As a specialist in palliative medicine, Dr Jeanna Stutinsky-Mason has chosen a career many people would find too difficult to contemplate. Every day she tries to bring care and comfort to those reaching the end of their lives and to help make dying more bearable. She talks about why she has chosen to work in this field and the impact of Covid-19.
A medical student stopped me recently and asked me what it’s like working on a palliative care ward. I asked them what they thought it would be like and they answered: “I think it would be scary to be around the sickest patients all the time.”
I replied by saying that there are moments of sadness working in a hospice but also moments of profound joy, helping people make the most of the time remaining to them. I said that, for me, it is a privilege to sit with someone as they take their last breath.
Of course, you will see these things in other parts of health care, but the frequency and intensity of how often we do these sorts of things is why I feel most fulfilled working in palliative care. There are always aspects of sadness in this field but you get that in every bit of medicine.
What kind of training is involved to work in palliative medicine?
I graduated in medicine from the University of Manitoba, Winnipeg, Canada in 2005. Later that year I moved to Leicester, to be with my husband.
From 2007 onwards, I worked as a junior doctor in Nottingham, Derby and Leicester and began to specialise in palliative care in 2013. I worked as a Registrar at various locations in Leicester, Kettering and Northampton until 2020 when I became a Palliative Care Consultant at John Eastwood Hospice in Mansfield, Nottinghamshire.
What happens in a typical day for you?
A typical day could involve doing a hospice ward round, seeing patients, then home visits in the community or reviewing patients on hospital wards. John Eastwood Hospice has kept most of its services running in some capacity during the pandemic, and has tried its utmost to allow families to see their loved ones.
I love the concept of holistic care and treating the “whole of a family". I feel confident that the patients we see are well symptom controlled and looked after. There is a lot of comfort to be found in a ‘good death’ for the patient themselves, but also for those who are left behind.
What kind of impact has Covid had on your work?
It’s been really tragic at times. We are saddened by the life loss and also the unseen aspect of the pandemic – the people who haven’t sought medical advice; the mental health impacts of the pandemic.
The flip-side is that we have seen progress in aspects of how we work. The video consultations, the meetings online. There is a lot of creativity coming out of this which will change how we practice medicine.
Are you happy with the way palliative care is delivered in the UK?
I’m passionate about making palliative care accessible to communities and individuals who are less supported – those with learning disabilities, dementia, incarcerated people, refugees and asylum seekers, LBGT+ and people without homes. I want to make sure it’s equitable. People experiencing homelessness, for example, may have chronic health conditions punctuated by acute episodes and may die in a less predictable manner – how do we ensure their needs and preferences are respected?
It’s also very important to consider the needs of relatives of patients who may not be able to get to a hospice because they don’t have a vehicle or can’t drive. We need to make sure that we accommodate them as well.
You're very interested in the concept of ‘compassionate communities.’ Can you tell us more about this?
We’ve really medicalised death in the last few generations, and this, in part, has made it a taboo topic. But it’s the end that waits us all. Compassionate communities within a public health palliative care context empowers and supports communities to talk about death and dying, and care for people with deteriorating health. It’s not a substitute for our services, but another layer of care.
Are you able to switch off at the end of a working day?
My life is fairly conducive to “switching off”. I’m commuting currently, so that gives me time to mull things over en route – I’ve usually either resolved it, or have a plan by the time I leave the M1. Plus when I enter the house I’ve got a bounding puppy and energetic daughter who engulf me!
Barring this, I’ve borrowed the idea of a “worry tree” that I saw some years ago on social media. I have a bay tree outside our entrance and if something from the day is still rattling around my brain, I try to leave it on the tree outside the house. That way I can “collect” it again in the morning on my way out if necessary. It works most of the time, and I really enjoy the symbolism of it too.
Jeanna with her new cockapoo puppy, Lexi.