Nurses, where to start? My mother was a hospice nurse and my sister a peds nurse. I met my wife when she was nursing in a home of the dying. Our eldest is now studying nursing in Brisbane, Australia.
Nurses have taught me so much of what is important in caring for people near the end of life today. How to lift! How to give chemotherapy! How to treat nausea and vomiting. Much of the pain management strategies I learnt with nurses as we worked together to improve a patients pain (clinical pharmacists have also been critical teachers in symptom management). I value greatly ongoing nursing input and interaction in research, education and the clinical practice of palliative care.
Nurses in all palliative care settings can be the most important players. While a specialist palliative care nurse may be in and out of a room a few times a day, it is the floor nurses and the clinical nursing assistants who are critical providers of palliative care, spending time and often seeing patients and families at their most human.
But there are two times I especially value nursing…
Breaking bad news
The Death of a patient.
When I, as a physician, break bad news I try very hard to have the nurse caring for the patient present. When I can’t, I make a particular point to let him/her know what took place. They are the person who will help the patient and family unravel and deal with the news they have just received! “What did he say? He said how long? Hospice?” They often working with patients on further questions to ask when I return that day or later the next.
A patient dies, and I or a colleague is called to pronounce. We are in, offer condolences, pronounce and complete regulatory stuff (such as ask about autopsies). It is the nurse who has usually been the first one with the family at the time of death. It is the nurse who continues to be with them until they leave, often hours after the death. This is not only true in hospitals but especially in home based palliative care, where in Wisconsin, nurses providing hospice palliative care are often the only ones with family at the time of death.
Yep, nurses. You can’t do without them……..
When do you value nurses most?
UW Pain and Policy Studies Group.