Wednesday, January 28, 2015

Why the thickened liquid challenge is important

Empathy via participation is a technique that probably deserves wider attention in health professions education. Drs Eric Widera and Alex Smith and the team at UCSF have come up with the ingenious Thickened Liquids Challenge. Thickened liquids can be a treatment that is overly used and poorly understood for any person who has swallowing difficulties. Most clinicians will be familiar with the terms ‘nectar-thickened’ and ‘honey-thickened’ from any experience in geriatrics or neurology. So taking the popularity of the ALS Ice Bucket Challenge and mashing it up with a likely non-harmful* experiential opportunity for the clinician to “take their own medicine,” we have the Thickened Liquids Challenge. The rules are thus:

  • 12 Hour Challenge: All fluids must be thickened to “honey consistency” using a beverage thickener for a 12 hour contiguous period. Food does not have to be thickened.
  • Mini-challenge: drink an 8 ounce drink thickened to honey consistency (coffee, wine, juice, water, or any drink of your choice)
  • Videotape yourself and include an announcement that you accept the challenge
  • If you fail the challenge you must donate $20 to a geriatrics or palliative care charity of your choice (see notes below for some suggestions)
  • At the end of your challenge, nominate a minimum of three other people/teams to participate in the challenge
  • When posting the challenge online, please use the hashtag #thickenedliquidchallenge

So I was challenged last week by Eric. I took that challenge and here is my video of the 12 hour experience condensed down to 4 minutes.


As you can see I could not last that 12 hours. But it wasn't the gross factor that got to me, it was plain thirst. Thirst for cold thin runny liquids that the thickened stuff just wasn't satisfying. Actually the nectar-thickened pre-mixed apple juice was not bad at all. I just thought of it like an apple smoothie, and really didn't have any problems.

I did learn a few things along the way:
  • Your local speech therapist/speech pathologist may have some samples to share with you
  • You have to stir a lot of thickener to get to the right consistency
  • They do not sell thickener at WalMart - but it is on Amazon
  • Clean up any thickened liquid you spill. It hardened like cement on my counter tops the next morning
  • That liquid cement you just drank, well...let’s say a few days later, I had some work to do (thus the asterisk above about non-harmful)
  • Making a video about this was actually fun and allowed me to feel creative (self-care for the week - CHECK!)
  • Orange juice and BBQ do not go together well - thickened or not
  • Pre-thickened and nectar consistency were very tolerable
  • Mixing the thickener before I could drink was frustrating and made me feel more thirsty
  • Your mindset towards thickened liquids is important to tolerating them
  • Speech therapists do not universally love thickened liquids, in fact they may be concerned doctors rely too much on them. 
  • It is better to work with rather than against speech therapy 
I nominated a few people but I do encourage anyone who reads this to nominate themselves and give it a try. And then to post a video! We will happily host videos as will GeriPal if you don’t have a YouTube channel.

The posting is the important part! Participation and public sharing make this different than all of the people I told about this, who said, “Oh yeah, I did that when I was a (nurse/medical/speech) student.” Yet without sharing that experience more widely we miss out as healthcare professionals to do some education to our peers and the public. So I hope many of you will take this up and give the Thickened Liquid Challenge a try!

Wednesday, January 28, 2015 by Christian Sinclair ·

Tuesday, January 27, 2015

National Drug Facts Week with Pharmacy Professor Mary Lynn McPherson!

by Mary Lynn McPherson, PharmD, MA, BCPS

This week is National Drug Facts Week! Why do we tell patients to take furosemide on an empty stomach? Ok, it’s not quite “why did the chicken cross the road” but it’s still an important drug fact! The answer is that taking furosemide on an empty stomach doubles the bioavailability and clinical response! If you want to learn about additional awesome drug facts – tune in this Wednesday evening, January 28, 2015 at 6 pm PST/9 pm EST for the #hpm tweet chat!

We’ll also be talking about the utility/futility of medications as patients approach the end of life. What strategies can palliative care teams use to set up hospice programs for success, and help patients achieve appropriate therapeutic goals? How can we have those sensitive conversations with patients, families and caregivers about stopping statins, dementia drugs, HIV medications, ALS meds and more?

National Drug Facts Week is actually sponsored by the National Institutes of Health and the National Institute on Drug Abuse and is intended to educate teens about drug abuse and addiction. In that spirit we will also be discussing suspected drug abuse and/or diversion in the home environment. “The dog ate your morphine” you say? “Show me the body!” Ok, that might not be the BEST strategy, but there certainly ARE strategies we can use.

