Pathways to Palliative Care

Dr. Rebecca Goett—Palliative Care in the Emergency Department

Marcin Chwistek, MD FAAHPM

During one of her recent shifts as an emergency medicine (EM) attending physician at Rutgers University Hospital in Newark, NJ, Rebecca Goett, MD FACEP FAAHPM, took care of a patient with advanced cancer who came in extremis and became nonverbal soon after arrival. Intubation and admission to the intensive care unit (ICU) would have been a standard approach. Instead, Goett, who is board certified in emergency medicine and hospice and palliative medicine, started with a conversation. It soon became clear that neither the family nor the patient wanted to take that approach. So, in place of an intubation and quick transfer to the ICU, Goett found a room in the emergency department (ED) where the patient’s symptoms could be treated with care and her family could spend time with her. The patient died soon after. When new staff arrived in the morning, someone glanced on the board and, seeing a deceased patient, asked, “Did you have a cardiac arrest?”