Palliative Perspective Podcast

Ep. 38: Discharged to Airport: Navigating Complex Symptom Management

Palliative Perspective Podcast

Show Notes

In this episode, Mary Lynn McPherson, PharmD, PhD, FAAHPM and Alexandra L. McPherson, PharmD, MPH discuss a complicated case involving a patient in her mid-50s from East Africa who is suffering from metastatic cancer. The conversation highlights the challenges of complex pain & symptom management while supporting a patient's goals of care. Related Resources: Down on the Pharm: Contemporary Issues in Pharmacopalliation About the Speakers: Mary Lynn McPherson, PharmD, PhD, FAAHPMDr. McPherson has practiced hospice and palliative care as a clinical pharmacist her entire career. She is a professor at the University of Maryland and executive program director of the online Graduate Studies in Palliative Care (Graduate Certificates, MS, PhD) program. She has served as a resource to medical staff for pain and symptom consultations, opioid conversion calculations, methadone dosing and other medication-related issues. McPherson is particularly interested in assuring patients with a serious illness receive goal-concordant medication therapy. She has authored five books including the popular Demystifying Opioid Conversion Calculations: A Guide to Effective Dosing and numerous peer-reviewed articles and chapters.

Alex McPherson, PharmD, MPH Dr. McPherson received her Bachelor of Science in International Business from the University of Maryland in College Park, MD, followed by her Master of Public Health (MPH) with a dual certificate in International Health and Pharmaceutical Assessment, Management, and Policy from Boston University in Boston, MA. She went on to receive her Doctor of Pharmacy from the University of Maryland School of Pharmacy in Baltimore, MD. Subsequently she completed a Pharmacy Practice Residency at Einstein Medical Center in Philadelphia, PA and Pain Management and Palliative Care Specialty Residency at the University of Maryland School of Pharmacy/MedStar Health. She is currently a Palliative Care Clinical Pharmacy Specialist at MedStar Washington Hospital Center in Washington, DC, where she serves as faculty in the interdisciplinary Hospice and Palliative Medicine Fellowship program. In addition, she serves as a faculty member for the nation’s first M.S. in Medical Cannabis Science and Therapeutics (University of Maryland School of Pharmacy), and M.S. in Palliative Care (University of Maryland Graduate School) programs. She is an active member of the American Academy of Hospice and Palliative Medicine and the Society of Pain and Palliative Care Pharmacists and has published and presented internationally on topics pertaining to pain management and palliative care. Her academic interests include early integration of palliative care in advanced illness, navigating transitions of care at the end-of-life, and the pharmacologic management of symptoms in serious illness. Her newest interest includes the integration of narrative medicine practices as a tool for reducing burnout and improving resiliency among palliative care providers.

More from Palliative Perspective Podcast

Oct 1, 2026

What if the key to reducing resistance to care isn't doing more, but approaching care differently? In this episode of HPNA Palliative Perspective, internationally recognized dementia care expert Teepa Snow, MS, OTR/L, FAOTA shares practical techniques for licensed practical nurses and nursing assistants that prioritize connection before providing care. From seeking permission and interpreting refusals to using body language, pacing, and creative storytelling, listeners will discover simple, actionable strategies that can improve comfort, trust, and communication across hospice, home care, and long-term care settings.

