Joy and Opportunity: A Conversation About Growing the Palliative Care Workforce
Advancing the life-changing benefits of palliative care and equipping health professionals to meet the growing demand is a shared passion of Helen McNeal, Executive Director of the CSU Shiley Institute for Palliative Care, and Katy Lanz, Chief Clinical Officer for Aspire Health. The two palliative-care powerhouses spoke recently about the critical need to train a new palliative-care workforce; the joy of treating patients in their own homes; and the unconventional idea that a career in palliative care can be sexy and fun.
HELEN: Katy, I think one of the most exciting things about palliative care is that it focuses on helping patients with chronic illness manage their symptoms and live in the way that’s most meaningful to them. It’s really about maximizing quality of life at any stage in an illness. And it means people are going to be cared for in the setting where they really want it – at home.
KATY: Absolutely! When people hear the words “palliative care” they often think end-of-life, but really palliate means to provide comfort. It’s most effective when applied to patients who are way upstream in the course of a disease and headed toward changes in their illness, versus where we are now as an industry, typically supporting people after a serious health crisis has happened.
At Aspire we reach those upstream patients; match a treatment plan that fits their life goals; and then support them so they can be at home, in the environment they love, for as long as possible. That’s the beauty of palliative care… and it’s what Aspire is all about. We’re only four years old, and we’re already the nation’s largest palliative care practice in the community setting.
We’re experts in providing relief from the symptoms, pain or stress that accompany a serious illness. But our ability to do this is dependent on highly skilled professionals who understand palliative care, embrace it and can deliver it to vulnerable patients. That takes good people and effective training.
“We’re experts in providing relief from the symptoms, pain or stress that accompany a serious illness. But our ability to do this is dependent on highly skilled professionals who understand palliative care, embrace it and can deliver it to vulnerable patients. That takes good people and effective training.”
HELEN: It really does. I remember when you and I first met, we realized pretty quickly we had a similar passion – growing the palliative-care workforce in both quantity and quality. Right now a lot of health professionals know something about palliative care, but the way it’s organized and practiced is very inconsistent.
KATY: I agree. There are still a lot of misconceptions about palliative care, so patients who request it from their own physicians or health systems might get widely different levels of service, if any. At Aspire, we train our clinicians to help people who are living with serious illness, and who often are still seeking aggressive curative therapies, and hoping to feel the best they can each day. In the best cases, our patients have a team of experts for months at a time and hopefully feel more in control, informed and comfortable at home.
HELEN: I know Aspire has had incredible success across the country and is poised for even greater things. What challenges remain? And what do you tell people thinking about a career with Aspire?
KATY: I tell people it’s a sexy job! It’s true. The sexiness is a combination of autonomy, flexibility and work you can be proud of. The autonomy comes because, as a health professional, you are part of a team virtually, but you are independently using your senses, creativity and full scope of your license. It’s a totally different culture than a sterile hospital environment. And the flexibility is key because nurses who have such caring, compassionate hearts are often the primary caregivers in their own families.
Typically in clinics or hospital settings, people are incentivized to see more people and stay onsite. The home setting at Aspire allows our providers to spend an hour or more with patients and families with space in between for the drive. Our incentives are based on quality and value, and we want our clinicians to get home on time and be present both physically and emotionally for their own loved ones.
Lastly, the beauty of connecting with patients in this phase of their lives is such a joy. Having a sense of meaning in your day-to-day work, and being able to sit on someone’s couch and laugh and cry together is just the best.
“The beauty of connecting with patients in this phase of their lives is such a joy. Having a sense of meaning in your day-to-day work, and being able to sit on someone’s couch and laugh and cry together is just the best.”
Our biggest challenge, though, is building that workforce. I wish we had serious-illness experts growing on trees, but there are very few out there, and not nearly enough to meet the demand. Health plans and insurance companies are asking Aspire to serve the whole country. The only thing holding us back is finding good quality providers who can do it. That’s why this relationship with the CSU Shiley Institute for Palliative Care is so critical. It’s an important part of how we develop new palliative care professionals and retain them.
HELEN: We want to build a pipeline for employers so that more health professionals can meet patients with chronic illness where they are and where they want to be. And we want to give professionals the skills that make them confident in having real conversations about what brings people joy, and then building treatment plans that help achieve that result. This is why it has been such fun working with Aspire to provide training for your Advanced Practice nurses.
“We want to build a pipeline for employers so that more health professionals can meet patients with chronic illness where they are and where they want to be. And we want to give professionals the skills that make them confident in having real conversations about what brings people joy, and then building treatment plans that help achieve that result.”
KATY: The Advanced Practice RN Certificate course offered some excellent serious-illness content that our staff could immerse themselves in when it was most convenient for them, in a very engaging way. The format meant they could connect with other Advanced Practice providers doing similar work, and apply the content in the setting where we currently practice. When information is applicable to real-life work, people become more invested and enjoy the learning experience.
HELEN: What kind of feedback have you heard from employees who’ve taken the course?
KATY: Across the board they said it’s been really valuable. In fact, from the moment I first polled our workforce, asking how many would be interested in doing a program, I was amazed at the response. More than 50 percent said they were craving this kind of training. Their reaction was “thank you, we appreciate you valuing us and our experience, and giving us a way to get our continuing education credits and develop ourselves outside of Aspire.”
The other thing that came out of our collaboration is a reminder that the training is fun and the work is fun! The course allowed our staff to interact with colleagues from across the country – anywhere from Amish country in Pennsylvania to rural Alabama to Manhattan. They’ve built relationships that will last a lifetime, as have I with some of the people at the CSU Shiley Institute for Palliative Care. It’s been a joy.
HELEN: Those relationships are vital and so is the training, because the need for skilled palliative-care professionals is so immense. And speaking of relationships … Katy, if you were asked by another organization what it’s been like to partner with the institute, what would you say?
KATY: I’d highly recommend it to anyone looking for a creative solution to train their workforce. We loved the whole process. You’re responsive to our needs, you listen, you understand the community setting, and you’re ready to adapt a program to conform who we are at Aspire. I just think it’s a great resource for any organization looking to build ongoing training and development for their staff.
HELEN: Katy, if someone who reads this is interested in learning about the fun and sexy job opportunities at Aspire, how can they find out more?
KATY: We’d love to talk to them! Aspire has grown from 10 employees in 2013 to 240 employees in 2015 to more than 520 employees today. Anyone interested in joining our team can contact me at firstname.lastname@example.org and visit our website at www.aspirehealthcare.com
Helen McNeal is executive director of the California State University Shiley Institute for Palliative Care, and an expert in palliative and hospice care in the United States and Canada. She previously served as vice president of San Diego Hospice and The Institute for Palliative Medicine; founder and president of Naria LLC; vice president of Strategic Partners Inc.; and founder, board chair and board member of Evergreen Hospice in Markham, Ontario. Helen has consulted with both U.S. and Canadian government agencies on palliative care strategies and is the co-author of “Module IV: Palliative Care of a Comprehensive Guide to the Care of Persons Living with HIV/AIDS.” She has a degree in Business Administration from the University of Michigan, has done post-graduate study in business, psychology and organizational development.
Katy Lanz, DNP, MSN, AGPCNP-BC, ACHPN is chief clinical officer at Aspire Health and a nationally awarded hospice and palliative advance practice board certified nurse practitioner who has developed and implemented clinical services, palliative care training programs, and support for mobile clinicians across the country. She received her doctorate at Vanderbilt University, completed a leadership fellowship at Duke University and was recently named a Fellow in Palliative Care Nursing by the Hospice and Palliative Nurses Association.