TY - JOUR T1 - Tips for GP trainees working in palliative care JF - British Journal of General Practice JO - Br J Gen Pract SP - 700 LP - 701 DO - 10.3399/bjgp11X606807 VL - 61 IS - 592 AU - Kieran R Tunnicliffe AU - Alex MacKay Y1 - 2011/11/01 UR - http://bjgp.org/content/61/592/700.abstract N2 - Trainees are faced with dying and death throughout their training. In hospital jobs the emphasis is not always on good palliative care. GPs spend a significant amount of their time with patients and their families as they embark on the journey from symptoms to diagnosis, via more symptoms, ultimately to death. Many people, doctors included, find the prospect of hospices a dark and depressing thought. Withhold judgement! Working in palliative medicine can be an overwhelmingly positive experience that will leave you feeling more confident managing patients in the community while knowing when to ask for support from the specialist palliative care team.It is hoped that this advice will prove useful when thinking about palliative medicine whether you are fortunate enough to have a rotation in it or not.1. Examine your patient. Physical contact is reassuring even if just to check a pulse.2. Nausea and vomiting are common and often managed poorly. Think carefully about likely causes and target your treatment. Not all antiemetics are equal.3. Understand ‘total pain’ that encompasses physical, psychosocial, and spiritual domains. Analgesia alone is not always the answer4. Bowel dysfunction, not to be confused with bowel obstruction, is a common symptom. Constipation, distension, nausea, and vomiting are features. This is a diagnosis of exclusion once other conditions (for example, opioid-induced constipation, hypercalcaemia, and renal failure) have been ruled out.5. It is acceptable to refer hospice patients to an acute ward. Bowel … ER -