Sep 1, 2026

Advocacy doesn't begin in the legislature—it begins wherever nurses use their voices to improve care. In this episode of Palliative Perspective, HPNA Advocacy Committee member Janelle Williamson MSN, NP-C, APRN, ACHPN, FPCN, and Kansas State Representative Melissa Oropeza DNP, APRN, NP-C, CGRN, join the conversation to explore how nurses can influence healthcare at every level. From sharing patient stories and engaging in professional organizations to testifying on legislation and serving in elected office, they discuss the many ways nurses can shape policy and advance the profession. Together, they reflect on their own advocacy journeys, the leadership skills that grow from speaking up, and why nurses are uniquely qualified to inform healthcare decisions. The conversation also addresses a common challenge: many nurses don't see themselves as policy experts, despite being the clinicians closest to patients and families. Whether you're attending your first advocacy event, participating in an HPNA Hill Day, or simply wondering where to begin, this episode offers practical insights and inspiration to help you discover where your voice can make a difference. Advocacy isn't reserved for a select few—it's a natural extension of nursing practice, and every nurse has a role to play. HPNA Advocacy __________________________________________________________________________________________________________________________ Melissa Oropeza, DNP, APRN, NP-C, CGRN, is a board-certified Nurse Practitioner specializing in Gastroenterology at The University of Kansas Health System and a Kansas State Representative. With more than 27 years of healthcare experience, she has been a leader in advancing the role of Advanced Practice Providers and improving patient care through clinical practice, leadership, and advocacy. Throughout her career, Dr. Oropeza has championed the nursing and advanced practice professions. She founded and served as the inaugural Chair of The University of Kansas Health System's Advanced Practice Providers (APP) Council, where she established professional recognition programs, created an APP endowment fund, and launched the institution's first APP Symposium. Her leadership has created lasting opportunities for professional development, recognition, and advocacy for advanced practice providers. A nationally recognized healthcare advocate, Dr. Oropeza served on the Kansas State Board of Nursing and became the first actively practicing Nurse Practitioner elected to the Kansas House of Representatives in 2022. She currently serves as Chair of the Wyandotte-Leavenworth County Legislative Delegation and as Ranking Minority Member of the Kansas House Social Services Budget Committee, where she works to improve healthcare access, strengthen behavioral health services, and advance policies that support Kansas families and healthcare professionals. In addition to her legislative service, Dr. Oropeza continues to provide direct patient care and mentor future healthcare leaders. She is a strong advocate for healthcare access, mental health, and patient-centered public policy. Her professional honors include the 2017 Kansas Nurse Practitioner Advocate Award and numerous leadership and service recognitions throughout her career. In 2026, she received the Legislative Leadership and Collaboration Award for Mental Health Advocacy, recognizing her commitment to building bipartisan solutions and improving mental health outcomes for Kansans. Janelle Williamson, MSN, APRN, NP-C, ACHPN, FPCN, is a nurse practitioner with Palliative Medicine and Supportive Care at Stormont Vail Health in Topeka, Kansas. A nationally recognized leader in hospice and palliative care, she has held specialty certification in the field for nearly 15 years and was named a Fellow in Palliative Care Nursing in 2023—an honor recognizing significant contributions to the profession. She has been a strong advocate for improving access to palliative car

Aug 3, 2026

For many nurses, retirement marks not the end of a career, but the beginning of a new chapter of service. In this episode, former HPNA CEO Judy Lentz, PhD, RN, reflects on how retirement created an opportunity to reimagine her role in palliative care through volunteer leadership and the development of palliative care ministry within faith communities. Drawing on decades of experience in clinical practice, education, research, and organizational leadership, Judy explores how retired nurses and other healthcare professionals can continue to improve quality of life by supporting individuals and families living with serious illness. She also discusses the concept of the palliative care doula as one model for companioning individuals and families through serious illness, alongside practical examples of how congregations can become compassionate partners in care by providing spiritual, emotional, and social support that complements the work of interdisciplinary palliative care teams. The conversation also reflects on the evolution of hospice and palliative care, the enduring value of mentorship and leadership, and the fulfillment that comes from continuing to serve beyond a traditional career. Whether you're approaching retirement, considering volunteer opportunities, or looking for new ways to extend the reach of palliative care, this episode offers inspiration for finding purpose in the next season of professional life.

Jul 1, 2026

Prolonged mechanical ventilation in rural long-term care settings brings a unique set of clinical, ethical, and logistical challenges for care teams, residents, and their families. In this episode, we explore the realities of ventilator use in rural long-term care environments, where limited resources and geographic barriers can complicate care decisions and delivery. We also take a thoughtful look at the emotional and practical impact of ventilator discontinuation, highlighting the experiences of those directly affected. Join us for a nuanced conversation that sheds light on an often-overlooked aspect of long-term care and the difficult decisions that come with it.

Jun 1, 2026

In this episode of HPNA Palliative Perspective, we’re joined by Betty Ferrell—Editor of the Journal of Hospice & Palliative Nursing (JHPN), nurse, and internationally recognized researcher. As the leader of the End-of-Life Nursing Education Consortium, she brings a unique perspective shaped by decades of connection with hospice and palliative care nurses across the U.S. and around the world. Now in her 49th year in nursing—beginning in oncology and entering hospice as it emerged in the United States—Dr. Ferrell reflects on the remarkable growth of the field and where we stand today. At the heart of this conversation is the idea of a “professional home.” Drawing on the foundational work of pioneers like Florence Wald and Cicely Saunders, she highlights the enduring importance of interprofessional, whole-person care—and the need to stay grounded in those values as the field evolves. In a time that can feel complex and demanding, this episode offers a clear message: you don’t have to do this work alone. Finding your people, building community, and staying connected—through colleagues and organizations like the Hospice and Palliative Nurses Association—are essential to sustaining both practice and purpose. A thoughtful and reassuring conversation about belonging, connection, and the future of hospice and palliative nursing.

See all episodes →