Managing COVID-19 and Cancer Requires Enhanced Palliative Care Skills

June 08, 2021 by Elisa Becze BA, ELS, Editor

Introducing palliative care from the moment of diagnosis is an essential component of comprehensive care, but it becomes even more critical when patients contract the COVID-19 coronavirus during treatment.  

In their article in the February 2020 issue of the Clinical Journal of Oncology Nursing, Rosa et al. outlined (https://cjon.ons.org/cjon/25/2/primary-palliative-care-clinical-implications-oncology-nursing-during-covid-19-pandemic) the enhanced primary palliative care skills that oncology nurses need to care for patients with cancer and COVID-19. 

Palliative Care Needs for COVID-19 

Patients with cancer are more susceptible to contracting COVID-19 and more likely to experience worse outcomes. They need comprehensive palliative care to manage those symptoms throughout the disease trajectory. 

For primary palliative nursing care, some of the virus-related competencies that Rosa et al. described (https://cjon.ons.org/cjon/25/2/primary-palliative-care-clinical-implications-oncology-nursing-during-covid-19-pandemic) were: 

Palliative Care Nursing Education 

To prepare nurses to provide person-centered palliative care during COVID-19, institutions should provide conduct and training in communication around end-of-life care, Rosa et al. said (https://cjon.ons.org/cjon/25/2/primary-palliative-care-clinical-implications-oncology-nursing-during-covid-19-pandemic). “Oncology nurses need coaching and mentoring around communication, common pain and symptom management, community resources, and planning within the confines of COVID-19.” That education should also include support for nurses to develop their own self-care and resiliency skills. 

The End-of-Life Nursing Education Consortium developed a collection (http://aacnnursing.org/ELNEC/COVID-19) of palliative care resources for nurses to use during COVID-19. ONS has a Nurse Self-Care Learning Library (http://ons.org/learning-libraries/self-care-nurses)

Questions to Guide Conversations 

Talking with patients and families about decisions and approaches when treatment turns from curative to comfort is never easy, but the uncertainty around COVID-19 adds another level of challenge. Rosa et al. provided (https://cjon.ons.org/cjon/25/2/primary-palliative-care-clinical-implications-oncology-nursing-during-covid-19-pandemic) a question guide that oncology nurses can use to facilitate patient discussions, assess learning needs and patient education opportunities, and inform the healthcare team about patient wishes for palliative and end-of-life care. The questions are organized according to the eight care domains that the National Consensus Project for Quality and Palliative Care identified for its Clinical Practice Guidelines for Quality Palliative Care. 

Structure and Processes

Physical

Psychological and Psychiatric

Social

Spiritual, Religious, and Existential

Cultural

Nearing End of Life 

Ethical and Legal

To learn more about the palliative care skills, competencies, and education needs for oncology nurses during COVID-19, including applying the skills and competencies to a patient case study, refer to the full article (https://cjon.ons.org/cjon/25/2/primary-palliative-care-clinical-implications-oncology-nursing-during-covid-19-pandemic) by Rosa et al. 


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