Department of Medicine (Y.S.), Palliative Research Center (PaRC), Section of Palliative Care and Medical Ethics, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Department of Psychiatry and Behavioral Sciences (W.E.R.), Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
J Pain Symptom Manage. 2024 Dec;68(6):641-646. doi: 10.1016/j.jpainsymman.2024.08.032. Epub 2024 Aug 28.
Clinician distress is common in serious illness care. Palliative specialists are often consulted for cases involving significant distress among primary teams. Consults involving clinician distress can be challenging to navigate when it feels like 1) palliative specialists do not have the right skills to be helpful or 2) palliative specialists are being asked to 'fix' difficult situations that would require changing other people's attitudes, beliefs, or behaviors, or healthcare systems writ large. This article uses three composite cases to illustrate types of clinician distress and examine the benefits and risks of palliative specialist involvement. We conclude with a discussion of potential impacts of palliative care consults for clinician distress on the field of palliative care and consider next steps in critically important efforts to support and sustain the entire workforce-both palliative specialists and nonspecialists alike-when caring for patients with serious illness and their family caregivers.
临床医生的痛苦在重病护理中很常见。当主要团队中出现严重痛苦时,通常会咨询姑息治疗专家。当姑息治疗专家似乎 1)没有提供帮助的正确技能,或者 2)被要求“解决”需要改变他人态度、信念或行为或整个医疗保健系统的困难情况时,涉及临床医生痛苦的咨询可能具有挑战性。本文使用三个综合案例来说明临床医生痛苦的类型,并研究姑息治疗专家参与的好处和风险。最后,我们讨论了姑息治疗咨询对临床医生痛苦的潜在影响对姑息治疗领域的影响,并考虑了在支持和维持整个劳动力方面的下一步措施,包括姑息治疗专家和非专家,在照顾患有严重疾病的患者及其家庭照顾者时。