Palliative Care Unit - University Hospital LHSC
| Contact person(s): |
Dr. Kyra Harris-Schulz, Palliative Care Unit, LHSC - University Hospital Dr. Kathleen Milne, Palliative Care Unit, LHSC - University Hospital |
The Palliative Care rotation at University Hospital provides residents and fellows with a unique opportunity to provide care to a diverse population of patients across a number of sites. The rotation is supervised by Dr. Harris-Schulz and Dr. Milne who are both fellowship trained, academically appointed Palliative Care physicians with a special focus in non-malignant Palliative Care. Our Palliative Care team provides consultations to diverse and complex patients in the tertiary inpatient setting, as well as to patients in the UH dialysis unit and in our Non-Malignant Palliative Care Clinic. Our team works closely with general internal medicine as well as a number of subspecialty groups including: neurology, cardiology, hepatology, nephrology, transplant medicine, and critical care. Given our teaching site is not associated with a cancer centre, residents and fellows will have a unique opportunity to provide palliative care to a high volume of patients with non-malignant diagnoses in the inpatient and ambulatory setting, in addition to those with cancer. This will allows residents and fellows to:
- Gain and understanding of how to apply the non-malignant and malignant models of Palliative Care at various stages of the illness journey from time of life-limiting diagnosis (even when curative treatments like organ transplant may still be being considered) until end-of-life
- Appreciate what the practice of palliative care looks like in a variety of different settings (i.e. in ambulatory clinic, dialysis, hospital ward, intensive care)
- Improve skills in goals of care conversations and advanced care planning with a patient population that most closely mirrors Canada's aging population
- Learn how to help navigate the complex intersections between quantity and quality of life interventions for patients with chronic, non-malignant illnesses like heart failure, end-stage renal disease, decompensated liver cirrhosis, neuro-cognitive diseases with chronic aspiration etc.
- Advance skills in managing symptoms specific to both malignant and non-malignant presentations and their treatments and learn how to safely prescribe symptom medications in the context of end stage liver and renal disease, and advanced age
- Gain an appreciation for the psychosocial impacts of living with serious illness and learn how to support patients and their families throughout the illness journey
- Become more comfortable with navigating uncertainty and the highly fluctuant trajectories of non-malignant illnesses with patients, their families, and their care teams
- Participate in interdisciplinary family meetings to gain an appreciation for how to effectively collaborative with other care providers and navigate complex patient, family, and team dynamics
- Learn more about how to coordinate palliative discharges to home and determine appropriateness palliative placement versus end-of-life care in the acute care setting
- Learn to manage symptoms associated with the dying process and support/prepare patients and families throughout the last hours to days
Our rotation is open to core and elective residents and fellows at all levels of training. Please note: University Hospital is a training site for the Enhanced Skills Program in Palliative Care. As such, our rotation provides an excellent learning opportunity for residents considering the PGY3 program, or for those interested in incorporating Palliative Care into their comprehensive family practice (e.g. home based palliative care, long-term care, hospitalist etc).
As clinical supervisors, we pride ourselves on ensuring the learning environment we create is safe and supportive. If you have any questions about our rotation or wish to discuss whether an elective in Palliative Care at University Hospital can help you achieve your unique learning goals, please feel free to reach out to both of us (Dr. Kyra Harris-Schulz, kyra.harris-schulz@lhsc.on.ca / Dr. Kathleen Milne, kathleen1.milne@lhsc.on.ca).
