Palliative Care Consultation Service
Sometimes in the moments approaching the end of life, alleviating pain and providing the spiritual and emotional support can help enable each person to die with peace, with dignity, and without pain. Palliative care is there when medicine alone isn’t enough. It’s another aspect of care to improve the lives of patients and families facing serious illness.
Palliative care has long been established in Europe, and in 2005 Cottage was one of the leaders in bringing palliative care to California. Organizations from our community joined together to bring this important program to the hospital. A unique and innovative partnership was established as Cottage, Hospice of Santa Barbara, Visiting Nurse & Hospice Care of Santa Barbara, and the Saint Francis Foundation collaborated to create, implement and fund the Palliative Care Consultation Service offered at Cottage.
The Palliative Care team—a group of physicians, nurses, social workers, and a chaplain—is well-trained for the intense work. Most agree that the work called out to them. They recognize that many would find it difficult, but as palliative care nurse Susan Gibson explains, “Not everyone can do this, work with people in crisis. I discovered that I can. And if you know you can, you really have no choice but to do it.”
Some might think looking mortality in the eye each day would be depressing, but social worker Sherie Davis says that’s not the case. Quite the opposite, as she sees it: “People facing life and death challenges are more real, they let down their ego defenses and show you their truest selves. Patients and families show such amazing strength and grace. It’s a privilege to witness that and share that time with them.”
The Palliative Care service’s nurse manager, Susan White, whose background is in critical care and pain management, explains her entrance into the field: “When I was called in to interview for this job it was as if I could see the ceiling opening up and a giant gift box landing. An unbelievable gift! It is so rewarding to have this role, to be the person who can sit and listen, hear what people need, and communicate those needs to other clinical care providers.”
Chaplain Clay Napier agrees, “This role called out to me, and being with people in crisis is one of the most powerful parts of health care. I get to be there for the best and the worst.”
In most cases, after a physician requests palliative care for a patient, all disciplines of the Palliative Care team are eventually involved in the case, because pain can be attached not only to physical suffering but psychosocial and emotional suffering. Palliative care is total person care. And it’s as much for family members as for patients.
Members of the Palliative Care Consultation Service appreciate being able to send people in the right direction and surround them with what they need. That might mean finding the right way to relieve a patient’s nausea or to help them breathe better. It might mean communicating with other nurses and care providers to ensure continuity of care. It might mean hospice coordination or healing touch or guided imagery therapy. It might mean calling a family member to offer bereavement support and counseling resources.
In one instance it meant going the extra mile to help reconnect estranged family members so they could share a healthy end-of-life experience. Sometimes simply reinforcing that every patient is unique and has a life story can bring compassion back where it needs to be.
The team tends to get emotional when remembering some of the long-term patients who’ve touched their lives. And they realize that caring for themselves is part of their work, a necessary part that enables them to care for others. “We check in with each other and have daily meetings,” says Susan White. “If someone has a really tough experience we honor that time they need to regroup before they can go back onto the floor and continue providing the best support for patients.”
Their gentle work is recognized in the many thank-you notes they receive from patients and family members. Sifting through a stack of those handwritten cards, Susan White nods, “The words of thanks sustain us.”
Cottage’s palliative care team includes four medical directors: Drs. Dennis Baker, Mike Bordofsky, Michael Kearney and Eric Trautwein. The team’s nurse manager is Susan White and nurses are Susan Gibson, Julie Hirsch and Lori Mendez. Sherie Davis is the social worker and Clay Napier is chaplain.