What Is Palliative Care? A Conversation with Palliative Care Nurse Carey Ramirez – Episode #6

If you’re wondering what palliative care is, you’re not alone. The phrase, “What is palliative care” is searched on Google almost 100,000 times every month. The reason for the widespread interest is that it’s a fairly new area of focus in the history of health care and it specializes in pain management and end of life issues and scenarios. But don’t confuse it with hospice. The two are very different things. On this episode of The Report Room, I chat with palliative care nurse, Carey Ramirez about those differences, his journey into palliative care, and why the discipline is an area of important focus for health care both now and in the future. Palliative care is not the same as hospice. Most people are familiar with the idea of hospice care so it’s important that you understand that palliative care is not a synonym for hospice. Palliative care is for anyone with a serious illness and can be administered at any age and at any stage of an illness, not just during the dying process. Hospice provides care for terminally ill patients who may have only months to live. People who receive hospice are also no longer receiving curative treatment for their underlying disease while those receiving palliative care may be. You can hear why those distinctions are important from my guest today, Carey Ramirez. Dealing with suffering every day: the life of a palliative care nurse. One of the questions I asked Carey Ramirez on this episode was what his typical day was like. He described a day filled with a series of emotionally-laden conversations with patients and their families that could even include the subject of death and dying. It’s not a job that just anyone can do, but Carey seems especially equipped for it, not only through his training but also by virtue of his temperament, personality, and gifts. You can hear how Carey moved into the area of palliative care and why he’s eager to see the subject taught in nursing and medical school, on this episode. When someone asks, “Am I dying?” - what do you say? As a palliative care nurse, Carey Ramirez is often asked by a patient if they are dying. It’s at that moment that a combination of knowledge, education, experience, and compassion go to work to help him assess exactly what that particular patient needs to hear - and how best to say it. He doesn’t shy away from speaking the difficult truths the question demands but also doesn’t want to cause unnecessary harm to the patient on an emotional level by an abrupt or uncaring response. You can hear what his years as a palliative care nurse have taught him about dealing with such difficult questions, on this episode. Two books every nurse and medical practitioner should read. When I asked Carey what resources he recommended for those who are interested in pursuing more knowledge about palliative care, he was quick to reference two books. First, he mentioned a more recent book, “Being Mortal” by Atul Gawande. His other recommendation was “On Death and Dying,” a classic by Elisabeth Kubler-Ross. Both books equip healthcare professionals to face the difficult questions they’ll face as they deal with the life and death situations they face daily. You can hear more of the suggestions Carey made concerning nursing and palliative care in particular, on this episode. Outline of this great episode [0:28] My introduction of my guest and today’s topic. [1:35] What is palliative medicine? [3:00] How palliative care is different from hospice. [4:32] Carey’s first nursing job and the path that led to palliative care. [7:43] Why are healthcare professionals focusing on end of life issues now? [11:58] How to get around the difficulties of talking about death and dying. [16:19] How Carey’s typical day runs at the hospital. [18:02] A typical conversation Carey has with patients and family. [22:59] How often do patients ask, “Am I dying?” and what does Carey say? [25:45] What are the basics about palliative care that  nurses need to understand? [30:46] How does Carey separate himself from the emotional load of his work? [32:58] What Carey feels is the best part of his job. [34:06] What nurse leaders can do to support palliative medicine. [39:06] Resources Carey recommends for those seeking to know more about palliative care. [40:35] Advice for those facing death or helping someone who’s dealing with death. Resources & Links mentioned in this episode Connect with Carey: Carey.Ramirez (@) uchealth.org BOOK: Being Mortal BOOK: On Death and Dying Connect with Brian Twitter @BrianWeirichRN BrianWeirichRN@gmail(dot)com