August 7, 2020
PAs on the Front Lines: Sarah Chobot in Palliative Care
“Providing excellent care to these patients is an honor”
May 13, 2020
By Sarah Chobot, MPAS, PA-C
I work on an inpatient palliative care consult service seeing patients throughout the hospital, from the emergency department, to hospital floors, non-COVID-19 ICUs, and designated COVID-19 units. Palliative care is specialized medical care for people living with serious illness and can include a wide range of care – pain and non-pain symptom management, assisting patients and families with complex medical decision-making based on their goals and values, providing psychosocial support through the stress of the illness – with the goal to improve quality of life.
During the COVID-19 pandemic, our team has thought creatively about how to best support our patients and their families, our colleagues, and each other. Our patients have been in the hospital by themselves due to visitor restrictions. Family members who are now struggling to cope with a seriously ill loved one may also have additional stressors such as recent job loss or homeschooling duties. Our colleagues have been redeployed to fields of medicine and areas of the hospital that are unfamiliar. We are all navigating uncertainty in the hospital and in the world.
Helping to connect families and patients
Our team has taken an “all hands on deck” approach to help families connect with patients in the hospital. In addition to clinical updates being given by various team members, we facilitate additional calls with family, using technology for video chats and multi-line conference calls so families can come together despite physical distance, and we encourage families to send photos to place in patients’ rooms. We want to keep families as connected as possible to their loved ones in the hospital.
Patients and families benefit from early conversations regarding values, goals, and preferences, and they often welcome these conversations so that they can make their care preferences known. We continue to have these conversations throughout the COVID-19 pandemic either in person or virtually. We prioritize patients’ goals and tailor treatment plans around what is most important to the patient.
As a result of COVID-19, at times, patients are requiring end-of-life care in the hospital instead of at home or in a hospice facility. Ensuring that families are able to connect with a patient at the end of life, either in person on a case-by-case basis with appropriate PPE, or virtually with the assistance of staff, is of the utmost importance. Additionally, providing excellent symptom management at end of life is also of the highest priority.
It is an honor to work with my fellow palliative care colleagues and hospital staff to provide excellent care to these patients. It is a true team effort.
My advice to other PAs is to try to support one another the best you can. Everyone is coping with some sort of change and uncertainty right now. It just looks a little different for everyone.
Sarah Chobot, MPAS, PA-C, practices palliative care at Penn Presbyterian Medical Center in Philadelphia, Pennsylvania.
Please consider sharing your own experience on the front lines of the COVID-19 response with us.