I’m looking forward to a lively discussion this Wednesday evening! See you online!

What: #hpm chat on Twitter
When: Wed 1/28/2015 - 9p ET/ 6p PT
Host: Mary Lynn McPherson 
Facebook Event Listing: https://www.facebook.com/events/375625979282160/

If you are new to Tweetchats, you do not need a Twitter account to follow along. Try using the search function on Twitter. If you do have a Twitter account, we recommend using nurph.com, for ease of following.

We will be posting the transcript and analytics here after the chat takes place. Chat Transcript and Chat Analytics courtesy of @Symplur

Mary Lynn McPherson, Pharm.D., BCPS, CPE is Professor and Vice Chair of the the Department of Pharmacy Practice and Science at the University of Maryland School of Pharmacy. 

Tuesday, January 27, 2015 by Pallimed Editor ·

Monday, January 26, 2015

2015 Pallimed and GeriPal Party - Philadelphia!

Time to gather your peers and join fellow readers of Pallimed and GeriPal for our annual party at the Annual Assembly of AAHPM and HPNA (and anyone still in town after SWHPN's conference on Monday and Tuesday!). Since the last two years were such a success with the progressive party, we will be doing that again this year. We will begin at McGillin’s at 8pm. After that follow the hashtag #HPMparty or our Facebook event page where we will be posting updates on the next location.

All are welcome, this is no exclusive crowd. There will be many writers from both websites at the party and we always like to meet readers and hear your feedback.

McGillin’s is near the corner of 13th and Chesnut just a few blocks South of the Marriott Hotel and Convention Center.

Date: Thursday, February 26th, 2015 - Start time 8pm. End time TBD

Where: Depends
Starting location: McGillin’s Olde Ale House
  • 1310 Drury Street, Philadelphia, PA 19107
  • Near the corner of 13th and Chestnut
 Map:

Add it to your Calendar:



Photo credit: Liberty Bell by Vishal via Creative Commons https://www.flickr.com/photos/9474286@N05/5996131042

Monday, January 26, 2015 by Christian Sinclair ·

Sunday, January 25, 2015

Results of 2014 Stories of the Year in Hospice and Palliative Medicine

by Christian Sinclair, MD, FAAHPM

The results are in and the public* has had their say!

The top story of the year in hospice and palliative medicine for 2014 is Atul Gawande's "Being Mortal" being published and becoming a best seller on numerous lists.  The honorable mention for story of the year was the Institute of Medicine publishing the Dying in America: Improving Quality and Honoring Individual Preferences near the End of Life. Here is the full list with links of all the top stories.

Here is the complete list of the top stories by category with the notable person or organization indicated in parentheses.

Story of the Year - Overall
Winner: Atul Gawande hitting the New York Times Bestseller list with “Being Mortal” (Atul Gawande)
Honorable Mention: Institute of Medicine “Dying in America” report released (Institute of Medicine)

Story of the Year - Media Spotlight
Winner: Atul Gawande hitting the New York Times Bestseller list with “Being Mortal” (Atul Gawande)
Honorable Mention: Institute of Medicine “Dying in America” report released (Institute of Medicine)

Story of the Year - Organizational Impact
Winner: NIH and NINR launch pediatric focused campaign, Palliative Care: Conversations Matter (NIH and NINR)
Honorable Mention: Hospice 40th Anniversary (NHPCO)

Story of the Year - Philanthropic
Winner: AAHPM Shaping the Future campaign ends with over $1 million pledged (AAHPM)
Honorable Mention: ResolutionCare crowdfunds a palliative care service (ResolutionCare)

Story of the Year - Policy, Financing and Regulations
Winner: CMS (Medicare) considers paying for Advance Care Planning (CMS via Patrick Conway)
Honorable Mention: Palliative Care mandate for Medicaid (Medical) patients in California (Coalition for Compassionate Care of California)

Story of the Year - Social Media Success
Winner: Heart warming stories across social media featuring people with serious illness
Honorable Mention: Geripal and Pallimed hit 2 million views each (Geripal and Pallimed)

In an oversight, the Research and Education category was mistakenly left off of the poll. Pallimed will be awarding the winner of story of the year in the research and education.

Story of the Year - Research and Education
Winner: First ever Palliative Oncology conference jointly hosted by ASCO, AAHPM and others
Honorable Mention: JAMA hospice article reinforces hospice benefit in late stage cancer

Here are the complete results.  Scoring was ranked from 0-3 with 0 = no answer or not important; 1 = somewhat important; 2 = very important; 3 = extremely important.




