February 2007, Volume 37 Number 2 , p 44 - 45
A FEW YEARS AGO, when I was working the evening shift in a palliative care unit, I cared for a patient I'll call Ken. This 55-year-old office manager had lung cancer that had metastasized to his spine, causing pain and paraplegia.
A month before I met him, Ken had had a large spinal mass removed from his spine for palliation; he then went to a skilled nursing facility for rehabilitation. When his condition worsened, he was admitted to my unit for palliative care.
Some patients receiving palliative care know they're at the end of their lives and are seeking comfort for their last days; others are just beginning to understand a new diagnosis. As a palliative care nurse, I helped these patients sort through new information and managed distressing symptoms.
When Ken arrived in the unit, he weighed less than 100 pounds. He was so frail and ill that I was sure he'd die in a few days. As I assisted him into bed, he reported sharp, shooting pain in his back. I promised to return with pain medicine after ...