This month, in line with National Hospice and Palliative Care Month, we are celebrating Faces of Caring. In our social media and email communications, we’ve highlighted just a few of our inspiring students and outstanding faculty. Faces of Caring are everywhere—especially in this time of extreme stress and ongoing crisis.
These days, the Faces of Caring I see are either bobbling in Zoom frames or swathed in masks–the blue pleated surgical style or made of festive fabric or displaying sassy slogans. Their noses, chins, and ears are rubbed raw, foreheads dented, and spirits holding but assailed. They are physicians and housekeepers, nurse aides and nurses, social workers and therapists, food prep workers and chaplains, physician assistants and records clerks. They are all genders, all ages, all races. They are all essential.
I hope whatever long-term legacies emerge from this time, one will be a deeper appreciation for all the different kinds of caring that support and serve people with serious illness and those who love them. We need more caring and we need more people.
Over the past year, I’ve participated in three national events* focusing on the challenges of building and sustaining a serious illness care workforce. Across the spectrum of roles – generalist and specialist, clinical and psychosocial-spiritual – our workforce is insufficient.
Right now, there are about 7,800 physicians board-certified in palliative medicine, which means about 1 for every 800 persons with serious illness (compared to 1 cardiologist for about 70 persons with heart disease). That number is expected to stay flat or even go down as the first generation of palliative physicians retires or leaves the field from burnout.
The gap between the number of HPC-certified advance practice nurses and the number we need is estimated to be about 7,000 to 9,000. And by 2024, we’ll need roughly a million more direct care workers—home health aides, nursing assistants, and nurse aides. This sector is especially strained by low pay, few worker protections, and a dearth of adequate training.
At these national events, a stellar lineup of smart, skilled, influential, and passionate people convened to not only identify these workforce gaps but propose changes in policy and practice to address the challenge.
I encourage you to explore the videos and publications from these events, but I’ll share with you some of the recommended policy changes—most don’t rely on governmental action: Every agency owner, organizational leader, program director, clinical supervisor, and indeed healthcare worker can help achieve these goals. Faces of Caring are attached to people; let’s do everything we can to strengthen and support them in their work.
Above all, especially as state dollars and healthcare organization budgets are pinched by the current economic crisis, foundations must prioritize funding curriculum development, training programs, and clinical placements with solid outcome expectations; and healthcare delivery organizations must prioritize and commit resources to ongoing education/training in palliative care aligned to organizational goals. Caring may be a basic human trait and virtue, but the practice of healthcare, especially palliative care, at any level requires education and experience. In order to do, you must know how.
Here are just a few ways the CSU Shiley Institute for Palliative Care is committed to meeting the policy and practice goals of these national panels:
- Establish education, clinical training, certifications, licensure requirements for PC specialty
- Emphasis on pain, symptom management, communication, interprofessional collaboration
- Create opportunities for training throughout career for all clinicians
- See our rich catalog of courses for clinicians at all levels and across all disciplines
- Increase undergraduate and graduate content on serious illness/EOL care
- Ask us about our Faculty Toolkit of resources for teaching palliative care and other programs for undergraduate training
- Ensure robust personal and professional support for clinicians to maximize well-being and high-quality practice
We are privileged to do our part to support these invaluable Faces of Caring, the organizations that employ them, and, ultimately, the patients they serve.
*National Academies of Science, Engineering, and Medicine Roundtable on Quality Care for People With Serious Illness: Building the Workforce We Need to Care for People With Serious Illness, November 7, 2019 (https://www.nationalacademies.org/our-work/building-the-workforce-we-need-to-care-for-people-with-serious-illness-a-workshop); and the Coalition to Transform Advanced Care, National Policy Forum, June 24, 2020 (https://www.thectac.org/event/second-annual-national-policy-forum/); and the C-TAC National Summit, October 27–30, 2020.