Some other interesting findings. A few people noted that we left the WaPo and Huffington Post investigative reports on hospice care off of the list. That was not an accident, it was intentional. While notable stories, we have some concerns about the quality of those stories as we have noted before.  It is a good topic for conversation and one we will include in next year's poll on whether to include stories with more of a negative reputation.

Also we asked how many of these stories were new to you at the end of the poll.  On average the poll-takers score was 70% awareness of the stories which is good to know you are all informed!

I will add that we at Pallimed only covered some (16/46) of the stories covered 2014 Story of the Year series, which tells us two things:

  1. We need more people to help us write and cover some of these great stories
  2. You can start your own website to feature some of these great stories

Thanks to all who participated in the poll!

*and by public I mean 43 people. So clearly not a representative sample.  This is the first year that we have done this and despite our broad reach on multiple platforms we learned a lot this year, and will be making a more invested effort in 2015.  If you are interested in helping we are looking for people to help run future Pallimed polls and the end of the year review poll. Email editor -at- pallimed -dot-org for more info.

Sunday, January 25, 2015 by Christian Sinclair ·

Saturday, January 24, 2015

January 2015 HPMJC: Palliative Care and heart failure in primary care

by Katherine Sleeman and Tara Whitburn

On Monday 26th January 2015 from 8-9pm London Time (3-4p New York/ET and Noon-1p California/PT) we will be holding the monthly twitter journal club for hospice and palliative medicine: #hpmjc. The aim of the journal club is to provide an informal multidisciplinary forum for discussion of latest research findings, and we hope you will join us!

You can find some more information about the journal club #hpmjc here in a previous Pallimed post.

The paper for discussion this month is ‘Palliative Care among Heart Failure Patients in Primary Care: A Comparison to Cancer Patients Using English Family Practice Data’. The paper was recently published in PLOS ONE, and is open access. Download it free here. We are pleased to announce that lead author of the paper, Dr Amy Gadoud (@agadoud), is joining us during the online discussion. This month’s paper has been chosen by Dr Tara Whitburn (@Tara_esw), a clinical fellow in palliative medicine at the Cicely Saunders Institute, King’s College London. Tara discusses why she has chosen this paper below:

Why this paper?

Over the past decade there has been increasing emphasis on providing care for people with non- malignant conditions such as heart failure. This paper uses data from the Clinical Practice Research Datalink (CPRD) to investigate recognition of the need for palliative care in a traditionally underserved group.

The authors use a national primary care database to investigate inequities with regard to recognition of the need for a palliative approach in heart failure in the primary care setting. They aim to explore whether people with chronic heart failure are identified as needing a palliative care approach, and to investigate the timing of this recognition in terms of the patient’s proximity to death.

How was the data gathered?

The CPRD is a longitudinal de-identified database of primary care medical records, including information gathered from 8% of all primary care practices in England. Data is collected on numerous clinical variables, and includes measures relating to the Quality Outcomes Framework (QOF).

What is Quality Outcomes Framework (QOF)?

The QOF is a voluntary annual reward and incentive programme for General Practitioner (GP) practices in the UK, started in 2004 as part of the new GP contract. Practices receive points for reaching targets and compiling registers of their patients with particular needs or conditions, for example the palliative care register and the heart failure register. The BMA provides a useful guidance document if you are keen to know more on the indicators used in QOF.

What did they find?

The authors found that only 7% of patients with heart failure were entered onto a palliative care register, compared with 48% of cancer patients. In addition, 29% of heart failure patients who were entered onto the register were entered in their last week of life.

Implications for practice and policy

The findings suggest that there is a large difference in recognition of palliative care need among patients with heart failure, compared with patients with cancer.

Questions for discussion

  • Are you surprised by these findings?
  • What are the policy implications?
  • How might these findings impact on your practice?
  • Are there any implications outside the English primary care system?
  • What are the main strengths and limitations of this study?
  • Should all heart failure patients receive palliative care?
  • What would you do next?

We look forward to discussing this on 26th January, and hope that you can join us. Just follow
@hpmjc and use #hpmjc.

Regular journal club participant @Elissa_Campbell has written this post on participating in a #hpmjc chat on Twitter.

