Perhaps the toughest part of working in a hospital is dealing with death. Every day, healthcare providers are eyewitnesses to patient pain, family stress and the other gut-wrenching issues surrounding end-of-life care. Death may go with the territory, but coping with it is never easy.
That's why hospital and health system managers should encourage staff physicians and other employees to evaluate the way they care for the dying. Research shows that patients want open communication with physicians so they can work as a team on pain relief, depression and life-support decisions. To widen the communication channels, the American Medical Association has launched an educational campaign to help physicians deal more compassionately with terminal illness. The AMA program offers conferences, videos, workshops and manuals that outline ways to discuss treatment options with patients and their families.
Although these are fundamental medical issues, physicians need the help and support of the entire organization, including top management. The crucial first step is encouraging dialogue among patients, families and caregivers. For instance, health systems should recommend that physicians share their philosophies regarding life support and care for the dying. In addition, hospitals should work closely with hospices and home-care agencies and let dying patients know those options exist.
On the pain management side, we see too many roadblocks and not enough research. What providers desperately need is access to clinically tested practice guidelines to treat pain control.