Impact of the question “how long do I have left to live?” On a graduate students in palliative care

Abstract

Advanced training in Palliative Care enables the development of specific skills in students. Aims: to report the experience of a postgraduate student during her internship integrated in an Hospital Palliative Care team (HPC) who was questioned by a patient: “How much time do I have left to live?” and promote reflection on the patient’s spiritual distress and what emotional management tools does the nurse need to have to manage emotions. Procedure: Descriptive study, experience report type. The experience described is based on the observation and records made during six visits by the student and the HPC. The report of the experiences in the 1st, 2nd, 3rd and 6th visits was prioritized due to the relevance of the data. Ethical principles, inherent to the report of experience, were respected. Male patient, at end of life, with stage IV pulmonary adenocarcinoma. Results: At the first and remaining visits, he expressed his wish to go home. The student developed a sense of observation and used active listening and therapeutic silence. At the 2nd visit, the possibility of Christian spiritual support was discussed.
This approach aroused in the patient the spiritual question “how much time do I have left to live?”. The student needed to develop self-reflection when confronted with feelings of compassion, fear and spiritual anguish. At the 3rd visit, there was the family conference and the patient’s mother asked the same question. The student used the awareness tools for the family. At the 6th visit, the patient continued to ask “how much time do I have left?”, expressing anguish by not having said goodbye to his family and friends. The student developed compassion, maintaining the patient’s psycho-spiritual comfort. Conclusion: The differentiated learning in palliative care endows the nurse with tools capable of maintaining humanizing care beyond merely technical interventions.