Saturday, January 24, 2015 by Pallimed Editor ·

Friday, January 23, 2015

Review of The Conversation: A Revolutionary Plan for End-of-Life Care by Angelo Volandes

by Andi Chatburn, DO

As a palliative care physician, The Conversation by Dr. Angelo Volandes is a book I want to see being read, passed along and read again in every coffee shop, book club and doctors’ lounge in my community. Volandes describes his new book The Conversation as a memoir, but in truth it is a “how-to” guide for having tough discussions in the context of serious illness. It is a “quick-start” for ubiquitous primary palliative care. Nothing in this book will be earth-shattering or revolutionary to the Palliative Care physician- it chronicles our every day experience. What makes Volandes’ book revolutionary is the way he makes it accessible to everyone.

Each chapter paints a different, yet familiar patient story: an elderly Italian matriarch with dementia, a professor of literature with brain cancer, a Hispanic gentleman with end stage Heart Failure, a young mother with breast cancer, the author’s own father who suffers a stroke. As Volandes recounts the story of his encounter with each patient, he reveals the unique social context and web of relationships that makes each Conversation different. He shows how there are many different approaches to The Conversation, and that there is no one “right road” but the same destination (77). He goes on to make all of this accessible:

  • Describes the complex medical ethics concepts of proportionality, capacity and futility in a way that is easy to comprehend (5).
  • Transforms complex heart failure physiology into common, accessible language, describing it “like a runner falling behind on a treadmill, the heart can no longer maintain the pace.” (55)
  • Cites up-to-date national guidelines discouraging dialysis in the frail elderly (90).
  • References the now classic NEJM article debunking the myth of effective TV CPR (79-80) and makes it accessible to a non-medical reader.

His easy scripting is a model for physicians young and old wanting to practice goals of care conversations asking, “Mrs. Sanchez, how was your husband these last few months? Was he doing the things he enjoyed, things that gave him happiness?” (56) Then shows the progression of The Conversation over several days and as different interventions come into play, including the honest aspects of moral distress created by being a keeper of the patient story when the proverbial “Daughter from California” changes the plan of care (59-60).

The second half of the book is a personal narrative on how Volandes started filming, creating, and studying the effect of the VIDEO Consortium (Video Images of Disease for Ethical Outcomes, see website acpdecisions.org) and his own reactions to his father’s stroke. The videos, which were were made to supplement doctor-patient discussions and to provide information for patients to make truly informed decisions about their care. “When patients have honest exchanges and have the tools necessary to understand their choices at the end of life, then they—not the health care system—remain in charge of decisions about how they want to live.” (137)

Half way through the book (62-63) and again in the four Appendices, Volandes provides a literal script for patients, families and providers to use when starting an uncomfortable conversation about wishes for end of life care. Appendix II provides a how-to guide for completing Advance Directives and Appendix IV is a brief list of online resources, including Ellen Goodman’s Conversation Project and CAPC’s public site getpalliativecare.org. Perhaps I will plant copies of this book in my local gym locker room and leave it on my neighbors’ doorstep.

“What people need most on this journey
is not the promise of the next new technology
but rather a guide to help navigate this dark forest
in which they will undoubtedly find themselves.”

- Angelo Volandes, MD
The Conversation p.5

You can find Dr. Angelo Volandes on Twitter @AngeloVolandes and find out more at ACPdecisions.org and follow them on social media (Facebook page, Pinterest)

Andi Chatburn, DO, MA is a Palliative Care Physician and Medical Director for Ethics at Providence Health Care in Spokane, Washington where she enjoys XC skiing and dining on delicious food. You can find her on Twitter @achatburn.

(Links to The Conversation from this page are Amazon Affiliate links and any proceeds from sales go back into supporting Pallimed. - Ed.)

Friday, January 23, 2015 by Pallimed Editor ·

Wednesday, January 14, 2015

Palliative Care Everywhere!

by Cory Ingram, MD

This Wednesday I look forward to a conversation on how palliative care principles and practices are able to be embedded across health systems in to various disciplines and delivery forms. Palliative care principles when applied in various clinical situations improve the quality of care for patients and families and even their longevity and care affordability. For the first time in history our society is experiencing an unprecedented medical and social situation. It is unprecedented that people are living longer, requiring more complex care, and experiencing more burdens of illness and treatment and dying more ill.

The interventions employed in palliative care focus on symptom management, psychological support, ethical decision-making, coordination of care, spiritual support, prognostication, and goals of care conversations. In practice, I wonder if distillation of these principles to three main areas of focus can sustain the positive impact of palliative care. I wonder if delicate conversations, physical symptom management and non-physical symptom management embedded in all areas of our health system will improve the quality of care for seriously ill patients and their families. Are those three areas comprehensive enough? I also wonder if these three areas of focus will be embraced in various specialties like primary care? How would it work? Is it being done? What tools are needed? Are the barriers of skill, time and money able to be overcome and if so how? How do we influence training and attitudes? What is the relationship between primary and specialty palliative care?

