How palliative care nurses support patients and families when it matters most

When people hear the words palliative care, many think only of sadness or the last days of life. But palliative care is so much more. It is about living well, even as life changes.

Palliative care is about improving quality of life for individuals with a serious or life-limiting illness to address their physical, social, emotional and spiritual needs with dignity. Palliative care can begin at diagnosis and continue alongside treatment.

Palliative care teams help manage symptoms and work closely with family doctors, nurse practitioners and other healthcare providers. They support home care nursing teams and collaborate with health professionals to ensure care is well coordinated and focused on the patient.

So what does palliative care look like? Nova Scotia Health palliative care consult nurse, Tracy Smith, describes her role as being a support person for patients and families, often helping them figure out how to access care and support.

“Many people feel lost when facing a serious illness, and the health system can be confusing, especially for people in rural areas where services may not be close by or for people who haven’t had much interaction with the health system,” says Tracy. “I remind patients and families that if they have questions, they can call me.”

Tracy has been a registered nurse for nearly 20 years and has worked in palliative care for almost 14 of them. “I chose nursing as a second career in my early 40s,” says Tracy. “I felt called to help people in a more personal way and serve them in a way that I couldn’t in a business career”. 

Tracy also helps patients manage pain or other symptoms related to their illness. A big part of her role is listening. “I love people and getting to know them and their stories,” she says. “It's such a privilege to have the time to sit and listen to them and talk about hope and what matters most to them. This is the best part of my job.” 

Originally from Rochester, New York, Tracy completed her nursing training with the goal of receiving her certification as a nurse-midwife in the U.S. Following graduation, Tracy moved to rural Nova Scotia, where she made her home on Cape Sable Island in the southwestern area of the province. “At that time, the certified midwife role wasn’t available here,” she says.

In her early days in Nova Scotia, she worked with the Victoria Order of Nurses (VON), supporting people at home at the end of their lives. She also worked in oncology, supporting people with cancer.

Through these experiences, she came to realize that what mattered most to her was not a specific job, but being present with people during life’s most meaningful moments. “There is so much meaning to the ending of a well-lived and fulfilled life,” says Tracy. “An opening came up in Palliative Care, and now I couldn't imagine being anywhere else.”

Many people assume palliative care workers are always sad. Tracy sees palliative care as a meaningful part of life’s journey and a phase of life. “What people need more than anything is someone to go through this journey with them, and as a palliative care nurse, I can be that person,” says Tracy. 

One of her most moving memories involved a woman in her final days, surrounded by her family, who gathered around her bed and sang hymns. The room was transformed; instead of only sadness, it was filled with love and hope. “That moment,” she says, “is one that the family and I will always remember. These are the moments in life that matter.”

Palliative care is not about giving up. It is about quality of life. “People are living right up until their very last breath,” Tracy says. “Even with a serious illness, there can still be meaning, love and connection every day.” 

In her spare time, Tracy has a small portrait photography business she started about 10 years ago. “This allows me to focus on people’s happier moments, so it balances things for me.”

To learn more about palliative care for individuals and families facing life-limiting illnesses or to access services, visit: www.nshealth.ca/clinics-programs-and-services/palliative-care

Photo of Tracy Smith.