Palliative care nurse Fred Parmanand has spent the past 22 years at Bridgepoint Active Healthcare caring for patients facing the end of their lives. For him, palliative care is much more than administering medication and checking fluids.

It takes a special kind of emotional resilience to work in palliative care. Your patients are all terminally ill, and you’re not only caring for them, you’re also caring for their family members. “You really have to empathize with what each person is going through. Both the patient and their family caregiver,” says Fred. “To put it bluntly, one person is staring down their own death. The other is trying to imagine a completely different life, losing energy and losing hope. You have to ask: what will bring peace to both of these people?”

That question isn’t easy to answer, but Fred believes that small acts of compassion can bring light to an undeniably dark situation. “When a patient is admitted, they’re looking to you for some kind of answer, and we don’t always have that. They’re walking into a strange environment and the best thing you can do is provide a simple act of kindness, something to level-set and break the ice. Something as small as offering a glass of juice. Then you can start a conversation and build a relationship. That is how the light gets in.”

Fred recalls a recent moment of joy: “A newly admitted patient and his wife were listening to soca music and I of course had to dance once I came into the room. The wife danced with me, while the husband was laughing and smiling from his bed. Then we started telling stories and jokes. I found these beautiful points of connection with an 80-year-old couple.”

Inevitably, there are heavier days, and they come with an emotional toll. Fred feels deeply for all of his patients, but some hit harder than others. Caring for the father of young children, or a daughter whose parents are both in palliative care at once, or a couple that has just gotten married, “Those are the days your heart is just ripped out.” And the burden of those heavy days only becomes worse in the midst of a global pandemic. “At the start, people in palliative care couldn’t have visitors,” says Fred. “It’s much better now with the vaccines, but March 2020 was so hard. People still found ways to connect, though, beyond the phone. A patient's son actually wrote ‘I love you mom’ in the snow outside of the window so she could see it.”

Ultimately, palliative care is about alleviating stress and suffering, not just for the patient, but for their loved ones as well. “You’re in a situation where you need to ask ‘how can I help?’, not just go about giving out medication,” says Fred. “As I grow older, I’ve realized my job has helped me understand my own life. I’ve seen so much over the years and have wondered ‘what can I do to improve my own quality of life?’ It’s important to not worry about trivial things you can wash that dish in the sink tomorrow. You need to take an hour for yourself to have a coffee or a glass of wine. And then after that, you can be humble, kind, and you can forgive. And that compassion for yourself and for others is how I find peace in my own work.”