Thrive by IU Health

June 01, 2021

Palliative care nurse during COVID-19: “I try to be a voice for patients and their families”

IU Health University Hospital

Palliative care nurse during COVID-19: “I try to be a voice for patients and their families”

She’s always been part of a team that cares for seriously ill patients. What’s changed since the COVID-19 outbreak is she is now in the role of bedside care and representing family members.

By IU Health Senior Journalist T.J. Banes,

It’s not only patients who are being treated for COVID-19. All patients are now experiencing a new type of care – void of visitations by friends and family.

It sheds new light on palliative care. A medical specialty focused on improving a patient’s quality of life, palliative care helps ease the symptoms of serious illness. Providers specialize in symptoms that cause distress such as pain, nausea, anxiety, and breathing. Advanced practice nurse Joy Howard is part of that team at IU Health. She cares for seriously ill patients. Others on her team include social workers, chaplains, physicians, pharmacists, and nurses.

Until recently, family members of the patient were also part of the team. With visitor restrictions, there’s a new level of responsibility for members of the palliative care team – patient communication.

“With no visitors in the hospitals if the patient is too sick to have conversations I make a lot phone calls with families,” said Howard, who has been a nurse with IU Health since 2008. “It’s normal to make phone calls but what’s different is that we’re usually able to meet families in person and establish a rapport. In person we can gage body language – see their faces and take all their feelings into account. We can no longer do that in person,” said Howard.

On a recent afternoon she was preparing to make one of those difficult calls to a family to tell them the status of the patient. She wanted to FaceTime the family but knowing the patient was unresponsive, she put herself into a place as the voice of the patient, and the voice of the family.

“I had a call yesterday talking with a family member about moving toward comfort measures and family members were talking about how they could say, ‘good-bye.’ In the background I could hear the spouse sobbing. It’s hard to hang up from a call like that and not feel great sadness,” said Howard.

To help the team members navigate the day-to-day patient care, the palliative care team at IU Health schedules daily WebEx meetings – including team members from IU Health University Hospital, IU Health West, Tipton, North and Methodist. Administrative Director Jim Luce offers updates and opportunities for team members to share information about each site.

“We ask if anyone needs extra help and we keep a pulse on how everyone is doing emotionally,” said Howard. “It’s tough. There’s a lot of focus on COVID patients right now but this is all patients who are receiving palliative care,” said Howard who works at both IU Health University Hospital and Methodist Hospital.

In the past, if a patient was in palliative care, team members may plan a special anniversary celebration, a birthday, or even a wedding. Now they are doing all they can to provide the maximum comfort offering simple things – like a favorite food or drink.

Howard, Patrick, Phoebe and Phoenix

“I went into nursing to care for others and I never anticipated this – who does,” said Howard who is married to Patrick. They have a daughter Phoebe, 7 and a son, Phoenix, 8. When she’s at home she relaxes by watching movies with her family, crafting with her children, and sewing medical masks.

“My husband is worried. He wants me to be as far away from the hospital as I can be. I feel the opposite. I want to be as helpful as I can.”

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