Opinion: As a nurse and as a person, my life is richer working in palliative care
As a nurse, my transition from the emergency room to a palliative care residence has been both humbling and somewhat disturbing.
From my experience, in the ER, we stress mostly curative and life-saving measures without much regard or time to spend on symptom management, empathy or positive communication with the loved ones of the patients whose lives we are trying to save.
I've seen many very good emergency room doctors who are masters at diagnosing and then saving patients' lives — but seem almost incapable of managing those whose illness have progressed beyond the point where they can be cured.
One would think that with our rapidly aging population, medical schools would stress the importance of palliative care to their students and make learning opportunities mandatory.
A 2020 study published in the Canadian Medical Association Journal suggests this is not the case. It found that of Canada's 17 medical schools, undergraduate palliative care rotations were mandatory at two schools, optional at 13 and not available at two others.
When I was in nursing school some 20 years ago, I can remember little, if any, importance put on treating patients in palliative care. The training was based on spotting signs and symptoms that could help diagnose and cure a patient. Judging by my interactions with young nurses in more recent years, I'm not sure things have changed all that much.
I suppose we shouldn't be surprised by this culture in health care. That's what we tend to see on TV in shows like The Pitt and other series about ERs and hospitals. Saving a patient's life is portrayed as being glamorous and heroic, while a patient 'being palliative' is often seen as negative and associated with the abandonment of hope.
Contrary to what appears to be the popular belief that working in palliative care must 'be depressing' — 'all you do is give morphine,' my ER pals often say — the truth is quite the opposite.
Palliative care is based on improving quality of life and treating all symptoms — physical, psychological, spiritual and social. Drugs used in palliative care are based on close supervision of symptoms and patient needs.
With help from specialized doctors, an experienced team of nurses, patient-care attendants, supportive care workers and volunteers, my life both as a nurse and a human being has become richer working in palliative care as I am surrounded with vivid lessons of humanity and new types of hope each day.
As we wind up National Palliative Care Week in Canada (May 4-10), it's a perfect time for nursing and medical schools to recognize there is a need for more knowledge about palliative care.
Let's make sure that empathy, humanity, critical thinking, communication and teamwork are seen as a cornerstone of health-care education in this country.
Nathan Friedland has been a nurse for 20 years and currently works at a palliative care residence. He lives in Roxboro.
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