3. The Role of the Healthcare Provider

This lesson will introduce the idea that healthcare providers may play various roles over the course of the palliative journey, and emphasizes the importance of remembering that healthcare providers are learners throughout the process.

Healthcare providers often function exclusively in a supportive role, as long as patients are able to advocate for their own wishes. As our story progresses, we see the patient’s loved ones disagreeing about care options for the patient, and how the patient’s needs and wishes change over time.

Support for the Patient and Their Loved Ones

Everyone needs individualized support and empathy as they navigate their emotions during the final weeks, days, and hours of life, including a patient’s family and loved ones. (When we speak of “family” we also include close friends, in other words, the patient’s “family of choice”.) As healthcare providers, we have an opportunity to connect with patients and their loved ones during difficult times. Without a deep connection with patients, it can become even more challenging to have conversations involving emotions and end of life wishes. However, we should aim to deepen these connections and hone our skills; to learn from others and our own experiences in order to provide holistic palliative care.

In this video, we see the nurse taking a back seat as Judy’s friends support her wishes to avoid hospice care, while still making it clear that she is involved with Judy’s care and that Judy can call on her for support whenever she wants.

(To read along click here.)

As a patient’s health deteriorates, their medical and emotional requirements change. Ensuring that new information is shared with the whole palliative care team is paramount to maintaining appropriate end of life support.

It is worthwhile to reflect on the conversation that happened in the video in the following exercise.

In this next video, we will see a disagreement about care options between the patient’s loved ones.

(To read along click here.)

The Importance of Advocacy

To provide good palliative care, healthcare providers need to be aware of the reality of emotional shifts on the part of both the patient and their loved ones. They need to openly engage and communicate with patients and their families, especially when there are disagreements.

In the next video, we will glimpse Judy’s perspective and see the role of the palliative care nurse as an advocate for Judy and her wishes. We will also see the emotional impact of end of life care on Judy’s friends and the significant need for support.

(To read along click here.)

Healthcare providers must navigate complex interpersonal relationships during end of life care—in the hospital, hospice and home setting. They also need to be flexible and understand that a patient’s needs and priorities will likely change over time.