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Healthcare providers are committed to caring for their patients, and patients expect to be cared for skilfully. Both patients and clinicians often have high expectations of the clinical encounter. As well as professional competence, the aspects of the healthcare relationship that patients value include:

  • Communication
  • Empathy
  • Honesty
  • Availability. 

All of these factors become even more significant for patients who are confronting a life-limiting illness, but sometimes these expectations can seem overwhelming to clinicians.

Due to the high level and intensity of the interpersonal relationships which are built into clinical work, and the complexities of surviving as a professional in a setting of competing, and often excessive, demands, some healthcare workers become stressed or risk burnout.

Factors unique to palliative care

  • Accumulated losses, emotionally charged care
  • Sustained and exclusive focus on terminal illnesses and terminal care
  • Mortality issues of the clinician (existential, spiritual, or personal)

Clinicians such as general practitioners, who care for only a few palliative care patients in their practice, may be greatly affected by this experience. They may experience:

  • Difficulty shifting from curative mode, where death = clinical failure, to a palliative and supportive role where death is an inevitable and appropriate outcome
  • Guilt, if perceiving that a diagnosis was missed or delayed
  • Trauma, if unable to relieve difficult symptoms or intense distress in the patient or their family
  • Confronting their own mortality issues.

However, those who work in well functioning palliative care teams can also experience some powerfully protective factors:

  • Supportive teams allow opportunities for reflection and debriefing
  • They create an emotionally open work environment
  • They have a shared culture of care and accumulated wisdom about supporting patients and families at the end-of-life.

This page was created on 19 May 2006 and is scheduled for review in May 2008, 
This page is currently under  review.
 

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