Integrating Palliative Care: The Power of Silence in Oncology

Integrating palliative care principles into oncology requires the ability to allow silence to create a space where patients can process difficult news and feel truly seen. According to Angela Thomas, MSN, APRN, AGPCNP-C, ACHPN, these intentional pauses validate the patient’s experience and provide a necessary emotional release. By sitting in silence, providers acknowledge the gravity of the patient’s situation, which Thomas identifies as a core “heart issue” learned from palliative care and successfully integrated into the oncology setting.

In a recent interview with Oncology Nursing News, Thomas, of Texas Oncology, discusses how practitioners can incorporate these techniques into their daily practice. She notes that while sitting in silence is often awkward and difficult for the provider, it is essential not to dictate the moment but to let the patient express their needs. Thomas emphasizes that simply acknowledging the difficulty of a situation, often with a brief statement of empathy, can be more powerful than rushing to the next medical answer.

Transcript

One of the main things that one of my mentors taught me in palliative care was the ability to allow silence to give birth to whatever is needed. There are so many moments in oncology where we give news—hard news—and we pass right through it. We give the next answer, the next treatment, the next lab result, but we don’t sit and allow that silence. It’s in those moments that I’ve realized that patients are really seen.

They realize that what they’re going through is hard, and it makes it okay. We validate in the silence. That is one aspect of palliative care that I will forever carry with me, and I like to share with whoever I mentor, but it’s hard. It’s hard to sit in a silence. … It’s awkward, but it’s not for us to dictate the silence. It’s for the patient to express what they need in that moment, though, too. I notice whatever feelings they’re having, and I say, ‘Wow, I can’t imagine. This must be really hard.’

Sitting in that and acknowledging that gives them the privilege to release whatever it is that they release. Those are some of the heart issues that I have learned from palliative care, and have been able to integrate into oncology.

This transcript has been edited for clarity and conciseness.