A recent study of nursing students providing palliative care in a Thailand-based intensive care unit (ICU) indicates a need to include exposure to these services in medical education and training.
Researchers examined the experiences of nine Thai third-year nursing students providing palliative care to terminally ill patients in the ICU who had varying levels of physical, mental, social and spiritual suffering.
The study, which was recently published in BMC Nursing, was intended to better understand not only the experiences of palliative care clinical delivery, but also its impacts on the seriously ill patients who received it.
Researchers’ analysis of the nursing students’ experiences revealed that increased experience and knowledge of palliative care services during medical training could result in an improved ability to manage pain and symptoms in seriously ill ICU patients.
“Nursing instructors should apply nursing students’ experiences of palliative care to improve and develop nursing education and activities to provide the better care knowledge and experience for terminal ill patients in the ICU,” researchers noted in the study.
The researchers performed in-depth interviews with each nursing student throughout a 12-week period of providing palliative care in the ICU.
The study gauged palliative nursing students’ self-perceptions around the quality of palliative care they provided, along with their ability to navigate their own personal biases and emotions throughout a patient’s ICU stay. Researchers also asked students to observe family experiences and outcomes of palliative care.
The analysis points to an association between clinical understanding of palliative care and quality outcomes.
Having a better understanding around palliative care helped to break down clinical misconceptions about these services and led to improved goals of care conversations, according to the researchers.
Addressing clinicians’ self-perceptions around death and serious illness was an important element to providing quality palliative care and understanding when and how to broach these conversations with patients and families, researchers found.
Additionally, the ability for clinicians to realize the value of palliative care services they provided was another key element to quality outcomes that included respectful and dignified experiences among patients, researchers indicated.
“Nursing students must be aware of [their] own feelings to be able to deliver humanistic care and enable patients to live the rest of [their] lives with dignity,” researchers stated. “Results can be applied to create learning activities to promote nursing students’ self-awareness.”
The study comes at a time when calls are growing louder in the United States for more experienced palliative care professionals amid rising demand.
U.S. medical students often receive little to no exposure to palliative care throughout the course of their medical training. This is leaving the United States among the nations worldwide strapped for clinical resources to provide palliative care as demand grows alongside swelling aging populations.
Palliative care providers have increasingly launched fellowships to address workforce challenges with local educational institutions, universities and colleges
Meanwhile, legislation has moved forward to shore up the nation’s palliative care workforce supply.
Sens. Tammy Baldwin (D-Wisc.) and Shelley Moore Capito (R-W.Va.) recently reintroduced the Palliative Care and Hospice Education Training Act (PCHETA), designed to grow the field’s shrinking workforce with federal support.
If enacted, the bill would bolster support for hospice and palliative care training programs for physicians, nurses, chaplains, social workers and pharmacists. It would also incentivize the development of continuing education and career development programs in the field.
