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By Grace Hammerstrom When junior resident Joshua Schiffman started his pediatric residency training, his first recollection was bewilderment. After four years in medical school, residents are thrust onto the front lines. "You realize it’s just you and the other residents in the middle of the night, until the attending arrives, and you realize you haven’t been trained for this," Schiffman recalled. "Obviously, it’s a stressful situation."Understandably, one of the most uncomfortable experiences for any physician, especially a new resident, is the death of a patient. When that patient is a child, the experience is almost unbearable. What do you say to the parents? How can you make time for the family when other patients need you? Should you attend the funeral? Write a condolence note? Each year, between 150 and 200 patients die at Lucile Packard Children’s Hospital. To help prepare residents to handle their patients’ deaths more effectively and compassionately, Packard has established a six-session palliative care training module, which is part of the hematology/oncology block of residency training. The program was developed through a collaborative effort, that included Schiffman; Lisa Chamberlain, MD; Nancy Contro, coordinator of education and research for the Pediatric Palliative Care Program at Packard; Laura Palmer, PhD, staff psychologist; Theodore Sectish, MD, director of pediatric residency training; and Harvey Cohen, MD, PhD, chair, Department of Pediatrics, and the program’s biggest advocate. "As an academic institution, it is important to train the next generation of caregivers to help families and advance the field," Cohen said. Funded through individual and corporate donations, the palliative care sessions are jointly taught by Contro and Palmer, with rotating guest speakers. Each group session also includes a role model, a physician residents can turn to for counsel in the difficult situations that they may face. The first group of 10 residents began this summer, and a new group has started this fall. Each week, the sessions cover one of the following topics: personal coping skills, practical issues involved in a patient’s death, pain management, being a caring professional and understanding cultural and religious considerations.
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Stanford Report, October 17, 2001
