Program eases family burden in tough time
Waiting is the hardest part
Patient- and family-centered care is at the heart of the University of Pittsburgh Medical Center (UPMC), says Deborah Maurer, RN, MBA, administrator, University of Pittsburgh Medical Center Transplant Services. As part of that emphasis, medical students would shadow patients who were called to come in for transplant. It did not matter the time of night or day of the week — when the call came, a student shadowed them. "They were considered objective observers."
Maurer knows that UPMC, as a large academic medical center, can be scary — particularly at night, alone, on a long wait during a dangerous surgery on a loved one. One of the students spent his shadow time helping guide a woman through the maze to find coffee and an ATM. He sat with her during the long wait through her husband’s surgery. At the end of it, Maurer, says, she told that student he had been her guardian angel. During the debriefing, some 20 or 30 shadow experiences later, that story and image stuck and the Guardian Angels program was born.
Maurer says they created a job description for someone to be a companion and help family members with "logistical maneuvering" through the facility. They are paid $3 per hour to be on call and $10 per hour when they come in. They are students and are there for a year or two. Usually, there are about a dozen at any one time, she says. There have been 40 since the inception. The low number was three, the high 15. Summers are usually the hardest to keep staffed because often students will have other jobs to go to.
As part of their orientation, angels have to shadow a transplant team as they evaluate patients, shadow social workers as they work with patients and their families, learn about organ allocation, and take a tour of the operating room where transplants take place. They also must master a list of common locations in the hospital: ATMs, coffee spots and vending machines, elevators, cafeterias, and entrances. The last event is handled like a scavenger hunt.
While the initial funding came from the Picker Institute in 2011, when that ended, UPMC found other grants to fund it, and patients and family members have also been generous in giving to the Guardian Angels program once they have experienced it, Maurer notes.
Since 2012, there has been a five-question survey provided to users, and Maurer says there has never been a single negative comment on one. The value the 300 users have placed on just having someone with them — to converse, to play cards, to wait with them — is immense.
The cardiac surgery program at UPMC is looking at a similar model, and other transplant programs have been in touch about starting up angels programs of their own. While acknowledging her bias, Maurer thinks it is best suited to a transplant program or some other program that involves very long surgeries and a lot of waiting. "There are unique aspects to what we do here. They may come in a half a day in advance for testing. And sometimes, things do not work out."
But the support they give with way-finding is certainly something that can be replicated in other programs. As for the compensation, because of the on-call aspect, it seemed important to pay them. "The struggle with odd hours of being available would make it difficult for us to find enough people who would be reliable volunteers," she says. Happily, it has been easy to fund.
For more information on this topic, contact Deborah Maurer, RN, MBA, Administrator, University of Pittsburgh Medical Center Transplant Services, Pittsburgh, PA. Email: [email protected]
