Lucy Taylor is a fourth-year medical student at the University of Leicester, Leicester, UK. Her winning entry for the Royal Society of Medicine Palliative Care Section’s essay prize on the future of palliative care is published in the September/October issue of the European Journal of Palliative Care. Here, Lucy explains how she gained exposure to palliative care and what she learned along the way.
When I saw the topic of the Royal Society of Medicine Palliative Care Section’s essay prize: the future of palliative care, I immediately wanted to enter. It was a great excuse to spend time developing the thoughts I’d gathered through my experiences, and try to come up with some practical solutions.
During my second year at medical school, I began to seriously consider palliative care as a specialty, and I realised the importance of gaining as much exposure as possible.
The simplest way I manage this is by proactively identifying and shadowing the palliative care input in each clinical rotation. For example, on my primary care placement, I attended a nursing home visit and shadowed the Hospice at Home team. In hospital, I try to see the patients who are identified as requiring palliative input both with the base specialty doctors and the palliative team. It can be daunting to ask to do this – I’m always worried that people will think I’m being insensitive by crowding the patient. So far though, very few doctors have asked me to leave and the patients are generally happy to have me there.
I arranged an extracurricular placement at LOROS Hospice during a university holiday and later worked there as a bank healthcare assistant. Through this, I gained exposure to hospice care from a perspective that I won’t be able to experience later in my career. One afternoon, a group of primary school children arrived at Day Therapy. I observed the arts and crafts project that they were participating in with some of the patients, and listened to their conversations. The inquisitive questioning from the children, who were old enough to be sensitive but hadn’t yet developed a taboo about these discussions, led to death and dying being discussed openly. Having experienced the difficulty of having these conversations within my own family, I was mindful that the patients might not have been able to verbalise what they were telling the children before this encounter. The therapeutic effect of the afternoon on the patients was obvious. Imagining the children going home and talking to their parents about the new friends they’d made at the hospice, I hoped that hospices would seem less daunting to the whole family, and maybe it would even prompt further discussions about death.
Leicester University offers a Medical Research iBSc, in which students undertake a year of research. I contacted Professor Christina Faull at LOROS Hospice, who kindly offered to supervise my involvement in her research into discussing DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) orders with people from minority ethnic communities. During that year, I spoke to many healthcare professionals, researchers, patients and relatives about the importance of palliative care, the challenges it faces, and attended conferences where the future of palliative care was the focus of conversation.
I also work in my spare time on the administration side of the University Hospitals of Leicester’s Medical Examiner process. A senior consultant reviews the care of every patient who dies within the Trust and speaks to their relatives to ascertain whether anything could have been improved or learned from. This gives me an insight into the issues concerning palliative care in my local area.
Winning the prize was unexpected, but this, and getting my essay published in the journal, has encouraged me that though I am inexperienced, I am thinking along the right lines!
This post relates to a longer article, ‘What’s next for palliative care?’ by Lucy Taylor, published in the September/October 2017 edition of the European Journal of Palliative Care (EJPC). (vol. 24.5).
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