When working in palliative care, one of the most common questions from the families, and often the patients themselves is 'how long doc?'. This can be a jaw-dropping moment, where the doc takes a deep breath and tries to give a satisfactory answer, without a timescale. We all know there is considerable risk in giving a timescale, as patients can 'bounce back' or unexpectedly deteriorate, and the consequences of an inaccurate timescale can be significant. Here, our ST1 reflects on this very challenge in his placement with our local hospice. A well written learning log is now transformed into an inspiring article. Over to you, Rob. I had anticipated many challenges before starting my palliative care post, but I found this question particularly difficult. The senior doctors and nurses seemed very adept at knowing when someone is approaching the end of life and what to say to families. In the first few weeks I stood on the ward round feeling out of my depth, both in recognising that a patient was approaching death and in what I might say to families who turned to me and asked: 'How long do they have left?'. I started to understand how difficult this part of a patient's journey is and the effect uncertainty, if not handled carefully, can have on patients, families and healthcare professionals.
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