The Master of Science in Palliative Care prepares physicians, nurses, physician assistants, and pharmacists to be Palliative Care Community Specialists.
Hi there, I am Regina Fink, one of the nursing co-directors of the new interprofessional Master of Science in Palliative Care Program (MSPC) at the University of Colorado. We are on an exciting journey – offering state-of-the-art palliative care education to working health care providers. We have also developed a Palliative Care Certificate program consisting of four courses that can get you started in palliative care and help you prepare for palliative care nursing certification.
What do you think patients living with serious and life-limiting illness in your hospital, long-term care facility, or outpatient clinic would say if they were asked:
Over the past two days, how much have you felt heard and understood by the doctors, nurses, and hospital staff? Completely, quite a bit, moderately, slightly, or not at all?
As a healthcare provider I am asked to weigh in on pain management by both patients and family members. Usually it is to treat a bad sprain or other recreational injury from hiking, skiing or some other fun Colorado outdoor sport. Or it could be because of some surgery, maybe to repair an injury.
I am of two minds. As a hospice doctor I visited a lot of people at home. I loved making home visits! The familiar smells of home cooking, the loved but “eclectic” collections of furniture that did not have to be pre-distressed because it was distressed. The home environment wrapping a dying person into the fold of every day family life. But I also grew up poor and know what inadequate housing looks like; what living on the edge means on a daily survival basis.
“Take My Breath Away” was written specifically for the movie Top Gun, starring Tom Cruise and Kelly McGillis. The movie was a hit but the song has lived on with covers by many pop artist. If only I could get people to pay as much attention to COPD as to this memorable song. After all, people living with COPD, constantly feel breathless.
In June 2015, I wrote about the need for new training programs in palliative care, because of the projected shortage in providers. At that time I wrote that Amos Bailey, MD, a well-known leader in the field of Palliative Medicine and a new colleague of mine at the University of Colorado had a pretty innovative idea. He had set up a task force to offer a new degree program: a Master of Science in Palliative Care. This would be an inter-professional executive master’s that would be provided predominantly online with three separate one-week on-campus intensives. The program would be designed for the clinicians (physicians and advance practice providers) who were already working and needed or desired more training in palliative care.
Aug 5, 2020
by Melissa C Palmer, LCSW, ACHP-SW, APHSW-C, JD
I turned 50 this year. A milestone birthday, heralding a new chapter in my life. What I was not prepared for was the change in attitude of younger people that I encounter in my work and personal life. As it was, I felt the sting of ageism during my pregnancy at age 40, having the term “geriatric pregnancy” included in my medical records. But I have experienced a rite of passage that is not talked about or acknowledged. I am becoming invisible.
What is important, and what gives meaning to life? Often families are most distressed that their loved one will not eat! It would be fine if the loved one could not get out of bed, but he/she must clean their plate. Healthcare providers must ask and record the pain score every shift, at least! Or get their knuckles wrapped and bad evaluations.
During this pandemic experience, we’re all adapting to new rules and restrictions. These changes often mean the loss of meaningful everyday activities. A few weeks ago, we could hug a friend, browse books at the public library, shop at the mall, or enjoy a sit-down meal in a restaurant. It’s easy to brush off our feelings about losses that seem trivial when compared to the loss of life some people are facing with COVID-19. But our grief about losses of any type is real and needs to be acknowledged. When losses aren’t validated, our grief is disenfranchised, and this affects our well-being and ability to remain resilient in challenging times.
The importance of goal-concordant care is not new or even substantially different in the context of this pandemic, but the importance of providing goal-concordant care is now heightened in several ways. J. Randall Curtis et.al.
I keep remembering the words of Cicely Saunders spoken to her young patient as he lay dying. “You matter because you are”. This became the mantra of Palliative Care and began a world movement and a new paradigm in caring for the dying. Death is regarded as a sacred rite of passage. To care for a dying patient became a privilege and honor.
I have heard many times how those around me are looking forward to getting back to “normal”. When I have asked people to clarify, “normal” means being able to go out without worrying about being careful, not having to wear protective equipment, taking a bike ride at a moment’s notice, or heading out for Saturday evening dinner and movie. For others it is travel to Hawaii for spring break. For many of us, we miss the life we enjoyed and took for granted prior to the pandemic.
“Well, if I am able to eat chocolate ice cream and watch football on TV, then I’m willing to stay alive. I am willing to go through a lot of pain if I have a shot at that.”
Jack Block PHD father of Susan Block MD regarding his goals of care as retold in Being Mortal by Atul Gawande.
Recently, while on a clinical service for the Inpatient Palliative Care Consult Service we remarked on all the patients we were seeing who had COVID-19 but what about those folks we usually consulted on? Those being considered for a destination LVAD, or living with metastatic and progressive cancer, being considered for, or recovering from a Bone Marrow Transplant…where are these people? Many are at home, impatiently waiting for things to get back to normal.
May 26, 2020
by Melissa C Palmer, LCSW, ACHP-SW, APHSW-C, JD
At the University of Colorado’s Graduate School 2020 graduation, Dean Engelke announced the exciting news that Dr. Regina Fink has been bestowed the Outstanding Dean’s Master’s Mentoring Award for 2020. Nominated by multiple students, Dr. Fink was described as “generous with her time” and “listens to students as individuals”.
I think I learned this joke from the famous Dolly Parton, and it works better in my Southern accent. At least once a week I would hear someone say this in relationship to a patient or family member who seemed to have unrealistic expectations.
COVID is not fair to anyone but is less fair to many in our society who have the least resources to cope. Those who get really sick and die are more likely to be poor, to live in communities with fewer resources, have less access to health care, and other supports that make up the Social Determinants of Health and are people of color.
When I saw this article and title I was intrigued. This could be very political, and this is in JAMA? Well, it is political, but isn’t everything? Don Berwick is the author; I met him over 20 years ago. He started the organization Institute for Healthcare Improvement (IHI). He popularized Continuous Quality Improvement and the omnipresent PDSA (Plan Do Study Act) programs. He has been sounding the alarm on the plague of iatrogenic harm and death patients experience from the health system, which is now estimated to be several 100,000 deaths a year.
May 5, 2020
by Melissa C Palmer, LCSW, ACHP-SW, APHSW-C, JD
I have heard many times how those around me are looking forward to getting back to “normal”. When I have asked people to clarify, “normal” means being able to go out without worrying about being careful, not having to wear protective equipment, taking a bike ride at a moment’s notice, or heading out for Saturday evening dinner and movie. For others it is travel to Hawaii for spring break.