Keeping Life in End-of-Life Care

There’s no way around it: Caring for patients with terminal illnesses is a tough job. But it’s also a special opportunity to focus on life in the end-of-life experience.

Kurt Pinto knows. As a registered nurse in inpatient oncology and pulmonary medicine at NYU Langone Health’s Helen L. and Martin S. Kimmel Pavilion, he is among the last caregivers for many of his patients. Yet every day he sees moments of grace that provide patients and families with comfort—and strengthen his calling as a nurse.

“Oncology is a unique nursing practice,” Kurt says. “Patients [with cancer diagnoses] often face an existential crisis that allows them to have a different perspective on life.” Everyone copes with terminal illness in their own way, but Kurt has noticed that patients focus on life and their loved ones. They tend to show a sense of optimism and openness. “The way that we talk about large-scale tragedies bringing out the best in people, it’s the same thing when tragedy strikes on a personal level.”

But Kurt also sees the flip side: family members getting caught up in their own fears over the loss of their loved ones. “I try to get the family in the here-and-now” and to look at the end-of-life experience from the same angle the patient adopts.

He recalls one family who mentioned him in the eulogy for their loved one. The patient was failing to thrive when she came into the hospital but started to perk up around Kurt. Though she was close with her adult children, their fears and frustrations about her illness were causing her even more stress. Kurt helped the children reconnect with their mother, even on difficult days. They were able to be more present and supportive before their mother passed away.

When the family wrote to Kurt about thanking him in the eulogy, he felt like he’d excelled beyond the calling of nursing. “When you care for someone at that point and provide them with comfort—physical and psychosocial—the gratitude they feel for giving them a sense of safety can be so rewarding that it eclipses sadness.”

Although Kurt finds his role deeply fulfilling, he admits that oncology nursing is not for everyone. “You need to have an interest in oncology to serve in it, especially for individuals who have lost loved ones to cancer—it can be scary.” He explains, “People are emotionally affected by the job, but there are evidence-based ways of helping nurses cope.” For example, at NYU Langone, a psychiatrist hosts a group session for the unit to debrief when a patient dies. “And visits from cancer survivors are amazing! People come back looking completely different.”

Beyond the emotional challenges, it’s also difficult to find an adequate way to measure the impact of end-of-life nursing. Nursing quality metrics are often based on health outcomes and patient satisfaction surveys, which just aren’t possible in this field. Less feedback and data make it hard to justify budgetary needs for nursing or quantify all that nurses bring to healthcare. Philanthropic gifts provide crucial support for nursing initiatives. “Philanthropy is a special way to recognize the love and holistic care that nurses bring to patients every day,” Kurt says.

Kurt Pinto, RN, is an assistant nurse manager in oncology and pulmonary medicine in NYU Langone Health’s Helen L. and Martin S. Kimmel Pavilion. He has a BA in international relations from Boston University and a BS and MSN from the NYU Rory Meyers College of Nursing.

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