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Service LearningDenise MonteroFerris State UniversityAgency DescriptionReverence Home Health & Hospice in Grand Blanc, MI provides care, state-wide through the Michigan Health Ministries of Ascension Health Borgess Health, Genesys Health System, St. John Providence, St. Joseph Health System and St. Marys of Michigan. Home Health ServicesHospice ServicesInfusion ServicesGrief Support (Reverence, 2014).

Reverence Home Health and Hospice is a non-profit organization in Grand Blanc, MI. They work in conjunction with the Michigan Health Ministries of Ascension Health; Borgess Health, Genesys Health system, St. John Providence, St. Joseph Health System and St. Marys of Michigan. It is through these agencies that they offer the following services:Home Health Services Home care is coordinated with physicians to provide care and services in the home for patients recovering from an acute illness, trauma or surgery. Staff work with patients to promote their wellness and independence, and adjust to meet the changing needs of the patient. Almost any care that is provided in a hospital, physicians office, clinic or rehabilitation facility is also available for homebound patients.Hospice - Hospice care allows terminally ill patients and their families to remain together in the comfort and dignity of their own home. The hospice team of physicians, nurses, nursing assistants, dietitians, social workers, clergy and volunteers are dedicated to providing compassionate medical and emotional care. Reverence strives to provide the best quality of life through expert pain control, symptom management, psycho-social and spiritual support in accordance with the individual patient wishes.Infusion Services Reverence offers pharmaceutical support and infusion administration in the home environment. Registered pharmacists provide prescribed dosing and monitoring, and supervise the compounding of all pharmaceuticals. Registered nurses assess and monitor the patients progress with therapy and work closely with caregivers to provide an individualized plan of care. Therapy services provided by Reverence Home Health & Hospice include: Total parenteral nutrition (TPN) Antibiotic/antifungal/antiviral therapy Pain management (subcutaneous, intravenous) Hydration management/electrolyte replacement Anti-emetic therapy Corticosteroid therapy Magnesium infusions Respiratory unit-dose medications Grief Support - Losing a loved one is difficult. It may raise questions that have no simple answers. Going through grief is difficult but it is part of the healing process. Reverence offers grief support sessions that are designed to provide a safe environment to talk about feelings as they relate to loss, to find new ways to cope with these feelings and changes in one's life and to identify new sources of strength and hope.

2Volunteer RoleHospice Volunteer:Provide companionship, Provide respite for family caregiversRunning errandsSupport for individuals at home or in a long term care facilityAdministrative assistance

There are many volunteer opportunities available with Reverence. Some of those opportunities are: Providing companionship (either at a patients home or the Genesys Convalescent Center); providing respite for caregivers; running errands for patients or family members; or administrative assistance at the convalescent center and Reverence main headquarters. I chose to offer my time with those hospice patients at Genesys Convalescent Center. The hospice patients are housed in the newly renovated hospice wing of the facility. Each room is decorated to resemble a bedroom at home, rather than a hospital room. My role as a volunteer consisted of: offering companionship to the hospice patients, helping with meal trays, transporting patients to the dining room and helping with administrative duties in the office.3Critical ReflectionGiving my time at Reverence Home Health and Hospice has allowed me to meet the following RN to BSN program outcomes:Collaborative Leadership - Working with other disciplines as a team towards a common goal.Professionalism - My research and leadership skills that have developed during the course of the RN to BSN program have supported my ability to work as an individual as well as in the group setting.Generalist Nursing Practice - Organize the interdisciplinary health care needs of diverse populations (FSU, 2011).

My service with Reverence Hospice has allowed me to meet the following RN to BSN outcomes with FSU:Collaborative Leadership Working with the hospice director, Loraine Travis, as well as the nurses, aides and other volunteers reinforced my ability to collaborate on the care of the hospice patients and their families.Professionalism My research and leadership skills that have developed in the RN to BSN program have supported my ability to work as an individual as well as a team member in my clinical setting. Many of the physicians that I worked with on a daily basis, also worked with Reverence Hospice. After receiving training with hospice and spending time with the patients, I felt confident in speaking with families and answering questions about hospice.Generalist Nursing Practice This outcome supports the organization of the interdisciplinary health care needs of diverse populations. I met this outcome through my collaboration with the patient, hospice care givers, support staff, physicians and family members, all working towards what is in the best interest of the hospice patient.

4SynthesisFSU has four criteria related to the service learning project (FSU, 2011). They are:Develop a plan for volunteer service.Completed in conjunction with Reverence Home Health & HospiceProvide a health-related service to a community in need.20 hours of community service completed at Genesys Convalescent Center in their hospice wing.Work with FSU faculty to create the volunteer experience.Completed as directed and approved by Dana Lehmann, instructor at Ferris State University, as well as Loraine Travis, director of Reverence Home Health and Hospice.Complete a capstone assignment that reflects on the project and personal growth.Completed through the service learning experience at Reverence Home Health and Hospice.

FSU has four criteria related to the service learning project. They are:Develop a plan for volunteer service This criteria was met in conjunction with Reverence Home Health and Hospice through their orientation and training period.Provide a health-related service to a community in need The community in need are the hospice patients at the Genesys Convalescent Center. Many of these individuals have no family or visitors; no one should spend their last days alone. This criteria was met through the 20 hours of service provided.Complete a capstone assignment that reflects on the project and personal growth This capstone assignment was met through the service learning volunteer experience at Reverence Home Health and Hospice. Through this assignment I have utilized my leadership skills in collaborating with members of the hospice / health care team in achieving the treatment path for hospice patients. This experience has exposed me to an area of nursing that I was unfamiliar with. I now feel confident discussing hospice with my patients and their families and collaborating with physicians on the best plan of care.

5RecommendationsAs nurses, we do our best to treat our patients with the goal of wellness in mind; however, recognizing and accepting that wellness may not happen is often a difficult concept to accept (for both patient and health care provider). Volunteering with hospice has given me the personal satisfaction and fulfillment knowing that I have made a difference in someone's life. It has made me a more well-rounded nurse and I feel privileged knowing that I provided care and companionship for someone when they needed it the most. To be invited into the last months, weeks, and days of a person's life is an honor and a privilege. I would recommend a hospice volunteer opportunity to anyone in the health-care field.

As nurses, we do our best to treat our patients with the goal of wellness n mind; however, recognizing and accepting that wellness may not happen is often a difficult concept to realize (for both patient and health care provider). Volunteering with hospice has given me the personal satisfaction and fulfillment knowing that I have made a difference in someones life. It has made me a more well-rounded nurse, and I feel privileged knowing that I provided care and companionship for someone when they needed it the most. To be invited into the last months, weeks, and days of a person's life is an honor and a privilege. I would recommend a hospice volunteer opportunity to anyone in the health-care field.6ReferencesFerris State University (FSU). (2011). BSN program outcomes. (2011, January). Retrieved from: http://www.ferris.edu/htmls/colleges/alliedhe/Nursing/BSN-program-outcomes.htm

Reverence. (2014). About reverence. Reverence Home Health and Hospice. Retrieved from: http://reverencehomehealth.org/