Educating Patients and Clinicians on End-of-Life Care and Discussions

Commentary
Podcast

Kelley A. Rone, DNP, RN, AGNP-c, provides perspective on approaching end-of-life conversations with patients with GI cancers.

CancerNetwork® sat down with Kelley A. Rone, DNP, RN, AGNP-c, to discuss the importance of speaking compassionately and ensuring patient awareness when leading end-of-life discussions among those with gastrointestinal (GI) cancers. The discussion also focused on combating burnout in the clinic, using opioids to help manage pain and other symptoms, and educating all members of a multidisciplinary team on initiating end-of-life conversations with their patients.

Rone is an advanced practice nurse (APN) in GI oncology at the Mayo Clinic in Phoenix, Arizona.

As part of leading these end-of-life conversations, Rone emphasized the necessity of addressing the discomfort patients tend to feel when talking about the fact that they may die from their cancer. Speaking with these patients may involve being open about the possibility of terminating therapy early if treatment-related toxicity such as fevers, diarrhea, and pain outweigh any potential efficacy or diminish quality of life. Additionally, Rone highlighted how APNs may be more comfortable with speaking about death than other team members.

Rone also discussed the importance of managing fatigue and pain as patients near the end of their lives. In her role, she initiates education on pain management early in end-of-life care discussions to make patients feel more comfortable about receiving opioids for symptoms.

When working with other members of a multidisciplinary care team, Rone illustrated the challenge of having physicians understand that their treatments may fail in younger patients and helping other oncologists become more experienced in speaking about death with patients. Regarding the idea of mitigating burnout and maintaining one’s mental well-being, Rone described how her role has given her perspective on what is truly important about life.

“This [role] helps you appreciate the finality of life. You don’t get upset about [minor] things after you see a 39-year-old with metastatic cancer,” Rone stated. “You learn to have an appreciation for the good things and not dwell so much on the bad things.”

Recent Videos
As patients are nearing the end of life, different management strategies, such as opioids, may be needed to help mitigate pain or fatigue.
Kelley A. Rone, DNP, RN, AGNP-c, highlights the importance of having end-of-life discussions early in a patient’s cancer treatment course.
Immunotherapy may be an “elegant” method of managing colorectal cancer, says Gregory Charak, MD.
Administering neoadjuvant therapy to patients with colorectal cancer may help surgical oncologists attain a negative-margin resection.
Increasing screening for younger individuals who are at risk of colorectal cancer may help mitigate the rising early incidence of this disease.
Laparoscopy may reduce the degree of pain or length of hospital stay compared with open surgery for patients with colorectal cancer.
Rahul Gosain, MD; Sam Klempner, MD; and Rohit Gosain, MD, presenting slides
Rahul Gosain, MD; Sam Klempner, MD; and Rohit Gosain, MD, presenting slides
Rahul Gosain, MD; Sam Klempner, MD; and Rohit Gosain, MD, presenting slides
Rahul Gosain, MD; Sam Klempner, MD; and Rohit Gosain, MD, presenting slides
Related Content