You are a ward doctor for the inpatient unit at Katharine House Hospice. Up to ten patients are admitted for reasons such as symptom control, end of life care, or respite. You work with two palliative care consultants at an inpatient and outpatient palliative care unit.
Each day begins with discussions with the palliative care nurses and consultants about community patients. This is a great opportunity to learn about managing patients in the community and how to make decisions about admission.
There is then a detailed hand over from the senior nurse about the inpatients followed by patient reviews and clerking new patients (done jointly by a doctor and a nurse)
On Wednesday afternoons there is an MDT meeting. All the patients at the inpatient unit over the last week are discussed. This is a good way of learning about every aspect of patient care including psychological, social and financial issues.
Katharine House Hospice, East End, Adderbury, OX17 3NL
Top tips for extra opportunities (e.g. teaching / skills )
Take the opportunity to learn about all aspects of the care of palliative care patients from the whole palliative care team.
Take advantage of the regular teaching available from seniors.
This post is very relevant to general practice and I do recommend it. It is a very well supported, consultant led job with regular teaching. We get the opportunity to learn at every step and seniors are very happy to support us throughout. There is always senior support and if there are any questions / doubt we can ask for help.
This is a great job for learning it:
- Improves your medical knowledge
- Improves your communication skills
- Enables you to work with patients and families
- Makes you capable of having a holistic approach
- Allows you to work with different team members e.g. nurses, social workers. This is very helpful to learn about their roles and how we can get work together in GP
- Enables you to manage symptom control including how to deal with opioids effectively and appropriately
- Improves prescribing knowledge and practical applications of this with patients in the community
- The emotional challenges of the job – you have to behave like a human being and perform like a professional. It can be upsetting, frustrating or sad in to see patients dying frequently. Support is there if you need it, we all support each other and do reflect.
- Difficult conversations with patients or the families for example if a patient is approaching end of life or to discuss resuscitation. However, there are many opportunities to improve our communication skills and again we are well supported if we are out of our depth.
- To look after complex patients can be challenging. For example, if pain control is not responding to usual management or it is more related to their psychological issues like anxiety or frustration related to their disease or fear of dying or denying the process of dying.
- We do come across ethical issues regularly for example differences of opinions within families about management plans.
The details are correct at the time of writing but are subject to change.