1. Westphal, Christine MSN, CCRN, RN

Article Content

Conversations in Palliative Care


edited by Joan T. Panke and Patrick CoyneOriginal Publisher, Pohl Publishing Inc, 312 East Nine Mile Rd, Suite 20-409, Pensacola, FL 32514


Rights purchased by Hospice and Palliative Care Nurses Association 2005


HPNA, Tele: 412-787-9301, Fax: 412-787-9305, E-mail: [email protected], Web site:


Price: Members, $40; Nonmembers, $50


Conversations in Palliative Care is a fundamental resource book for clinicians written by some of the most recognized leaders in palliative care and hospice. The book uses a question and answer format with a very easy-to-read style. In fewer than 350 pages, the authors respond to some of the most commonly asked questions in palliative care. Chapters include hospice, palliative care, communication, culture, psychosocial issues, spirituality, pharmacologic and nonpharmacologic pain and symptom management, nutrition, physical and occupational therapy, ethical-legal issues, dying, bereavement, pediatric issues, clinician self-care, resource utilization, and development of palliative care services.


Given the scope of the topics, each question is generally answered in a paragraph or even a few sentences; subsequently, there is little depth. For example, the culture chapter focused on ethnicity but did not explore other dimensions of culture (ie, socioeconomic class, education, gender, and race) that could influence how one might respond to serious illness, death, palliation, and hospice. Some of the content, such as spirituality, culture, supportive therapies, and physical changes and care of the dying, is common to fundamental nursing textbooks. Content related to one of the most controversial and difficult processes in practice, withdrawal of support, was minimal. Other topics that were addressed, such as financing, developing a palliative care service, and managing data, may be of greater interest to managers and advance practice providers. The majority of the book provides an overview of many basic topics related to patient/family care for beginning practitioners and also addresses complex issues related to system change and reimbursement in fundamental fashion.


In most chapters the questions are posed from the perspective of an inquiring clinician and an expert replies. However, in some chapters questions are posed from the perspective of a patient or a family and the response models how a clinician might reply to the inquiry. Similar questions are posed in different chapters with almost identical answers. Although this demonstrates consensus among the experts, there is redundancy of some content.


The book is useful as an introductory text but not a strong reference resource since topics are approached in a conversational style from several directions. Without a strong thread of systematic inquiry it may be difficult for the reader to acquire an organized body of knowledge. The conversational style may make it difficult for beginning practitioners to extract key concepts, standards, and principles.


Responses to questions, although consistent with current practice guidelines and resources, tend to be within the context of personal experiences with little evidence documented from current literature. In some chapters reference is made to algorithms and practice guidelines, raising the reader's awareness of other resources; however, these features were not included in the book, which limits the utility of the text for advance practice clinicians. Although the basic information may meet the needs of entry-level nurses, it would not be sufficient for individuals with advanced preparation and/or experience.


Conversations in Palliative Care is a resource book for entry-level hospice and palliative care practitioners that provides an overview of the most common trends, issues, and clinical practices. The question-answer format and conversational style makes it very easy to read, which maintains the reader's interest. This will hopefully stimulate further inquiry and encourage practitioners to explore the many resources referenced for more in-depth information.


Christine Westphal, MSN, CCRN, RN


Christine Westphal, MSN, CCRN, RN, is a clinical nurse specialist for Ethics and Family Support for the Oakwood Healthcare System in Dearborn, MI. She assists patients and families to make difficult decisions including transition to palliation and hospice care. She recently completed a post-master's certificate program in palliative care at Ursuline College in Ohio.