By Christine R. Olsen, RN
When the first words I hear in the morning are: “I haven’t pooped in a week,” I know it’s going to be an interesting day. About a month into my time working at Hammer, I woke up to one of those calls from an individual we support. Now, I’m a nurse, so to be honest, this wasn’t the first time I’d been called upon to relieve a bowel, nor will it be the last. I drove out to the house medically confident of what I needed to do to make the situation right. When I arrived, I was greeted by a rather uncomfortable looking young man. I explained what I was going to do, he nodded gratefully, said he understood, and willingly got into position. But as I gestured to insert an enema, his eyes widened and in a tone of disbelief and terror he groaned, “Where do you think you’re gonna put that?!”
Prior to working at Hammer, my experience with intellectually disabled populations was limited. In the past, when I described a procedure and a patient told me they understood, I could take them at their word. This was my first Hammer lesson: healthcare is not one size fits all. Further, the people we serve are not just patients; they are active participants in their own care and have a right to be cared for and communicated with in a way that’s appropriate for their individual needs.
Hammer has reinforced these values by building its Health Service Department on a foundation of person-centered care. Traditionally, healthcare has been delivered through a hierarchical model in which the healthcare provider bestows their education and experience upon their patient and is ultimately responsible for deciding the course of care. Conversely, in the philosophy of person-centered care, decision making is returned to the people we serve, regardless of their functional or cognitive ability, so that their personal goals and preferences become central to care planning. However, this requires that the healthcare professional take a step back to act as an advisor and advocate rather than simply a provider.
In the year I’ve been a nurse with Hammer, I’ve come to understand that my role here is not just to deliver healthcare but to collaborate with the people we serve and their caregivers to develop creative and appropriate approaches to ensure that their health related needs and preferences are met in ways that are both individualized and meaningful. I’d be lying if I said person-centered care was a concept I learned once and instantly understood; as a nursing professional I continue to be challenged by this every day. There are certainly times when I feel doing things “my way” might save time and energy. But none of us work at Hammer because it’s easy; we’re here to make life better for the people we support. That’s why when I see creative strategies like incentive driven weight loss plans at our homes, or a DSP urging a doctor to speak directly to the person we support rather than addressing staff, I am pleasantly reminded that this person-centered philosophy actually runs through all that Hammer does day in and day out.