Join me @cjingram this Wednesday night at 8pm CST to explore the concept of palliative care everywhere.

T1: What comes to mind when you think of #HPM everywhere?

T2: What tools will advance #HPM everywhere?

T3: What are and how do we overcome barriers to #HPM everywhere?

References

Temel J.S. et al. Early Palliative Care for Patients with Metastatic Non-Small- Cell Lung Cancer. New England Journal of Medicine. 2010; 363:8:733-742.

Bakitas M. et al. Effects of a Palliative Care Intervention on Clinical Outcomes in Patients with Advanced Cancer. JAMA. 2009;302(7):741-749.

Morrison R.S. et al. Cost Savings Associated with US Hospital Palliative Care Consultation Programs. Arch Intern Med. 2008;168(16):1783-1790.

De Roo M.L. et al. Quality Indicators for Palliative Care: Update of a Systematic Review. Journal of Pain and Symptom Management, 2013, in press.

Quill T, Abernethy A. Generalist plus Specialist Palliative Care – Creating a More Sustainable Model. N Engl J Med. 2013;368:1173-1175.

What: #hpm chat on Twitter
When: Wed 1/7/2015 - 9p ET/ 6p PT
Host: Croy Ingram 

If you are new to Tweetchats, you do not need a Twitter account to follow along. Try using the search function on Twitter. If you do have a Twitter account, we recommend using nurph.com, for ease of following.

We will be posting the transcript and analytics here after the chat takes place. Chat Transcript and Chat Analytics courtesy of @Symplur

Wednesday, January 14, 2015 by Pallimed Editor ·

Tuesday, January 13, 2015

POLL - Hospice and Palliative Care: The Year in Review 2014

We would love to hear what you thought about the tops stories for hospice and palliative care in 2014.  Have some fun and take our survey!  If you want to learn more about the stories you see in this poll take a look at our year-end wrap up.

Tuesday, January 13, 2015 by Christian Sinclair ·

Hospice and Palliative Care: The Year in Review 2014

by Christian Sinclair, MD, FAAHPM

Looking back on 2014, it seemed like hospice and palliative care issues were constantly in the news. But then again, I may be standing in the single loudest position in the echo chamber of palliative care. Even with the awareness of that bias, it is clear to me that we had many significant events this year in our field that will really influence where we go in 2015 and beyond. (Although if you look at the graph below hospice and palliative care are steady to declining in percentage of search on Google.)

We have never done a formal year in review here at Pallimed, and now that we are finally doing one, I’m sorry that I don’t have the past years to reflect back upon. Big shout out to Kathy Brandt for also doing a year-end review on her fantastic site the kb group (if you have not yet subscribed, you should.) She brought up a few ideas I had not had considered myself. CAPC also published a year in review worth a look. In addition, last week at #hpm chat, Dr. Meredith MacMartin hosted on just this topic. There was a lot of great discussion and some new topics were brought up that I was not aware of.



So what were the big events of 2014 for hospice and palliative care? (in no particular order and with categories I just made up)

And if you want to have a bit of fun with us, please join us in a poll to pick the top news stories of the year for hospice and palliative care.

In the media spotlight
Brittany Maynard and the national conversation about the right to physician assisted death
Hospice service quality being questioned by the Washington Post and Huffington Post
Philanthropic praise
Cambia Health Foundation awarding the University of Washington $10 million for palliative care
Anonymous $10M gift to Dartmouth Hitchcock Center for Hospice and Palliative Care

Policy financing and regulations
Medicare Part D requirements impacting how hospice organizations cover medications

Research and education
MJHS Palliative Webinar Series innovates free CME for primary and secondary palliative care

Social media success
Both GeriPal and Pallimed hitting over 2 million views to each website
Numerous heart-warming stories featuring people with serious illness shared with social media

Organizational impact
AAHPM announces 40 under 40 - highlighting leaders for the next wave of palliative care
HPNA, HPNF and HPCC launch the $5M Advancing Expert Care campaign
NHPCO launches Moments of Life campaign
World Health Assembly resolution on palliative care
40th anniversary of hospice care in the United States
FHSSA expands and rebrands as Global Partners in Care
Global Atlas of Palliative Care at the End of Life published by WHO and WPCA
NIH and NINR launch pediatric focused campaign, Palliative Care: Conversations Matter

Don't forget to take the poll!

