Opinion: Improving Hospice Care Is a Concern for Oncology RNs and Social Workers


Access to hospice and palliative care is lacking in many low- and middle-income countries.

Debi Fischer, MSW, BSN, BA, LCSW, RN

Debi Fischer, MSW, BSN, BA, LCSW, RN

Combined with the effects of the pandemic, there has been a growing crisis worldwide for those who need hospice and palliative care. Unfortunately, only 31% of palliative care is delivered in low- and middle-income countries (LMICs), although patients living in these areas represent 80% of the global palliative care need.1

One solution that has been identified and created was the formation of an international network, PallCHASE (Palliative care in Humanitarian Aid Situations and Emergencies).1 Its purpose is to provide a structure to offer palliative care in the worst-case scenarios, such as “humanitarian crises or emergencies.”1 The war in Ukraine is a good example of such a crisis—natural disasters also fall under this umbrella. The network has an emphasis on helping displaced persons, which includes individuals who lost their homes due to war, climate change, disasters, and other emergenciese.1

According to the United Nations Sustainable Development Goal 3.8.1, access to palliative care is key to maintaining health. It represents a basic tenant of universal health coverage, along with “promotion, prevention, and treatment to rehabilitation.” If we were to lack access to palliative care, the cycle of health care from birth through death would be lacking a key component.

Local Action

As oncology RNs and clinical social workers, the reality is that some of our patients may require palliative or hospice care, whether it be at home or an in-patient setting. In the oncology setting, pain control is one of our primary focuses. Walk into any oncology unit and enter a patient room. Better yet, complete a care plan. The white board where goals are written for the day and the computerized care plan will reflect pain control and the clinician’s assessment of this fifth vital sign as first and foremost many times.

For that reason, it is useful to stay ahead of trends and conversations in these spaces.

Now that the world is, for the most part, online, RNs and social workers can now access learning opportunities beyond the 4 walls of their hospital setting. Because of the COVID-19 pandemic, more conferences are being streamed online, including hospice and palliative care centered presentations. In 2020, the Memorial Sloan Kettering Cancer Center (MSK) Supportive Care Service and Department of Psychiatry and Behavioral Sciences was launched—it went online around the time of United States Celebration of World Hospice and Palliative Care Day.1 

The fourth conference at MSK will be held October 3-4, 2023, and will be available virtually.2 Questions regarding the conference can be directed to the hospital at uswhapcday@mskcc.org.2 This year’s topics will include “dignity in careracism and structural discrimination, and care for historically excluded populations”.2

Awareness of these conferences is vital if the clinician wants to stay current in the ever-changing field of oncology. It is not enough to just show up, punch a time clock and go through the shift. Because of the advent of virtual conferences, participation in conferences is easier than ever.Educating ourselves to the best of our ability is the first step in improving palliative care where we are able.


  1. Rosa WE, Pandey S, Epstein AS, et al. The 2nd annual US celebration of world hospice and palliative care day: a virtual coming together to support equity in palliative care access. Palliat Support Care. 2022;20(3):307-312. doi: 10.1017/S147895152200013X
  2. 3rd annual U.S. celebration of world hospice & palliative care day: a virtual coming together. Memorial Sloan Kettering Cancer Center. Accessed March 28, 2023. https://mskcc.cloud-cme.com/course/courseoverview?P=5&EID=35651
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