Palliative care coordinator
My patients and their stories are the things I love about my job. My work is never boring because everyone is an individual. Recognizing their individuality leads me to approach people in slightly different ways based on who they are and what they need. It is my belief that we all wish to be seen for our whole selves and not just the illness that is impacting our lives.
I once worked with a patient who helped reinforce how important it is to see people as individuals. She was single, had children living at home, and was running a business from her home. When I saw her, her pain was not well controlled yet.
When I arrived, she was almost hostile asking why I was there. I explained my role as the coordinator of her in-home care and my wish to get to know her better. She stated she didn’t believe I could learn enough about her in an hour to help her. I offered to reflect back to her after the assessment what I felt I had learned about her. She entered into the assessment, but she remained cool and aloof. At the end, I told her what I saw. “You’re a mother who cares very much about her children. It’s distressing to you that your illness is impacting them, and your hope is that as we help care for you, we will have as little impact on your children as possible.”
When I looked up, tears were streaming down her face. Initially, I worried that I had said something to upset her. But then I realized I had said exactly what she had needed to hear. I understood what her greatest goals were. They weren’t only about her health, but the impact on the people she loved and her need to keep working to support her family.
I learned from that visit the power of I reflecting back to the client what I have learned about them and how that will help me oversee the care they receive at home. We all want to be seen as people, as unique human beings and have that respected. There’s a dignity that comes with having someone honour who you are.
I had another patient who was very close to dying. She had been through months if not years of treatment and suffered along the way. When I visited her she could not get comfortable in bed. She could not be still. She was moaning and moving about trying to get comfortable. She wasn’t sure that I could offer any value. She basically said to me “just get the doctor out here as soon as possible to help me die”. She was seeking medical assistance to die. Her family doctor had initiated it. I reassured her that I understood her main goal and that addressing that goal was in process. In the meantime, I encouraged her to let me do what I could to get her more comfortable while she waited.
I needed her to understand that I was honouring what she wanted and wasn’t trying to convince her of an alternative. She agreed to the medical equipment and services needed in her home. The palliative doctor was notified about the symptoms that were out of control & addressed them quickly with medication changes. When I checked in 2 days later she was pain-free, able to eat small amounts without nausea and she was able to visit with her family. She died the day before the doctor was scheduled to come to provide medically assisted death. We managed to keep her comfortable until the end of her life.
One day we all die. We cannot prevent this. Yet with good palliative care, we can promote physical comfort so that symptoms do not stand in the way of someone achieving their goals. And we can honour the uniqueness of each person and care for their whole being. When that is achieved I feel really good about the team I am part of. It is my reward. We all hope for a good death.