“The idea of early palliative care was really a strategy for preventing people from going through unnecessary and unwanted suffering, treatments, and things that were not consistent with their values and preferences. . . . For people who have a serious illness, it’s not good to wait until you’re facing these very critical decisions. You need to plan upfront,” ONS member Marie Bakitas, DNS, APRN, FAAN, AOCN®, professor and associate dean for research and scholarship at the University of Alabama at Birmingham, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS, during a conversation about implementing palliative and supportive care for patients with cancer. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center’s Commission on Accreditation. 

Learning outcome: The learner will report an increase in knowledge related to palliative care for patients with cancer.

Episode Notes:

• The NCPD activity for this episode has expired, but you can still earn NCPD through many other ONS Podcast episodes. Find a full list of opportunities.
• Oncology Nursing Podcast episodes:
  • Episode 41: Advocating for Palliative Care and Hospice Education
  • Episode 135: ELNEC Has Trained More Than One Million Nurses in End-of-Life Care
  • Episode 204: How Radiation Is Used in Palliative Care
• ONS Voice articles:
  • APRNs Can lead by Example When Integrating Palliative Care in Practice
  • Managing COVID-19 and Cancer Requires Enhanced Palliative Care Skills
  • ELNEC Milestone Marks Transformation of EOL Care for Countless Patients With Cancer
  • Palliative care topic tag
• ONS Position Statement on Palliative Care for People With Cancer
• Clinical Journal of Oncology Nursing article: Clinical Oncology Nurse Best Practices: Palliative Care and End-of-Life Conversations
• Palliative and Supportive Care articles:
  • The Project ENABLE II Randomized Controlled Trial to Improve Palliative Care for Rural Patients With Advanced Cancer: Baseline Findings, Methodological Challenges, and Solutions
  • Developing a “Toolkit” to Measure Implementation of Concurrent Palliative Care in Rural Community Cancer Centers
• Journal of the American Medical Association article: Effects of a Palliative Care Intervention on Clinical Outcomes in Patients With Advanced Cancer
• New England Journal of Medicine article: Early Palliative Care for Patients With Metastatic Non–Small-Cell Lung Cancer
• Book: Charting Your Course: A Life-Long Guide to Health and Compassion
• End-of-Life Nursing Education Consortium
• American Society of Clinical Oncology: Palliative Care in Oncology Resources

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From Today’s Episode

“Now we think of palliative care as really the umbrella—it’s a medical specialty, it’s a nursing specialty field that you can get certified in. And hospice and comfort care are a subset of palliative care. Think of palliative care as the umbrella, and then toward the very end of life, hospice care—which is often guided by a very limited prognosis time frame of six months or less—and then within hospice care, comfort care is that care that is provided typically at the very end of life.” Timestamp (TS) 03:13

“For us, the idea of early palliative care was really a prevention strategy for preventing people from going through unnecessary and unwanted suffering, treatments, and things that were not consistent with their values and preferences. We took a page out of the childbirth movement playbook and said, ‘If you’re pregnant, you don’t wait until 8 months and 29 days, to say, ‘Oh, I’m having a baby. Maybe I should think about how to plan for that.’’ Similarly, for people who have a serious illness, it’s not good to wait until you’re facing these very critical decisions. You need to plan up-front. That was the genesis of our program that we call Project ENABLE.” TS 07:18

“ENABLE was about at the time people were diagnosed, meeting them there and helping them to learn skills of symptom management, communication, problem solving, advance care planning. So that when they were ill and facing these issues, they had the skills and preparation to do so.” TS 08:17

“I think the health equity issues are ones that we can overcome. We have to be aware of them. In particular with palliative care, we need to offer these treatments in ways that have been determined to be culturally acceptable.” TS 11:20

“We need to be doing what we call primary palliative care, and that is that every clinician who interacts with an oncology patient who has advanced cancer, metastatic disease, or high symptom burden, has these skills of communication. Oncology nurses are the lead for pain and symptom management. But there are many communication skills that are really important and prioritizing these kinds of conversations and this kind of content being presented at the front end when people are newly diagnosed.” TS 26:34

“I think it’s really beneficial for individual nurses to understand to get their own individual information, but I know we all have the need to do quality improvement projects and other kinds of efforts in our clinics and organizations. This might be something that you prioritize for the year: What aspects of palliative care—this extra layer of support—can we provide? . . . We should continue to educate ourselves about the differences and the ways to present and talk about palliative care so that it removes some of the mystery, reduces some of the perceptions. . . and skillfully say, ‘Hey, this is an extra layer of support for you and your family.’” TS 29:46