By: Joan Tupponce, Joan Tupponce & Associates, Inc.

Each day, palliative care nurses treat patients who are experiencing the unyielding pain and symptoms that accompany a life-limiting disease.

"These nurses work with the patient and that patient’s family," explains Pat Coyne, ANP, clinical director of the Thomas Palliative Care Services at VCU Massey Cancer Center. "They treat patients who are actively dying and patients who have years to live with horrible symptoms." Palliative care nurses come up with a plan for the management of the pain and symptoms that coincides with the patient’s goals.

"They look at what is best for the patient and the family," Coyne says. "They’re always looking at the benefit of any treatment versus the burden and risk to the patient and family." These highly trained nurses have expertise in physical assessment, helping to figure out why a symptom exists.

"They are well-seasoned," Coyne says. "They have been in the profession for a long time. They have a lot of autonomy."

As part of their duties, palliative care nurses teach families how to take care of their loved one. They educate the family about medications and how they are administered.

"The palliative care unit is like any other nursing unit in some respects," Coyne says. "Nurses focus on three to five patients, helping them feel better."

Palliative care nurses work with a team of professionals from different areas of the hospital. "They work with physicians all the time," Coyne says. "They meet with the professional group twice a week. They always work to make sure the right things happen."

Like others in the field, palliative care nurses work in shifts that include nights and weekends.

"The unit is different in the fact that families can spend the night there," Coyne says. "They cook in a kitchen and bring in pets. We make it as homelike as possible. The nurses promote that. Sometimes they even put together weddings, baptisms and graduations to meet the patient’s goals."

The field came into its own about 10 years ago and is growing at a fast pace. Palliative care nurses must first be a registered nurse before receiving extra training in pain and symptom management. Many are certified in hospice and palliative care nursing. Job opportunities exist in hospitals and in hospice.

"We have a waitlist for nurses who want to work on the unit," Coyne says. "I think a lot of that has to do with the fact that nurses have more autonomy and physicians and nurses are working together well. It’s a team. Decisions aren’t made without the input of the bedside nurses because they are the ones with the patient and the family."

The realities of the job can be challenging. "You have to cope with knowing that the person you are caring for may not survive and that this is going to happen regularly," Coyne says. "I think it takes a special person. You really have to have good self-care techniques. You have to be able to know when you need a break and you have to leave your work at work most of the time."

The benefits far outweigh the stress of the moment.

"These nurses get hugs every day from the families," Coyne says. "They get a lot of cards and letters thanking them and there’s a lot of laughter as they celebrate patients going home or a wedding on the unit or a graduation."

Pull Quote: "We have a waitlist for nurses who want to work on the unit."