Cynthia Persily, PhD, RN, FAAN
Dr. Persily is the CEO of Highland Hospital in Charleston, WV
Today, I had the privilege of being asked to talk about strategic career development at the 2015 Cancer Nursing Symposium sponsored by Cabell Huntington Hospital in Huntington WV. I will not bore you with what I talked about, but rather, I wanted to talk to you about what I learned. I had the chance to get to the symposium a little early today, and heard Sheila Stephens, DNP, MBA, Palliative Care Nurse at Cabell Huntington Hospital speak before me.
The topic of Dr. Stephens’ discussion was Palliative Care: Support for the Patient. Palliative care is a multidisciplinary approach to specialized care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, physical stress, and mental stress of a serious illness—whatever the diagnosis. The goal of palliative care is to improve quality of life for both the patient and the family. Palliative care is provided by a team of physicians, nurses, and other health professionals who work together to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness. Sheila provided data today that indicated that palliative care actually prolongs life in the seriously ill. Too often, we think of palliative care as “end of life care”, however, if we use this definition, palliative care is appropriate with any serious illness, for instance, chronic mental illness.
As Sheila talked today about the strategies that she uses in providing palliative care, including talking with families and patients about what to expect, understanding a patient’s wants and needs, implementing interventions to increase their quality of life, and more importantly, discontinuing interventions that decrease quality of life, it struck me that a lot of what we do in caring for patients and families with mental illnesses would fall under the heading of palliative care. We are constantly striving to improve the quality of life of our patients and their families. We do this through a variety of methods, but are there things that we can learn from the world of palliative care?
One of the most striking stories that Sheila told today was in relation to non-aware patients and pain control—particularly whether patients who are nonresponsive can feel pain. She told the story of a patient of hers, long ago, who had advanced cancer, and who, during her hospitalization, became nonresponsive. She could be turned, bathed, or treated without so much as a grimace. She was not being treated for pain. However, one night, when Sheila was in her room, the patient suddenly grabbed her arm and said “please can I have pain medication?”. The patient went on to tell Sheila how she marked the days and nights by the sound of the nurses voices, and related stories that they told over her bed.
While Sheila told this story as a cautionary tale about pain management, I can’t help but see the parallels with our patients who we think may be less than aware. Can they hear us? Are they absorbing what we are telling them? Are they hearing us talk about them when we think that they are not aware?
I’m so glad that I had an opportunity to hear this fascinating talk today. I look forward to talking more to our staff about the concepts of palliative care and how they might apply to our patients. We never know what we can learn from other fields and how the knowledge can be applied to our work—and as an organization, I hope we never stop learning!