Pandemic and palliative care | Expert network | Future Planet



When COVID-19 reached Ukraine, infectious disease specialist Stepan Karabinyosh was left at the center of the crisis. As he worked day after day in an intensive care unit, Karabinyosh found that his medical training had prepared him for the practical challenge of treating his patients, but not for the emotional side of informing more and more of them that, for the risk of infecting their loved ones, they would most likely die without seeing them again.

But Karabinyosh was better equipped for this experience than many of his colleagues: he had also received training in palliative care, a multidisciplinary approach that optimizes a patient’s quality of life during severe and terminal illness.

Karabinyosh learned the hard way about the need for palliative care training. When he began his career, he was overwhelmed by the burden of interacting with very sick patients. Even though she had little time to eat, she gained weight, stopped talking to friends and family, and did nothing but work and sleep.

Then one day, while taking an X-ray of a woman in her 70s, she took his hand and said, “Please do something, son … I’m dying!” At that moment, he saw his mother. He knew he had to guide her through a medical procedure that she might not survive, but it was difficult for him to face that conversation. He realized that if he wanted to continue working as a doctor, that had to change.

After receiving hospice training, those conversations became easier for her. He says the training helped him develop skills for active listening, establish a communication relationship and create empathy. And it taught him something fundamental: to separate the person who needs help from the disease to be treated. The ability to respond to patient fears was especially important during the early days of the pandemic, when the best approach to COVID-19 had not yet been determined and medical options were limited.

The ability to respond to patient fears was especially important during the early days of the pandemic

Palliative care also helps create a space for discussion about death when all medical options have been exhausted. Patients and their families are often unaware of the course of diseases. In these circumstances, palliative care helps them understand the prognosis and better prepare for the end of life.

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Although this specialty is associated more with improving the quality of life of terminally ill and seriously ill patients, it also includes techniques to help healthcare providers deal with the emotional burden of their work experience. It includes recommendations for self-care and psychological support, especially for medical personnel who work in settings where patients frequently die, or who must cope with the loss of patients whose death they would not normally expect, such as young people.

Palliative care also helps create a space for discussion about death when all medical options have been exhausted.

This type of support is now more necessary than ever. During the pandemic, healthcare workers faced unprecedented levels of stress. Rates of burnout, depression, and anxiety among physicians, nurses, and general healthcare personnel skyrocketed. An expert commented on an article in the medical journal The Lancet that the effects on professionals prevent recovery from the pandemic and endanger health in the world more generally.

Keeping experienced workers on the job is important for hospitals that already suffer from a labor shortage. We have found that clinicians with training and experience in palliative care were better prepared to meet these challenges and avoid burnout.

Many organizations – including mine, the International Renaissance Foundation – promote initiatives to train more health workers in this area. With the support of the palliative care teams of the Ivano-Frankivsk Center and the Mother Teresa Foundation, we created online seminars on grief and loss for healthcare professionals. We also conducted three workshops for medical personnel who worked during the pandemic. The program included psychological training, group and individual consultations with a psychologist and a chaplain, prayer, virtual tours, and art programs. The more than 50 participants in the courses noted that their psycho-emotional state stabilized and their sleep patterns improved.

We have found that healthcare workers with training and experience in palliative care were better prepared to meet these challenges and avoid burnout.

However, much more remains to be done. Preparing for future pandemics and providing better overall care requires fully integrating palliative care into health insurance and making it part of standard training. Medical personnel should gain practical experience in this specialty. As health care strategies are reevaluated in light of COVID-19, we need to consider palliative care as a critical part of the therapeutic process.

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George Holan

George Holan is chief editor at Plainsmen Post and has articles published in many notable publications in the last decade.

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