- Sometimes palliative care can be challenging. Issues that may be hard for GPs to deal with include:
- Clinical anxieties eg, if there is a perception that a diagnosis was missed or delayed
- Difficulty in working out how and when to switch from a curative to palliative approach
- Feelings of reluctance to take on complex problems because of time constraints in general practice
- Difficulty dealing with clinical uncertainty
- Feelings of clinical helplessness if unable to completely relieve the distress of a patient or family, or feeling that an outcome was unacceptable
- Being involved in caring for a dying friend, colleague, or family member
- Caring for a patient with whom one identifies in some way.
- In a busy general practice setting it is common for GPs to 'soldier on' despite a level of distress. However, accumulating stressors can lead over time to burnout which:
- Affects wellbeing and relationships
- Impacts on workplace and colleagues
- May reduce the quality of the care the GP is able to provide.
- Useful clinical strategies for professional self-care to reduce the risk of burnout include:
- Recognising that all doctors will sometimes be troubled by difficult cases
- Sharing care with others, or referring on, if there are 'boundary issues' or strong feelings involved
- Accepting the limits of the care that can be provided within the constraints of a busy general practice, and not setting unrealistic expectations - sharing care may be helpful here
- Discussing a difficult case with a trusted colleague or a member of the palliative care team - this can be very reassuring, even quite some time later.
Tools and Resources for professionals
Last updated 14 February 2017*
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