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LEARN Reflection: Palliative Patient

Erin Power

Trent University
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LEARN Reflection: Palliative Patient

In the surgical unit of Ross memorial hospital, the majority of patients heal and then are

able to return home and continue on with their daily lives. However, I had the opportunity to care

for a patient who knew the chances of them being able to return home were slim, and if they

were to get home, their lives would never be the same. I had the pleasure of working with a

gentleman who was recovering from a left hip repair as a result of a fall, while living with

prostate cancer.

This man understood that he was going to die, and had seemed to come to peace with

this. He had expressed how happy he was with the way he had lived this life. His fears for his

wife that will outlive him, but the joy that they shared now. I have never cared for someone who

knew that they were going to die. Listening to him talk made me quite emotional. He said maybe

it would be easier if he were to die now, rather than linger on and deal with more pain. I did not

know what to say in that moment. He and his wife were both crying, my eyes were filling with

tears, and so was the primary nurses. The primary nurse started to whisper in the patient’s ear.

She told him that there is no reason he should be in any pain at all, and that the world will not be

the same once he’s gone, so that he should let his loved ones cherish the moments they have

together. I was amazed by the primary nurse’s response. She held his hand, and had an arm

around the wife while they all cried together.

In my schooling thus far I have been told countless times that we will cry with our

patients, but this was the first time that I had. I’ve always known that death would be a part of

nursing, however I had never really thought about how I would be able to work through it. For

this man death was not a frightening thought. When I first started caring for him I did not know

how I should act. After a while it was almost like I forgot he was palliative. He was no different
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than any other patient I have been assigned to. I joked and had a great time talking with him all

morning. However, when he began to talk about death I froze. I did not know what would be the

right thing to say. I didn’t want to say too much, but I knew I couldn’t brush off the comments he

had made. I found myself at a loss for words. I was thankful that the primary nurse stepped in

and was so smooth in the way she spoke with him. I really did admire her actions.

Studies show that there is a knowledge deficient when it comes to nurses caring for

palliative patients (Prem, et al., 2012). Nurses do not seem to have enough exposure to palliative

patients, therefore have not developed philosophies regarding their care (Prem, et al., 2012).

Some studies have looked into the impact of patients being referred to specialized palliative care

teams; however the results show no significant difference in quality of life for patients with or

without the specialized care (Zimmermann et al., 2014). Perhaps caring for patients in this

situation is not a skill that can be taught. Rather, a skill that is developed with experience.

Next time I am in such a situation, I think that I still will not know exactly what to say to

my patient. However, I think that I will be more comfortable next time. After watching the

primary nurse I know that it is okay for me to show emotions. I do not need to always be strong

and stable for my patients. I learned that sometimes it’s okay to take a minuet and share their

hardships. Death will never be easy, however as a nurse you can work to make to journey as

pleasant as possible.
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References

Prem, V., Karvannan, H., Kumar, S. P., Karthikbabu, S., Syed, N., Sisodia, V., & Jaykumar, S.

(2012). Study of nurses’ knowledge about palliative care: A quantitative cross-sectional

survey. Indian Journal of Palliative Care, 18(2), 122-127. doi:10.4103/0973-1075.100832

Zimmermann, C., Swami, N., Krzyzanowska, M., Hannon, B., Leighl, N., & Oza, A. et al.

(2014). Early palliative care for patients with advanced cancer: a cluster-randomised

controlled trial. The Lancet, 383(9930), 1721-1730. http://dx.doi.org/10.1016/s0140-

6736(13)62416-2