Palliative care, pending subject in the degrees of Medicine and Nursing


The experts gathered at the XIV International Conference of the Spanish Society of Palliative Care (SECPAL) have agreed on the qualitative leap that would achieve the specialty for palliative care professionals and, meanwhile, advocate including specific training in a way widespread in the faculties of Medicine and Nursing.

“It should be a compulsory subject, and it is not so in almost any Spanish medical school,” lamented Dr. Marcos Lama, palliative doctor at the Rioja Salud Foundation. The same occurs in Nursing, where the situation is even worse than that confirmed in a 2014 study, since an update carried out in 2021 indicates that only 39 percent of faculties or schools include palliative or end-of-life subjects. life, according to the nurse Lourdes Guanter, coordinator of the Teaching Unit of the Catalan Institute of Oncology (ICO).


On the other hand, these experts have also highlighted the need to better delimit the competences of each specialist, always under the prism of teamwork with the patient and their family at the center.

It is a complex task on many occasions, firstly because, as Lourdes Guanter has indicated, “there is an ambiguity of roles, not so much in the doctor-nurse binomial, in the clinical aspect, but in the psychosocial aspect”, so In his opinion, it would greatly facilitate the service “that we better explain our role, seeking more meetings and more common spaces for it.”

“Sometimes it is not so much the attitude or training in palliative care as the time it takes,” added Jorge Maté, clinical psychologist and specialist in Psycho-Oncology at the ICO. Or also, as Dr. Marcos Lama has indicated, “the scope and the members of the teams”, often incomplete and in which competencies that are not their own have to be assumed, especially in home care and in rural areas.

“When you put on the gown, sometimes you feel that you are given all four degrees in palliative care at the same time,” said social worker Mª Puerto Gómez, from the Fundación Instituto San José de Getafe, to refer to the overlapping of competencies that sometimes it occurs, in a special way, in the psychosocial sphere.


On the other hand, Dr. Enric Benito, specialist in Oncology, and expert in Palliative Care has closed the conference. During his speech, Dr. Benito has offered a reflection on how “living with dying” transforms the professionals who care for people with advanced diseases and limited life prognosis.

“Working in palliative care gives us the great privilege of deepening our own humanity,” he said. “We see great transformations, partly because of our interventions, but also because of the resources that the person himself has, who ends up accepting and passing through the suffering in a sweet and serene way.”

“Our work allows us to peek into the intimacy of those we accompany and discover values ​​of great importance. We experience the intensity of the process and we are forced to learn to manage emotions, to forge the ability not to run away, to be with the patient and their family and, at the same time, to remain equanimous and serene “, Dr. Benito abounds.

These experiences lead palliative care professionals “to discover little by little their depth, to cultivate spirituality and, finally, to lose their fear of death and to live with confidence.” In this sense, Dr. Benito has referred to the results of different studies that show that, based on their daily practice, palliativists end up “integrating into their daily life the wisdom acquired by sitting next to those who approach the death and look back at their life itinerary. “

Finally, he highlighted that health professionals come from a biomedical model supported by the scientific paradigm and focused on the disease in which the objective of care is “to cure” and the sick person is “a passive subject”. “However, the process of dying is not a disease, it is a unique and radical human fact that is characterized by its dynamism and puts us on the brink of the mystery of living and dying”, has defended the oncologist and expert in palliative care.

For this reason, he added, “our profession changes our way of seeing reality, moving from a conception of life as a matter to a much more comprehensive and human vision.” In the healthcare setting, this change in perspective allows “seeing the patient as a person, and not only as a body, giving meaning and value to their inner world, their emotions and their values ​​and integrating them into care”.

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