Palliative care nurses

Advanced Practice Columnist / Guide · Dec 11, 2020

I'm not a Palliative Care RN but I have transferred many of our ICU patients who transitioned to comfort care to our Palliative Care rooms. We don't have a specific Palliative Care Unit but we have designated Palliative Care rooms in a nice floor of the hospital with large windows looking out to wonderful views.

Our Palliative Care patients are those who have decided with their family members and the care team to focus on comfort and symptom management rather than treating the medical conditions that brought them to the hospital. For the most part, the goal is to make the transition to death peaceful and pain-free. These are patients who have hours to days to live.

There is a lot of opioid use for comfort/relieve air hunger and benzodiazepine to minimize anxiety. Some patients have a tendency to have increased secretions so sometimes scopolamine patches are used. Many unnecessary tubes are removed per patient's preference (ie, feeding tubes). Nausea is treated. If oxygen is offered, it is used for comfort. Vital signs are monitored as a way to assess distress and discomfort.

Family visitation is relaxed and the rooms are large enough to allow loved ones to be present during the last few hours or days the patient has to live. I feel like some RN's love the role because it is very much centered in the nursing tradition of providing comfort and maintaining a therapeutic environment.

As a new grad, you will not have the traditional curative concepts and interventions you learned in school but that is not a bad thing in my eyes.

JBMmom, MSN, NP · Dec 11, 2020

You got a very good overview in the previous response, just like any other first job you will focus on some areas and skills but may not build some others. You will learn the medications related to palliative care, but you many not become as familiar with many of the other acute care medications. But, you can always transition to other areas if you want to. You're going to get the general feel for patient care, you're still going to do assessments and administer medications. You may have a lot of stress related to families and patients transitioning to end of life, or you may find that it's a good patient and family population for you to deal with. Not everyone is ready to accept that they are no longer appropriate for curative therapy, so that could have a challenge, but for patients and families making that transition it could be a very fulfilling population to provide care and comfort.