Making the emotional connection is the first and, generally, hardest part. As a nurse on the Oncology/Palliative Care unit, Amy Dawe, RN treats and cares for patients who have serious or terminal illnesses. Most are cancer related.

"I meet the most amazing people on this floor," said Ms. Dawe. "I go through so many experiences with these patients."

Palliative Care nursing is a specialized form of nursing. The 4North nursing staff at St. Joseph Hospital treat not just a patient's physical symptoms, but also emotional, psycho-social and spiritual issues that can be part of the dying process.

"The nurses deal with quality of life and end of life issues with our patients," said Kim Leets, RN, OCN, Nurse Manager of the Oncology/Palliative Care Unit at St. Joseph Hospital. "Oncology and palliative care nursing is a demanding job and requires advanced nursing and clinical skills, confidence and an ability to communicate well."

Communication is Critical
Palliative Care nurses must have excellent communication skills. Many times the nurses and social workers help patients initiate conversations about their disease and feelings. Taking this first step is an emotional risk.

"Making that first step or point of contact is the most difficult because I run the risk that a patient may become upset," said Ms. Dawe. "But as a nurse, I get to know the patients so well that I know what emotional stage they are ready or not ready for and the discussions that may need to happen."

Empowering the Patient
Many times these conversations provide the catalyst for patients to take control by discussing options for medical care and writing letters to loved ones. The end goal, said Ms. Leets, is to provide the support and resources to their patients so they can decide how and where they want to die. For example, she said some patients are not comfortable dealing with family issues and psycho-social issues.

"It's an intense environment because both the patient and family are affected," said Ms. Leets. "A person can't control the fact that he or she is dying, but that person can control how he or she dies and what's left behind for their loved ones."

A Team Approach
The Circle of Life Palliative Care team at St. Joseph Hospital supports the 4North nursing staff. This specialized team includes a dedicated physician, oncology and hospice nurses, a social worker, ethicist, chaplain and program coordinator.

"Dying can be a positive experience," said Ms. Leets. "It can happen in a way that, although there is a great sense of loss, the patient and family are supported through the entire process. Whatever we, as healthcare professionals, can do to facilitate the dying and bereavement process will make a significant difference in promoting healthy grieving and closure."

For more information about The Circle of Life program or Palliative Care nursing at St. Joseph Hospital, please call 1-800-210-9000.