Margaret Campbell: A Maverick in Palliative Care

When Margaret Campbell, professor at Wayne State University College of Nursing in Detroit, began her career in 1974 as a critical care nurse, she couldn’t help but notice the severe lack of palliative care occurring in her ICU. She believed change was needed.

AACN’s immediate past president Clareen Wiencek witnessed firsthand Campbell’s dedication to palliative care many years ago as Campbell treated a patient addicted to illegal street drugs. However, Campbell refused to intervene unless he was honest about how much he used so she could properly implement evidence-based equianalgesic dosing conversions and be sure she administered the proper amount of medications.

“It was at that moment that I knew I was in the presence of a master,” Wiencek said in her introduction of Campbell during Monday’s Distinguished Research Lecture.

Campbell has garnered international recognition for changing the management of dyspnea and respiratory distress, moving away from patient-reporting tools — such as analog and numeric rating scales — to something more objective.

“Critically and terminally ill patients are often unable to report their symptoms because of metabolic changes or nearness to death,” Campbell said. “This inability to self-report leads to under- or overtreatment and thus, patient distress or hastening of death.”

Campbell created the Respiratory Distress Observation Scale (RDOS), the first tool that measures dyspnea via scores of patient behavior, heart rate, oxygen saturation and respiratory rate. Based on RDOS scoring, she developed treatment protocols ranging from patient repositioning to morphine titration.

Campbell’s career continues to evolve, with new studies on ventilator withdrawal and pediatrics on her immediate horizon.

“We’ve come a long way in recognizing that we don’t save everybody in the intensive care unit, so for critical care nurses to embrace their role in midwifing a dying person in the ICU … it is an important part of the work that we all do.”

4 Responses

  1. Anne says:

    Jennifer – there are two top hits when you do a lit search for this, both by Dr. Campbell:
    Campbell, M. L., Templin, T., & Walch, J. (2010). A Respiratory Distress Observation Scale for patients unable to self-report dyspnea. Journal of palliative medicine, 13(3), 285-290.
    Campbell, M. L. (2008). Psychometric testing of a respiratory distress observation scale. Journal of palliative medicine, 11(1), 44-50.

  2. Deborah Brunkhorst says:

    I work on a CICU with palliative extubation.

  3. Sherri Harkless says:

    I am very thankful to Dr. Campbell and her work. I used her RDOS in my graduate work.

  4. Jennifer Batongbacal says:

    Thank you for sharing about the Respiratory Distress Observation Scale (RDOS). I have not heard about it. Is there a way to get an article about RDOS? Thank you.