the learners need to know.asked Q to C if the info found is good #hpm Wed May 25 18:53:39 PDT 2011 AliveHospice A must-read for #nurses, especially those who work in #pediatrics: http://bit.ly/iCdJC2 #hpm Wed May 25 18:54:04 PDT 2011 SheyontheBay @GailZahtz And dis-ease = not at ease #hpm Wed May 25 18:54:23 PDT 2011 doctorfisher @GailZahtz I like that- we take the 'dis' out of 'disease'! #hpm Wed May 25 18:54:32 PDT 2011
- 24. EOLnavigator Agree & it's scary! RT @MeredithGould: @dockj Theres subjectivity in all research -- we just pretend there isnt. #hpm Wed May 25 18:54:38 PDT 2011 dockj RT @doctorfisher: T3 lots of 'subjective' research in social sciences and even #psych, can #hpm learn from them? Wed May 25 18:54:51 PDT 2011 MeredithGould @DoctorFisher Subjective research, aka, qualitative research used to be essential sociology & anthropology #hpm Wed May 25 18:54:54 PDT 2011 EOLnavigator I can tell! RT @revdoc: I dont know about the rest of you...my treatment plans are ALWAYS the best! ;) #hpm Wed May 25 18:55:24 PDT 2011 GailZahtz @DoctorFisher @SheyontheBay Yes, we're easing the pain for others, we aren't taking it away, can't cure it, shouldn't minimize it. #HPM Wed May 25 18:55:31 PDT 2011 MarksPhone Knowledge translation is the scientific study of methods for closing the knowledge- to-practice gap what is gap for pateints and HCP? #hpm Wed May 25 18:55:55 PDT 2011 MeredithGould Factoid about me: exquisitely well trained in qualitative methods! Can do & understand quantitative stuff but not under its thrall #hpm Wed May 25 18:56:20 PDT 2011 SheyontheBay @MeredithGould @DoctorFisher Cant really do controlled studies in EOL care. Not ethical! #hpm Wed May 25 18:56:35 PDT 2011 rebeccatrocki RT @MeredithGould: Factoid about me: exquisitely well trained in qualitative methods! Can do & understand quantitative stuff but not under its thrall #hpm Wed May 25 18:56:44 PDT 2011 GailZahtz @MarksPhone Gap for patients on HCP? That 10 point "pain scale" Funny, yet true! #HPM Wed May 25 18:56:46 PDT 2011 EOLnavigator Thank you all for sharing your thoughts. Any final words of wisdom? #hpm Wed May 25 18:56:52 PDT 2011 MeredithGould @SheyontheBay @DoctorFisher Even if you could, why would you? Makes NO sense given the research questions. #hpm Wed May 25 18:57:14 PDT 2011 revdoc @MarksPhone What do I have? What are my options? What are risks/benefits? Best and worst case? #hpm Wed May 25 18:57:14 PDT 2011
- 25. MarksPhone @EOLnavigator we can apply priciples of adult to identify problems to be solved #hpm Wed May 25 18:57:19 PDT 2011 GailZahtz Final thoughts- validate others' pain and suffering, support them how they need, ease and comfort how individually works. #HPM Wed May 25 18:57:51 PDT 2011 KathyKastner #hpm we (non hcp) need to know more about dying as well as eol options (hence my post, she said encouragingly)http://tinyurl.com/26k4kpm Wed May 25 18:58:40 PDT 2011 GailZahtz Rockin' Thanks to "classic" and new people from #HPM. Congratz and thanks @EOLnavigator for doing a great job moderating! Love to all :) Wed May 25 18:58:40 PDT 2011 PracticalWisdom @EOLnavigator @marksphone and I R Adult Educators. We believe in the importance of a Need Assessment & Androgogy. It's in our Blood. #HPM Wed May 25 18:58:45 PDT 2011 revdoc "How are you suffering?" is a very powerful tool #hpm Wed May 25 18:58:52 PDT 2011 EOLnavigator RT @MarksPhone: @EOLnavigator we can apply priciples of adult to identify problems to be solved #hpm Wed May 25 18:58:58 PDT 2011 Lux_Seeker RT @KimberlySMoore: Musical Analgesia: Using Music for #Pain http://bit.ly/kFvLSZ #musictherapy #hpm #cancer Wed May 25 18:59:04 PDT 2011 pamojamo RT @AliveHospice: A must-read for #nurses, especially those who work in #pediatrics: http://bit.ly/iCdJC2 #hpm Wed May 25 18:59:07 PDT 2011 KathyKastner RT @EOLnavigator: RT @MarksPhone: @EOLnavigator we can apply priciples of adult to identify problems to be solved #hpm Wed May 25 18:59:15 PDT 2011 DrSnit You cats rock my socks! Thanks for all the amazing insight tonight! Great moderating! #HPM Wed May 25 18:59:16 PDT 2011 EOLnavigator RT @GailZahtz: Final thoughts- validate others pain and suffering, support them how they need, ease and comfort how individually works. #hpm Wed May 25 18:59:16 PDT 2011 MeredithGould Final thoughts: Listen carefully with care & caring. Be present. Don't get hung up on the so-called science of care delivery. #hpm Wed May 25 18:59:25 PDT 2011
- 26. KathyKastner RT @MeredithGould: Final thoughts: Listen carefully with care & caring. Be present. Don't get hung up on the so-called science of care delivery. #hpm Wed May 25 18:59:37 PDT 2011 EOLnavigator RT @KathyKastner: #hpm we (non hcp) need to know more about dying as well as eol options (hence my post) http://tinyurl.com/26k4kpm #hpm Wed May 25 18:59:38 PDT 2011 MarksPhone Obviously I am not being clear here this is not about the obvious but the issues that impede patients family & HPC from knowledge #hpm Wed May 25 18:59:38 PDT 2011