Thoughts on Palliative Care

By Saara Mohammed

Leafing through the National Association of Social Work Standards for Social Work Practice in Palliative and End of Life Care, I recognized a lot of values and roles outlined that I had observed when shadowing a social worker last year. I shadowed a social worker working in the University of Michigan hospital, who, during the day I spent with her, dealt with a patient with sepsis whose family members refused to meet and come to a conclusion about continuation of care, as well as treatments prescribed by a physician that did not align with the social worker’s goals. 


This is the part that truly struck me. I remember the social worker mentioning all the health care professionals that she collaborated with in order to do her job well: two attending physicians, two registered nurses, one other social worker, as well as an intern. As I remember from my day, all of the aforementioned caregivers met to discuss all areas of a patient’s care. 


It seems that the collaboration between health care professionals is not the lacking piece that is making end-of-life care such a difficulty to handle. All health care professionals, from the interaction between techs and nurses to those between primary care physicians and specialists, are vital to the ability to help a patient. It wouldn’t make sense that a lack of interaction or collaboration is what is leading to the lack of quality care for patients at the end of life. 


So it might be that those interactions are lacking in respect to the professionals’ willingness to understand each other’s roles and goals, and that idea is scary. The idea is that hours of time have been spent in meetings aimed at helping the patient, without an understanding the necessity of a treatment over a lack of treatment, or the value of pulling back on treatments over pushing harder. 


If there are prejudices about the place or role of either professional or a lack of understanding in these interactions, then both health care professionals are failing their patients.