"Engaging with patients is necessary and palliative professionals learn to maintain that engagement." So says María Arantzamendi, co-principal investigator of the ATLANTES Global Observatory of Palliative Care of the Institute for Culture and Societyin her recent article How palliative care professionals develop coping competence through their career: A grounded theory. This work, published in the first quartile journal 'Palliative Medicine', analyzes how palliative care professionals develop coping competence throughout their care ers degree program through a comparative analysis of interviews with 21 nurses and physicians from Spain and Portugal.

According to the lead author of article, caring for patients with advanced disease involves a great emotional challenge , so coping skills are essential. In research it has been identified that the acquisition of skills is developed through five steps: starting with enthusiasm, recognizing one's own vulnerability and emotions, as well as the need to disconnect; then, proactively managing emotions; cultivating an integrative approach of care; and, finally, consolidating care in inner balance, accepting one's own limits. This process sample a growth of palliative professionals.

To promote the effective development of these coping skills, Arantzamendi recalls the importance of considering the influence of oneself, the patient and the family, as well as the context of the worker. The needs of a person with serious illness and his or her family are very deep, so "to care in all their depth and complexity, it is essential to have done self-care and self-knowledge," he says. In this axis, the emotional management is core topic. The professional is human and has to accept that he or she has emotions; it is necessary to connect with them, whether positive or negative, in order to be able to manage them.

Transcendental vision

All this would be impossible without a supportive context for the professional. For the expert, the support of the institution is core topic: "The institution must provide a minimum of resources and support to care or, at least, not give extra pressure". In the research it has been found that the cases in which professionals experienced greater burnout coincided with moments in which institutional support and resources had been lost. In the opposite case were professional colleagues. "Colleagues are a network of support and security," he points out. As he explains, at first, peers serve as a reference point, then as a support. In fact, 'micro-teams of strength' are created, i.e. informal groups of workers with affinity who support each other and share their experiences.

"The strategy of seeing the meaning, the bequest, is very powerful," says Arantzamendi. In senior professionals, the path left to colleagues gives meaning to the effort. Along the same lines, the expert stresses that, if the professional sees that his work is also useful for the patient, this gives him peace of mind and brings a special meaning to his work. "The patient tells you that his or her life is worth living to the end," she says. Moreover, the interviewees agreed that "experiences with families and patients are a trigger for improvement".

The expert concludes that palliative care professionals remain passionate about their work and develop skills to continue to do so. "The other becomes a spur for you to be your best version."