palliative care nurse

A Day In The Life Of A Palliative Care Nurse

This Lionfighters post features Katie Vail, MSN, APRN, CPNP. Katie is the nurse practitioner for Children’s palliative care program, Hand in Hand.

Palliative care is not hospice care. It’s about providing comfort and support to patients and their families. This support is all about meeting a person’s physical, emotional, social, and spiritual needs.

Here’s what Katie’s day is like as a palliative care nurse.

Q: How did you become a palliative care nurse?

Katie Vail, MSN, APRN, CPNP: I have worked in pediatrics during my entire 12-year nursing career. I started working with palliative care because I love caring for others and supporting the entire family.

I became interested in palliative care because I previously worked in the pediatric intensive care unit (PICU). I got to know several of the team members there. I had the opportunity to shadow the previous palliative care nurse practitioner before I joined the team.

I could see that this was an area that can be extremely beneficial to pediatric patients who are chronically ill, and to their families. I love being active in the total care of a child’s body, mind, and spirit, and also giving support to the entire family.

I like that palliative care is an interdisciplinary medical specialty. That means it pulls together treatments from many different areas of medicine.

I also like that it’s a way to prevent and relieve distress. It helps patients and their families have the best possible quality of life.

Q: What kind of background and education did you have before you went into palliative care?

Katie: This is my first role as an advanced practice registered nurse (APRN). That’s the title given to nurses who have a master’s or doctoral degree. I’d previously worked in the pediatric intensive care unit (PICU) as a bedside nurse and as a primary care nurse with Children’s Physicians.

Q: How is the Hand in Hand palliative care program especially helpful to kids with cancer and their families?

Katie: The Hand in Hand team is an extra layer of support for all of our families.

Our approach is multidisciplinary. We have two physicians, a nurse practitioner, a social worker, a nurse case manager, a chaplain, a child life specialist, and a healing touch practitioner.

palliative care nurse

Our team focuses on quality of life, and we help with complex medical decisions. We can adjust our approach to meet the needs of each patient and family. We assess their goals and discuss treatment options without passing judgment.

So, for instance, we can discuss all of the options for families who are trying to make decisions about breathing tubes, feeding tubes, or the right medication for pain.

Our goal is to stay true to the path that the family wants to follow and make sure they are always supported.

And we provide support for the whole family, including siblings. A child life specialist can assist with this by explaining procedures or diagnoses at a developmentally appropriate level.

Sometimes, this means using play therapy to help them understand devices like a g-button—the part of a feeding tube that you open to deliver food or medicine.

We also offer healing touch therapy. Healing touch is a relaxing, nurturing energy therapy (biofield energy therapy) that balances the body’s energy fields to encourage pain relief and healing.

Healing touch provides an alternative approach to pain and symptoms management. It is a holistic approach, recognizing and honoring that we are of mind, body and spirit.

Q: What is a typical day like for you as a palliative care nurse at Hand in Hand?

Katie: Typically, I see all inpatient palliative care patients either daily or weekly, as needed. I also oversee consultations for new patients. And our whole team meets weekly to keep everyone on the same page.

While kids are still inpatient, we create a palliative plan of care (POC) with goals for each patient. We coordinate with a child’s primary care team to work toward a goal of a safe discharge plan from the hospital.

Once a child is outpatient, we talk with the primary team to stay updated on what is going on with the child. We follow up and call the family post-discharge and assess for any additional palliative care needs. They can schedule an outpatient clinic appointment, if needed.

Q: What are 5 things you want families of childhood cancer patients to know about palliative care?

Katie: First, palliative care begins at the time of diagnosis. A lot of people think we only provide end-of-life care, but we can walk the path with them throughout, beginning at diagnosis.

Second, we provide both inpatient and outpatient support. We have an outpatient clinic, and we’re available by phone when a child is not hospitalized.

Third, palliative care is appropriate at any age and at any stage of an illness. It can always be provided alongside therapies that are aimed at treating the disease—like chemo or radiation.

Fourth, palliative care is not end-of-life care or hospice care. But our team can help coordinate hospice services, if necessary.

And fifth, our team does not judge. We are here to help families make the best informed decisions for their child.

Please share your thoughts in the comments below.

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Anisa Hoie
I've been a nurse for nearly 32 years, mostly taking care of kids with cancer. My job is to give the kids and their families a personal touch while they go through treatment.

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