Christian Sinclair is an palliative care physician at the University of Kansas Medical Center and editor of Pallimed. When he is not advocating for palliative care on social media (@ctsinclair), you can probably find him playing board games.

by Christian Sinclair ·

Monday, January 12, 2015

Sharing your genius in hospice and palliative care

by Allie Shukraft, LCSWA, MSW, MAT

This morning was like many on the weekends.  I got up before the rest of the humans in the house, fed the dogs and let them out while I tooled around in the kitchen. The room was, I'll be honest, a typical after-holiday mess, so it took me a few minutes to notice the small package that had come unannounced in the mail the day before.  It was addressed to me, like so many boxes had been in the weeks leading up to Christmas, but unlike those other boxes, I had no recollection of ordering this one.  I opened the package, eager to see what I had forgotten that I had ordered only to find a gift-wrapped package that had been totally unexpected.  What was inside was inspiration, something that got me up and typing even before making coffee -- a copy of Austin Kleon's Show Your Work! 10 Ways to Share Your Creativity and Get Discovered.

So far I have only cracked this book.  I am still on the first concept, "you don't have to be a genius", but that one portion makes me want to get up and do, to make something and share it, no matter how simple. What this concept makes me think about is the growing fire that is hospice and palliative care.  Not only are those of us that practice this on the cutting edge of holistic medicine/care, but we are a growing, passionate voice gaining a larger audience every day. We learn something daily, sometimes even hourly in our work and I am starting to see those lessons out there for the world to share in through social media posts, books, movies, and "newspaper" articles (that term feels a bit outdated now).

The big take away from the book is no surprise: we in hospice and palliative care (HPC) need to “show our work”.  We need to talk and write and tweet and so-forth about what we do.  This is important for so many reasons, not the least of which is that it is the right thing to do.  We practice a specialty that is doing amazing things for quality of life and in many cases, even quantity of that quality life.  Something that I have heard in my practice and know that others out there have heard as well is the patient/family question “where have you been?”, meaning “why didn't I know about palliative care sooner”? Remember, I work with children, so this is parents asking this question, begging for this support.  Not to say that all are open to the consult, but for many, they would have welcomed our faces at diagnosis and ask for us at each crisis or decision-point along the illness trajectory.

So how do we show our work in an ever-changing world? Within our institutions/practices, that often means bending the ears of the people I've heard called “low-hanging fruit” – the HPC-friendly doctors, nurses, administrators, etc. are the easiest to collect, so we need to talk to them about what we do at every opportunity.  Do you attend a committee that likes to start meetings with a connect-to-purpose?  Tell a story about relieving a patient’s pain or helping her find meaning in her illness experience. We all talk about the “elevator speech” and having those ready, but what about when you have someone’s attention for longer than that? What will you say to them about your practice then? Another thing to be aware of within your institution is what the audience wants. If they want evidence-based practice, choose a palliative care article to share at a journal club.  If they want staff support, discuss lessons learned from palliative care about coping and resilience.

Working within our institutions, however, is not enough. We need to get our voices out to the community, both locally and nationally.  Presenting at an HPC conference is great, as is writing for an HPC publication – these inform the field and improve what we do.  In addition to these things, we need to broaden our focus to other audiences. I am speaking next month at a local workshop about professional burnout and ethics to mostly social workers. Although this won’t drive throngs of social workers into palliative care, it may educate some who practice medical social work and/or who may talk to their clients or peers about palliative care. What other avenues are out there for us to create opportunities to spread the HPC word?


The final lesson that I wanted to share from this book is one of personal “promotion”, for lack of a better term. One of the things Kleon writes about is not being afraid to talk about yourself and what you are doing.  Although this can have a secondary-effect of self-promotion, the true purpose behind this can be promotion of HPC. This is how collaboration is done – through an open sharing of information – and this is how we operate within this medical community we are a part of.

So get out there, talk, write, tweet, sing, and paint about what you are doing.  Share it with the world so we all can learn from you and grow our HPC fire together.

Allie Shukraft, LCSWA, MSW, MAT, is a pediatric palliative care social worker for Carolinas Healthcare System in Charlotte, NC where she loves reading and walking with her dogs. You can find her on Twitter @alifrumcally

Photo Credit: Christian Sinclair for Pallimed, from the book Show Your Work by Austin Kleon

Monday, January 12, 2015 by Allie Shukraft ·

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