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The People Behind Palliative Care

Nurses, social workers, chaplains, and doctors work together to help patients live well until the end

By Anne Kavanagh

Photo: Susan Merrell

Palliative care requires resilience, compassion, honesty, and communication. We asked the people who power the field to share their thoughts.

“So much of palliative care happens at the bedside, with nurses,” says Susan Barbour, BS ’79, MS ’86, a clinical nurse specialist. Barbour and her colleagues have trained more than 500 UCSF nurses in how to manage symptoms and communicate effectively with those facing life-threatening illnesses. These nurses have gone on to champion palliative care in their units, and many have instigated projects to improve care. “It’s a grassroots effort,” she says. One of their human touches: Bereaved families from the ICU now receive a card signed by everyone who cared for their loved one.

Even the most dedicated clinician can experience burnout from the daily deluge of suffering and loss. Denah Joseph, an ordained Buddhist minister, trained psychotherapist, and palliative care chaplain at UCSF, teaches physicians and other caregivers how to be resilient. One of the most powerful ways, she says, is to develop “prosocial” skills — learning to cultivate awe, joy, appreciation, generosity, and compassion for oneself and others. “And community,” Joseph adds. “Sharing and talking is the number-one intervention for burnout. Connection is protection.”

“Health care professionals are trained to share a lot of information, but we are not trained to respond to emotions or talk about the big picture,” says Wendy Anderson, MD, a palliative care physician at UCSF. She’s also a faculty member at VitalTalk (, a nonprofit that teaches evidence-based skills for communicating with the seriously ill. All kinds of practitioners — even longtime physician-leaders — are flocking to VitalTalk trainings, where they practice how to share serious news and tailor care plans to patients’ unique needs. Anderson says these tactics can help clinicians get to the heart of a matter quickly and answer the most important question of all: “What do I need to know about you as a person to best care for you?”

UCSF Magazine

UCSF Magazine shares the stories behind the science at the…

UC San Francisco (UCSF)

Written by

UC San Francisco is the leading university exclusively focused on health.

UCSF Magazine

UCSF Magazine shares the stories behind the science at the University of California, San Francisco, the leading university focused exclusively on health.

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