I have spent 5 years working on an Indian reserve. Probably about 30% of the kids I teach have lost a parent in some untimely way (found them hanging, cancer, diabetes, murder, etc). Even more have lost a sibling or close relative. In the time I've been here, two girls have gone to Winnipeg and been murdered brutally. Many of the kids themselves are dealing with serious drug and alcohol addictions either personally or with those they love. There is a lot of gangs and violence. Many drop out of school by Grade 9. Many have started out nice kids and become drug dealers and racked up an extensive criminal record before the age of 20. The pregnancy rate before age 18 is astronomically high. Fetal alcohol syndrome and crack babies are very common. Even those in the community who are doing well are bled dry by all of the people close to them that are so deeply mired in their own problems and grief.
While this isn't the same as working in palliative care, it is very hard dealing with the reality that whatever measures I can take may improve things, but cannot make a difference on a large enough scale to alter much of what is inevitable (barring a miracle). In both cases, it leaves us with a sad heavy feeling which we cannot carry around constantly, but which should not be turned off completely if we are going to be effective in what we are doing.
I have found that having someone to talk about what is happening and why has been very useful in leaving it behind at the end of the day and in keeping me from becoming hard and complacent. It also has helped me come up with proactive ways that I can try to make things better in the realms of influence that I do have. As a result, I have come up with new ways of teaching or thinking about things that have made a positive impact. I have tried projects that I would not have embarked on otherwise. Even if it does not change the larger picture, it gives me something to focus my energies on and I think that it does change a little corner of the world.
I have lost three grandparents to cancer, and I can tell you that the palliative care people that helped us are remembered to this day (even 20 years later). For most people, this is the first time they are dealing with a loss like this. In many cases this has happened quickly - and some have not even had a chance to restore a broken relationship with the person who is dying. Many are not even sure how to make their loved one comfortable, or they are not used to the feelings that losing a loved one may bring. Some avoid being there as much as possible because they do not know how to deal with it. You treating not only the patient, but the whole family with care and compassion will make a long term difference. Because you have seen many people go through the process, you have a perspective that they need and will value. I think that by focussing on what difference you can make for them and then finding someone to help you process it aloud, it will help you to deal with the every day sadness you are facing.