A Story of Implementing Palliative Care in an Inner-City Trauma/Surgical Intensive Care Unit

Foundation of the University of Medicine and Dentistry of New Jersey Medical School (Newark, N.J.)

Synopsis of Work: The Trauma/Surgical Intensive Care Unit (SICU) at University Hospital in Newark must deal with the fallout of life and death traumas. This is the focus of the interdisciplinary palliative care program at University Hospital, part of RWJF's Promoting Excellence in End-of-Life Care national program.

Story Told: Recognizing when it's time to stop treatment is something most surgeons have to learn, says SICU Chief Surgeon David Livingston. "There's a difference between when you are doing something for a patient, and when you are doing something to a patient, but that transition is subtle."

The program's innovations have affected the unit's nursing staff. "I'm not saying that before we were not sensitive," said Shyla Joseph, a seven-year veteran on the unit, "but now they make more resources available."

La Vern Allen, a nurse who has been on the unit two-and-a-half years, notes: "The program has made our job easier. It's difficult when it's just you and the families and they are upset with you for breaking bad news. Now we can call a team to back us up. We've learned from them to be more conscientious in what you say—and you say it with more compassion. You keep it in the back of your mind: If that was you, how would you want bad news to be told?"

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