Alberta Cancer Foundation

Red Deer nurse provides stellar palliative care

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MULTI-TASKER: Nurse Lisa Bailey has 20 years of experience in the palliative care field, and says she has learned to prioritize her patients’ needs and always be on her toes.
Photo by Cooper and O’Hara

Lisa Bailey is “absolutely passionate” about her work in palliative care, nursing and education. A registered nurse specializing in oncology and palliative care at Red Deer Regional Hospital, Bailey’s job is to help guide patients and their families through a challenging time. “It is such a difficult time, and to have that opportunity to connect with them and care for their loved one is probably the best part of it,” she says. “It is a privilege to be in their lives at this time.”

“Palliative care has lots of components. It’s a very complicated part of medicine and has so many opportunities for growth and learning,” says Lisa Bailey.

For nearly a decade, Bailey has worked as a staff nurse at the Red Deer Regional, which has 20 oncology beds and 10 palliative care beds on Unit 32, the oncology palliative care unit. In addition to her regular nursing duties, she is also a unit coach, helping with staff education and orientation.

A typical day for Bailey looks like this: Nurses are a part of the multi-disciplinary palliative care team, which is made up of physicians, nurses, pharmacists, social workers, recreation therapists, occupational therapists, physiotherapists, a dietitian and a chaplain. She works a combination of day and evening shifts as part of the nursing team, which “is the link between the multi-disciplinary team the patient and their family,” she says. Each shift encompasses all aspects of patient and family care including assessments, care implementation and measuring a patient’s psycho-social, physical and spiritual needs.

During her shifts, Bailey receives a report on the patients she will be looking after and starts on her rounds, going into each room and introducing herself to the patients. She conducts assessments of each patient and determines whether there is anything urgent to deal with, then looks at the medications she needs to administer. She is there to care for a patient’s various needs, handling everything from administering medications, to changing dressings, drawing or transfusing blood, washing up and helping them eat – whatever each patient requires.

Bailey says a key aspect of her work is always being on her toes. “The day is ever-changing and you must be flexible and able to prioritize what needs to be done now, and what can wait until later,” she says. “It is very involved and can change very quickly.”

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CONNECTED: Lisa Bailey, who is certified in hospice palliative care nursing, keeps motivated through the connections she makes with her patients and their families.
Photo by Cooper and O’Hara

And if a patient needs to talk about something, she’s there to listen. “Often, it’s not just physical pain – it can be psychological or spiritual pain as well,” she says. “The key to good end-of-life care and nursing is communication and collaboration,” she says. “We are responsible for providing patient-centred care, which involves so many different aspects, but it all revolves around our ongoing assessments of the patient and their family.”

She says there are many things to consider when implementing palliative care. “We take into account our assessment, lab values, diagnostic exams and all of the other disciplines’ assessments and opinions. We ensure the doctors are up to date with any events or changes that occur when they are not there, and we also ensure that the doctor’s orders are checked and implemented.”

Bailey, 42, has been a nurse for the past 20 years and has worked in palliative care since the start of her career. After graduating from the Foothills Hospital nursing program in 1994 she worked on the acute spinal cord injury unit at the Vancouver General Hospital, while also holding down a second job doing palliative home care. “It was amazing to be there, not only for the patients, but also for the families,” she says. “It absolutely embodies what nursing is all about.”

She praises educational opportunities that are available to palliative care workers. “Palliative care has lots of components. It’s a very complicated part of medicine and has so many opportunities for growth and learning,” she says, noting that networking with other people who are equally passionate about palliative care is rewarding in itself.

“We don’t like to see anyone die alone, so if there isn’t someone there with them and death is imminent, then we will take that time and try and be there when they are dying.”

In 2012, she took a sabbatical to enhance her education in the field, enrolling in the MacEwan University certificate program in hospice palliative care. In 2013, Bailey became certified in hospice palliative care nursing through the Canadian Nurses Association. And in 2013 she received the Dr. Solomon Levin Memorial Award, which promotes palliative care professional education, knowledge and skills for Alberta Health Services employees working in cancer care.

The award was established in 2007 by the Alberta Cancer Foundation, in partnership with the Department of Symptom Control and Palliative Care at the Cross Cancer Institute in memory of Dr. Solomon Levin. The initial fund was created through the generosity of Dianne and Irving Kipnes, in support of the award as well as additional funds received in memory of Dr. Levin. The award is managed by the Alberta Cancer Foundation and Alberta Health Services’ CancerControl Alberta. Bailey used the award to attend a week-long course, Psychosocial Care of the Dying and Bereaved, held by the Victoria Hospice in Victoria, B.C. “It was amazing,” she says. “It covered so much material. Meeting other people at the conference was really incredible as well, and hearing their stories and networking.”

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Photos by Cooper and O’Hara

The most challenging part of Bailey’s job is when a patient’s symptoms at the end of his or her life are difficult to control. “When that happens, there are feelings that maybe we could have done better,” she says. But what keeps her motivated is the connection she feels with her patients and their families. She values being present for this time in their lives, and providing patients what they need in terms of holistic care. “Just the idea you can make it a little bit better for the patient and family is quite incredible,” she says.

A huge part of her job revolves around patient education. “We do lots of teaching about their diagnosis and symptoms. We are always keeping patients informed of what is going on,” she says. “Often they’ve got lots of questions about dying, and what dying is going to look like. We are available to the family and patient, and if they do want us there at the end we are there with them. We don’t like to see anyone die alone, so if there isn’t someone there with them and death is imminent, then we will take that time and try and be there when they are dying.”

Afterward, she focuses her care on family members: sometimes sitting with them, and at other times listening as they talk about their loved one. Even years afterward, she’ll run into families who will thank her and tell her they couldn’t have gone through the experience without her.

Bailey, who expects she’ll continue working in palliative care for the rest of her nursing career, is planning to earn a master’s degree in nursing and become a nurse practitioner in palliative care.