The destructive effects of COVID-19 have made palliative care more important than ever in the hospital setting. Around the globe, nurses and physicians are struggling to provide effective and holistic care to a growing number of patients whose lives have been threatened by the virus.
Billy Rosa, PhD, MBE, ACHPN, FAANP, FAAN, is a Postdoctoral Research Fellow in Psycho-Oncology at Memorial Sloan Kettering Cancer Center. Betty Ferrell, PhD, RN, FPCN, FAAN, is the Director and Professor of the Division of Nursing Research and Education at the City of Hope as well as the Principal Investigator of the End-of-Life Nursing Education Consortium (ELNEC). The two medical experts discussed their strategies for improving palliative care in any setting during Tipton Health’s October 20 webinar, “Every Nurse is a Palliative Nurse: Alleviating Serious Health-Related Suffering Worldwide.”
According to Dr. Rosa, the key to true palliative care is understanding the definition and applying it to your practice. The International Association for Hospice & Palliative Care describes palliative care as “the active holistic care of individuals across all ages with serious health-related suffering due to severe illness, and especially of those near the end of life. It aims to improve the quality of life for patients, their families and their caregivers.”
When you understand this definition, you can begin to incorporate some of the following strategies into your hospital’s plan of care:
Where to start?
Integrate palliative care into all aspects of nursing care. Start by understanding your patients’ palliative care needs, then reflect on how to address them through your individual nursing practice and interdisciplinary collaborations—both within your unit and across the organization.
Take advantage of available resources. ELNEC offers a range of free resources including newsletters, publications, videos, educational slide decks and more. This information will deepen your understanding of effective palliative care and the latest best practices. You can also access an in-depth COVID-19 resource center to help your nurses navigate through these challenging times.
What can I do as a nurse leader?
Make your voice heard. Pay attention to institutional planning, collaboration with the community, policies being introduced and how palliative care fits into each of these areas. Use your voice to advocate for incorporating palliative care in your organization’s day-to-day practices.
Collaboration is key. Push for your ethics council, social workers, physicians, spiritual care and other internal stakeholders to work together. This will lead to better understanding of how their roles fit into effective palliative care. Bringing these experts together, along with your nurses, will help you deliver the care your patients deserve.
How do we promote health equity through palliative care?
Examine your approach. Take a careful look at where you may be falling short when it comes to caring for minorities. Death and after-life care are very important across different cultures, and it’s important to respect the spiritual, cultural and religious practices of patients and their families. Be sensitive to and accommodating of cultures that are different from your own. To get in touch with your own unconscious biases that may factor into your approach, you can take Harvard University’s implicit bias assessment.
Disparities come from all directions. When examining health equity, it’s not enough to consider structural discrimination and inequitable policy. You must also understand how powerful the effects are—economically, socially, politically and historically. Acknowledge these different factors when you’re working on equitable care. As an example, Dr. Rosa pointed out that you should always use inclusive language when dealing with members of the LGBTQ+ community. Don’t make assumptions—ask the patient what pronouns they prefer and what name they would like to be called.
Adopt an attitude of naïve curiosity. Recognize that there are huge variations in cultural influence, and that we’re all from different backgrounds. Again, don’t make assumptions—even if someone may “look the same” or “speak the same” as you. Keep an open mind and be politely curious about who your patients and colleagues are. This will help you to be more attentive to their needs, so you can provide the care they deserve.
Learn More from Our Speakers
Click here to view our on-demand webinar video featuring Dr. Rosa and Dr. Ferrell’s full interview.
Tipton’s next webinar, Stories from the Front Lines of the Pandemic, will be held November 10, 2020, 12:30–1:30 p.m. EDT.