Spectrum Spotlight: Palliative Care Nurse Katarina Bvoc Berta

This spring we profiled one of our very special nurses who works with our dedicated and recognized Palliative Care Team: Katarina Bvoc Berta.

Our palliative care nurses provide unique care and support to patients who choose to die at home.

What drives you every day to work with palliative patients?

Sense of duty, compassion and purpose.

From your perspective, what else could we be doing for our patients? If you had a magic wand what else could we be doing as a sector to support patients and their families?

If I had a magic wand ... I would make sure palliative care at home would offer more spiritual and psychosocial support to patients and family members. Perhaps even more importantly, I hope for more round-the-clock caregiver support in final stages of illness when burden is greatest on the family and the patient.

This care would close the gap between the need for institutional care vs the wish to die at home, a difficult choice even in ordinary circumstances, but especially challenging since the start of the pandemic.

What would you say to people who don’t know what their options are? What would you want people to know about what’s possible in palliative care?

Palliative care has many benefits in managing many chronic conditions. The essence of palliative care is about minimizing the negative impacts a serious illness has on the day to day life of a person and their family or support system. The goal is to reach "good days," when the person can feel more like themselves, and focusing on priorities set by the patient.

For example, severe chronic respiratory illness will impact someone's life differently than pain from advanced cancer. Aside from the symptoms, priorities for the patient may lie, for example, in the ability to stay independent or maintain an activity that gives the most meaning to the day. In collaboration with various professionals (e.g. nursing, MD, OT, ET, PSW, pharmacy, home lab, foot care, hospice, volunteer service) we work to meet the goal of the client, implementing appropriate tools, medical and non medical interventions as needed.

As the impact of the illness increases, so does the need to bring healthcare to the client. Thankfully, with much support from informal caregivers, we can bring advanced levels of medical care to the home.

How do you envision the future of palliative care? 20, 40 years from now?

Average life expectancy is increasing as modern health care is more and more successful in curing acute illnesses. As people live longer lives we are observing a rise in chronic conditions, with increasingly complex needs. Many more people may benefit from receiving palliative care, if we can shift the current popular perception from palliative care that is limited to "end of life care". Instead, we should promote its true focus which is to improve quality of life in all stages of the illness.

What role does a palliative nurse play in the palliative team? How is this type of nursing unique?

Nursing is often the first and most consistent contact between the patient and the rest of the health care team. Nurses are relied upon to assess and recognize changes in the patient's shifting health status, communicate those changes to the health care team and implement treatments in real time, while continually negotiating the plan of care with patients and their family.

This often becomes a complex job in the home setting, where housing, psychosocial, economic, communication barriers, as well as many other circumstances, play as much of a role as the diagnosis itself. Nurses have a privileged position to directly impact patient care and improve the outcome for the patient and their family.