Value of an emergency doctor in a palliative care team (part 1)

Publisher’s note: The following post was written by two contributors: Jean Kriz, MD, Emergency doctor, and Sheri West, Rn. The two serve in the same palliative care team at the OSF Saint Anthony Medical Center in Rockford, Illinois.

Jean Kriz, MD – Emergency doctor

When I started this position part -time as a palliative care doctor a year ago, I felt like I was jumping in the bottom of the pool. I thought that I would be terribly under-qualified to assume this role because I had no experience in palliative care as an emergency doctor … or did I do it?

Much of palliative care is the management of symptoms. Do I do this in the emergency room (ED)? You bet I do! Why does a person come to an emergency, with the exception of symptom management? ED is not the place to go for a “assessment”, although some have tried! Emergency doctors manage a wide variety of symptoms ranging from pain and nausea to fatigue and anxiety with each change we work.

Another important role of the palliative care doctor is to help decision -making. This is an integral part of the practice of emergency medicine. Family meetings are very common in an emergency, although the circumstances and the framework are very different. The biggest difference is that these meetings are not scheduled and generally take place due to the need for an immediate decision with regard to the Care Department.

Finally, the establishment of good working relationships with primary care physicians and specialists is crucial to successfully coordinate care for our patients. As an emergency doctor, I have an in -depth interaction with these people every quarter work. They seem more receptive to my calls, however, when I wear my palliative care “hat!”

Does that mean that I was immediately comfortable in my new role as a palliative care doctor? Of course not! The last months have been a wonderful learning and growth adventure with moments that have been triumphant and moments that have been clumsy and painful. But what a great adventure! It is the one who, I hope, will continue for many years to come.

Sheri West, BSN, RN, CHPN – Palliative care nurse

An emergency doctor can provide a unique perspective on supporting patients and families seen by the palliative care team. This doctor generally practices in a very fast environment focused on aggressive treatment and survival interventions.

When the emergency doctor takes care of the palliative care team, they open conversations with patients and families who explore the patient’s medical preferences for future care beyond current admission.

The palliative care team becomes involved with patients facing a serious illness or chronic diseases that progress towards the end of the scene or the end of life. There will be a time when aggressive medical interventions will no longer encourage life but will extend the process of natural rolling. Patients often respond to the current treatment provided during hospitalization, although they are unable to maintain an optimal condition once released.

An emergency doctor throws a unique overview of the future to wonder if the patient returns to the emergency room. . . . What then? What can be offered? Is treatment aligned with patient’s medical preferences?

The emergency doctor, as a member of the palliative care team, influenced the whole team to consider the patient’s pathological process to anticipate the needs of patients and families. Supporting patients and families as they explore medical preferences is an important conversation for preparing them for the emergency service environment at a rapid rate in order to ensure that patient decisions are honored.

Last update: February 9, 2022