We hear from a new palliative care nurse about his experience on the job.
I have worked as an intensive care unit nurse for seven years, and when COVID-19 hit, I was directly involved in taking care of infected patients. Working during the pandemic was the most difficult experience of my career because while I feared the deadly virus, I still needed to care for my cardiac, surgical, neurologic and pandemic patients. After caring for COVID-19 patients for the past three years, the experience sparked an interest in palliative care. To pursue my dream, I joined the Singapore Cancer Society in 2022, where I took care of terminally ill patients.
Being a palliative nurse is more of a calling because it is demanding, stressful and challenging. However, through workshops, mentoring and support programmes, I have become better adapted and equipped for my career in palliative care.
As a palliative nurse, I spend most of my time caring for terminally ill individuals to relieve their pain, suffering, and symptoms. While it has been fulfilling working as a palliative nurse, I often encounter complex situations that have no clear answer or immediate solution. This is because patients at the end of life often experience complicated emotions and are less able to make clear decisions about their own care. I once had a male patient who was diagnosed with stage 4 lung cancer. He was in denial of his condition, refusing care and even forbade me from visiting him at home. I was in a quandary, as I needed to respect his autonomy and privacy, yet ensure he received the support needed to improve his quality of life.
It was frustrating for me to go to his house; sometimes, he would chase me out, but there were times when he welcomed me too. However, I did not give up. I kept trying to establish rapport with the patient to gain his trust and accept care. Soon, we started communicating about his health over WhatsApp. I also managed to develop a close relationship with his wife and son, and when he got very sick and weak, the family worked with me to promote his well-being. When his health deteriorated and he could no longer chat on WhatsApp, the family decided to include me in their family chat group where we would update each other and decide on ways to improve the patient’s quality of life. This was a very fulfilling moment for me. Sadly, the patient passed on a few months later, but his family was grateful for my care and support. In this case, I learned the need for perseverance in building strong relationships.
Another issue I faced working in palliative care is burnout and compassion fatigue, which have affected my health and well-being. Spending a lot of time with people in chronic pain and suffering is emotionally draining and demanding for me. At first, I was so focused on the job that I neglected personal care, health, and well-being.
Soon, I realised the need to balance work and life, and I have become more self-aware and take regular breaks to engage in physical exercise and other leisure activities to relax and rest. Since starting this routine, I have been coping well with the stressful working conditions in the palliative care unit and enjoying good physical and psychological health outcomes. The palliative care journey is not easy , but it makes me feel grounded and more appreciative of life. I thank my patients daily as they are my best teachers in palliative care, as well as being my friends too.
Photo: SCS Hospice Care