Intensive Palliative Care Unit (IPCU)
Fellows spend three weeks rotating on the IPCU as part of an interdisciplinary team caring for terminally ill, hospitalized oncology patients. Hallmarks of the IPCU include collaborative interdisciplinary team care (including physicians, PA’s, RN’s, pharmacists, chaplains, social workers); focused attention to symptom management and quality of life; ongoing attention to psychosocial issues that arise at the end of life including anxiety, spiritual distress, and others; care of the family as well as the patient; ongoing effort to clarify goals of care and match a rational treatment plan to those goals; and comprehensive discharge planning. The fellow’s role on the IPCU resembles that of a closely-mentored junior attending. Educational goals and objectives for this rotation follow.
- Demonstrate use of the interdisciplinary approach to develop a care plan that optimizes patient and family goals and reduces suffering
- Perform appropriate diagnostic workup; review primary source information and evaluation; determine prognosis and appropriate palliative course
- Manage physical symptoms, psychological issues, social stressors, and spiritual dimensions of care for the patient and family
- Recognize signs and symptoms of impending death and care for the imminently dying patient and their family members
- Coordinate, orchestrate, and facilitate key events in patient care, such as family meetings, consultation around goals of care, advance directive completion, conflict resolution, withdrawal of life-sustaining therapies, and palliative sedation, involving other team members as appropriate
- Demonstrate the ability to educate patients/families about the medical, social and psychological issues associated with life-limiting illness