The Power of Palliative Care
RN's use tools such as therapy and education to
soothe patients' end of life care.
Nursing Spectrum — www.nurse.com
By Pamela Stone
The hospital room is dimly lit. A recording of harp music plays softly in the background as Sister Suzanne Skowronski stands over the patient. She asks her to relax and picture herself on a vacation. Her hands then sweep across the patient's body, barely touching her.
Sister Skowronski's approach is called healing touch therapy. "I use my hands to move the heat, which is often associated with the pain," explains Skowronksi, RN, MSN, CHTP, a Religious Sister of Mercy.
Although it was once thought to be controversial, Skowronski believes in touch therapy. As she puts her hands on a patient's joints, such as their ankles, knees, hips, elbows and shoulders, she feels the warmth under her hand.
"Touching these joints puts energy back into the muscles, bones and circulation, so that the parasympathetic system can get stronger," Skowronski says. "Then the body relaxes, allowing healing chemicals and increased blood flow to return from the body's limbs to vital organs."
Skowronski believes most pain is caused by stress. When stress is relieved, healing begins. However, Sister Skowronski doesn't believe that healing touch is a cure, or should take the place of medicine. "It isn't as effective as morphine, but it is as effective as aspirin."
Sister Skowronski is not alone. As part of a team of palliative care nurses at St. Joseph Mercy Oakland Hospital in Pontiac, Mich., a Catholic community hospital, she partners with other members of the pain management, palliative care services team. The team includes musical therapists, nurse practitioners, and a nurse manager, as well as the director of the program, Peg Nelson, RN, MSN, a board certified palliative care nurse. In addition, the palliative care team is supported by a hospital social worker, chaplain, and counselor, as well as 80 volunteers who assist nurse and patients in a program called No One Dies Alone.
Sister Skowronski held the first staff position dedicated to providing healing touch services to inpatients at St. Joseph-Mercy. Since the No One Dies Alone program began in 2001, she has served as the healing touch practitioner in pain management, palliative care services at St. Joseph Mercy Oakland.
To Skowronski, healing touch is unique because it "brings the heart back into nursing," she says. Her approach is so effective some patients refer to her as the "angel of mercy."
"The touch helps with healing, providing a sense of balance, which helps overcome their illness – or relaxes them if they are dying," says Skowronski, who formerly specialized in the care of burn patients. "If a person is dying, the resistance or fear holds them back. As they breathe easier; they go with the process that is happening to them. It's like riding a bicycle, you get the rhythm, then you can relax and go with it."
During the dying process, Skowronski encourages families to gather around their dying loved one, talk to each other, tell stories, or share pictures. "Family talk can be comforting," she says. "It helps families to terminate the relationship and say goodbye."
Nelson believes that the pain management, palliative care services team has made a valuable commitment to dying patients. "About 10 % to 20 % of the patients who die in the hospital do not have family with them," she says. "The idea of dying is difficult for nurses, so they welcome the assistance of volunteers who often sit with six to eight patients a day." Since March 2005, No One Dies Alone program volunteers at St. Joseph Mercy Oakland have sat over 2,000 hours with patients, Nelson adds.
The goal of palliative care is to prevent and relieve suffering and to support the best possible quality of life to patients and their families, regardless of the stage of the disease or the need for other therapies, according to the American Academy of Hospice and Palliative Medicine.
Nelson says palliative care provides ways to alleviate pain or end-of-life problems, such as clarifying goals, supporting family, and dealing with psychological-spiritual issues, including how to make an environment soothing and peaceful around these patients.
Nelson defines palliative care — as consisting of pain management and palliative or "supportive care," offering nontraditional therapy integrated with traditional medicine. Palliative provides ways to alleviate pain or end-of-life problems, such as clarifying goals, supporting family, and dealing with the psychological-spiritual issues of end-of-life issues, including how to make an environment soothing and peaceful around these patients.
(More information can be obtained by contacting Pamela Stone at firstname.lastname@example.org).