Hearts above water: Palliative care during a pandemic

Abstract

Social workers and nurses, as members of interprofessional palliative medicine teams, faced unfamiliar challenges and opportunities as they endeavored to provide humanistic care to patients and families during the coronavirus (COVID-19) pandemic. Typical methods for engaging patients and families in medical decision-making became thwarted by visitation restrictions and patients' dramatic health declines. This paper presents an innovative social work and nursing intervention aimed at enhancing humanistic patient/family care and advanced directive dialogs. Through incorporating a narrative synthesis of the teams' reflective journals from COVID-19, the paper chronicles the intervention implementation, patient/family responses, and team members' personal and professional meaning-making processes.

Palliative care strategies in the management of people with serious cases of COVID-19

“…Additionally, according to the studies, this new scenario highlighted other limitations at the clinical level in disease management, especially in cases of severe involvement, such as the need to “choose” which patients would or would not receive life-sustaining interventions ( 24 ) . With the increasing number of situations where severity was imminent and irreversibility was a fact, the need to increase care focused on relieving suffering and quality of life linked to conventional care became evident, with palliative care entering the scene in this context ( 15 , 17 - 18 , 22 ) .…”

“…In addition to allowing patients to be closer to their families, the strategy of virtual visits, telephone calls and recorded audio messages also enabled a closer relationship with the nursing team, even helping to better direct treatment, considering that many patients are submitted to mechanical ventilation, failing to express their wishes, so families act as their spokesperson ( 19 , 21 - 22 ) .…”

“…It is noticed among the reports observed in the descriptions of the studies that this assistance tool will become permanently present in the units, because in addition to helping in patients’ physical and psychological recovery, overcoming communication barriers with the outside world, it awakens in health professionals a deep sense of compassion. Faced with these experiences, the teams find valuable forms of reflection and confidence to face the daily mishaps imposed by the pandemic on their professional life ( 15 , 18 , 21 - 22 ) .…”

“…In addition to the fight against COVID-19, palliative care was essential, considering that it can contribute to controlling the symptoms of the disease, as well as providing psychological and spiritual support to patients and their families, helping the health team remain motivated to provide high-quality care to people who are in a state of extreme vulnerability ( 18 , 22 , 27 ) .…”

“…Hearts above water: Palliative care during a pandemic (22) 2021 Describe the aspects involved in nursing approaches during palliative care assistance that were structured to foster humanistic patient and family care amidst social distancing and visitation restrictions in the context of the COVID-19 pandemic.…”