LAVENDER HEARTS. Pamela Dayon RN, BA Management PACU Kaiser Fresno Cohort 6

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1 LAVENDER HEARTS Empowering Bariatric Surgical Patients By Implementing The Caring Sciences With Breathwork, Guided Imagery, Meditation And Aromatherapy For Improved Outcomes Pamela Dayon RN, BA Management PACU Kaiser Fresno Cohort 6

2 PURPOSE Lavender Hearts will be a dynamic team of nurses, surgeons, anesthesia and supportive personnel to improve the outcome of bariatric surgical patients by presenting integrative and holistic medicine modalities.

3 Lavender Hearts Team

4 PACU Frontline Nurses PACU Frontline Nurses interested in Dr. Jean Watson's Caring Science are being educated in the Ten Caritas Processes, reading The Philosophy and Science of Caring by Watson, and Caritas Mediation CD. The goal is to set examples to change the environment with leadership and literacy and therefore create overall change and loving-kindness, whether it is in the operating room, recovery room or medical-surgical floor.

5 PATIENT EDUCATION Breathwork Smell the Flowers Blow out the Birthday Candles Belly Breathwork Guided Imagery and Meditation CD and Pamphlet Encourage a Mental Mindscape for Calmness CD Preparing for a Successful Surgery

6 Stop and Smell the Flowers

7 Blow Out the Birthday Candles!

8 Belly Breathwork

9 Guided Imagery and Meditation Utilizing Kaiser s Preparing For Successful Surgery CD Or, if patient preference, using their own relaxing or meditation music

10 CD and Pamphlet

11 Encourage a Mental Mindscape for Calmness

12 AROMATHERAPY Medical quality and evidenced-based aromatherapy synergies from AromaMD will be introduced and utilized. The surgical patient will be educated on the ancient art of aromatherapy and its benefits.

13 Categories of the synergies: Psyche anxiety, inner emotions Soma- perception of pain nausea and vomiting urinary retention

14 Empower the Patient The patient will select a dedicated synergy(s) for psyche and somatic conditions. This will empower the patient to direct and focus on wellness and health using the favored synergy during breath-work, guided imagery and relaxation times preoperatively. Synergies will follow patient during hospitalization to be used as needed.

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16 Ministering to the Patient By ministering to the patient, utilizing caring and integrative modalities, the patient may require less allopathic /medicinal intervention and subsequent side effects. The synergies will be patient driven by the inhalation method 6-10 inches from nose, one drop on a cotton ball as a supplement and charted as a caring science intervention. These oils are medical quality and will not have adverse affects on staff. Aroma should only disperse 12 inches in diameter.

17 Co-Create: Caritas Process #8 The reduction of a stressful situation with the patient will improve staff morale and thus co-create a caritas environment.

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19 IMPLEMENTATION Communication and agreement with pharmacy, MDs, nurse managers to coordinate the aromatherapy segment of study. Staff education with dedicated Caritas Nurses in initial phase. Patient Education in Preoperative Bariatric Classes. Patient supported and encouraged in self care with loving-kindness to use breath-work, meditation, CD, aromatherapy synergies. Staff Co-creating healing environments.

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21 PROJECT PROJECTED EVALUATION This project will be over a six month period. Patient data will be collected evaluating calmness, anxiety, nausea, vomiting, perception of pain and urinary retention. Control groups will be utilized. Staff will be interviewed and patients will be given an opportunity to report satisfaction.

22 Project Projected Outcomes This study will show that integrative and holistic modalities can and do have a solid place in the surgical experience that benefit the patient and providers with a positive and caring process. As we give to our patients we can as nurses and providers BE THE CHANGE WE WANT TO SEE.

23 Implementation of Reflection to Refine and Guide Staff

24 BE THE CHANGE WE WANT TO SEE

25 Acknowledgements My deepest appreciation to Dr. Jean Watson, for her unfailing light and encouragement as we walk. Dr Kamyar Heyadat, AromaMD for his support, encouragement and education. To my fellow nurses in the PACU at Kaiser Fresno who are choosing to follow Caritas to Co-create by being a part of this project: Brenda Apparcel RN; Cecile Balanon RN and Kathy Zuniga RN. Ann Foss-Durant RN, KP Regional; Amy Tobin RN, CNO Kaiser Fresno; Debra Parker RN, Interim Manager PACU; Chi Ly, Inpatient Pharmacy Manager; Kevin Rhoden CRNA And especially to Diana Rouse RN, TPMG Bariatric Educator/ Assistant Manager for giving me the opportunity to be a part of the education process for bariatric patients.