Zhuldyz Sarimova: ‘Palliative care isn't about the end of life; it’s primarily about life itself’

‘Palliative care isn't about the end of life; it’s primarily about life itself’

Kristiāns Dāvis / Photo from personal archive

Zhuldyz Sarimova, a student with 23 years’ medical experience, a mother of five, and a nurse with Aktobe’s only mobile palliative care team, is the guest in our latest Masters of Care interview.

Zhuldyz spoke with PACED’s Katerina Nikitina and Uliana Pavlovskaia about entering palliative care by chance and staying out of love for the profession; the importance of listening in medical leadership; the systemic challenges facing mobile teams in Aktobe; and finding the strength to protect patients from pain and loneliness each day.

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Beshbarmak — a traditional dish in Kazakh cuisine, consisting of boiled meat (typically horse or mutton) served over wide sheets of thin dough and topped with a rich, onion-infused broth.

Katerina: You’ve worked in healthcare for more than 23 years. Could you tell us a bit about your professional journey?

Zhuldyz: As a child, I never thought about medicine. I dreamt of becoming a lawyer to defend people. But after leaving school, I didn't secure a place at a state-funded university, and studying on a fee-paying basis wasn't an option. My parents suggested I apply to a medical college, and to my surprise, I was accepted into a tuition-free programme. At first, it was just studying, but over time I fell in love with medicine with all my heart. As a result, I’ve been in this profession for 23 years.

I spent 18 years as a surgical nurse. In that role, I learnt resilience, responsibility, and how to make swift decisions. For the past few years, I’ve worked in a palliative care team, and this work has completely transformed my mindset. Palliative care isn't just about treatment; it’s about being there in a difficult moment, easing pain, and ensuring a person isn't left alone. I now realise this is my calling. I truly love my work.

Katerina: How did you transition from surgery to palliative care?

Zhuldyz: In 2021, I moved to Aktobe and was looking for work. Quite by chance, I secured a job with a mobile palliative care team.

Katerina: Moving into palliative care is a significant decision. Have you ever regretted taking that step?

Zhuldyz: When I joined palliative care, my perspective on medicine changed completely. For 18 years, I had devoted myself to surgery, where you fight disease and save lives.

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Palliative care showed me that even when a disease cannot be cured, you can still give a person so much.

Often, a patient doesn't need anything complex—just pain relief, easier breathing, someone by their side, or simply someone to talk to. For me, palliative care is, above all, about humanity and compassion. When we visit patients, we see not only their illness but also their home environment, fear, and confusion. Another major difference is that we support not only patients but also their families.

The longer I work here, the more I love what I do. My mindset has changed completely, and I haven't regretted it for a moment.

Katerina: You recently earned a degree in nursing, didn’t you?

Zhuldyz: Yes, that’s right. I earned my Bachelor’s degree in Nursing and enrolled in a Master’s programme this year. But it’s not so much about the diploma as it is about building confidence.

Medicine is constantly evolving—new approaches, solutions, and even medications emerge all the time. No matter how long you’ve worked in healthcare, you can never think, ‘I already know everything.’ I have 23 years’ experience, yet I still learn from every patient, especially in palliative care, where each individual requires a tailored approach. That’s why I strive for continuous professional development. My principle is simple: I don’t learn just for myself, but to share knowledge with my colleagues and support my team.

Zhuldyz (the first on the left) with her colleagues / Photo from the personal archive

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Experience makes us professionals, but knowledge helps us build on it. In medicine, you learn for life.

Uliana: Do you feel like a leader in palliative care?

Zhuldyz: Honestly, I don’t consider myself a leader. For me, the key to a team is listening to one another and working as a cohesive unit. Everyone has their role: doctor, nurse, psychologist, social worker. The tasks differ, but the goal is the same—to help the patient and their family as much as possible. I always try to listen to my colleagues, offer support, and share my experience. If someone’s opinion differs from mine, I listen carefully; sometimes someone else notices what you’ve missed.

The strength of a good team isn’t in one person bossing everyone around, but in trust and mutual support. If my colleagues see a leader in me, that reflects trust above all—and trust is a huge responsibility. Leadership isn’t about walking in front and issuing orders; it’s about being alongside people, supporting them through difficult moments, and walking that path together. In our work, the priority isn’t ourselves but our patients. When the team keeps that in mind, everything falls into place.

Zhuldyz at work / Photo from the personal archive

Uliana: It’s interesting that you say you don’t feel like a leader, yet you’ve listed all the core leadership qualities: listening, accepting criticism, sharing expertise, staying humble, and mentoring colleagues. I’d still argue that you possess very strong leadership traits.

Could you tell us how you communicate with patients and their loved ones?

Zhuldyz: Trust doesn’t appear instantly. It’s built less on words and more on attitude and actions. When I visit a patient, the first thing I do is listen to them or their family. As healthcare workers, we often rush to give instructions and forget the most crucial part—hearing the person themselves. This is especially vital in palliative care.

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I don’t enter a home thinking, ‘I’m going to do this and that,’ but with the question, ‘How can I help?’

The shortest path to trust is to remain yourself, stay human, and show humility. I think that is often the true purpose of our work.

Uliana: Is there a particular story from your practice that stands out to you?

Zhuldyz: There are many such stories, but I’ll share just one.

An elderly couple lived together in one home. The husband had severe lung cancer, was bedridden, and had developed pressure sores. His wife found it extremely difficult to care for him on her own.

I visited them every day, assisting with care and monitoring his condition. Over time, we became more than healthcare workers to them—almost like family. They lit up with childlike joy whenever we arrived.

This went on for about nine months, and I grew deeply attached to them too. When he passed away, I took it very hard. That experience taught me a profound lesson. In palliative care, you have to work with your heart and offer warmth, but you must also learn to maintain a healthy emotional distance. We can help a patient, but we cannot save them.

Katerina: What is the current state of palliative care in Aktobe? What are the main challenges you face in your work?

Zhuldyz: I feel that palliative care here is gradually developing, but there are still many difficulties.

For a specialist, the hardest part is not only the heavy workload but also the emotional strain. Every day we encounter severely ill patients and their pain and fear. At the same time, we must preserve our energy and humanity. I would love for mobile team specialists to have more opportunities for both professional development and adequate rest.

Zhuldyz with a patient / Photo from the personal archive

Katerina: Wow. That's really impressive.

Kristiāns: It's all about having a very good team.

Katerina: Totally agree! Tell us about your team and your organisation.

Kristiāns: My main company, Magnum Social Medical Care—operating under the brand name Rūre—is the parent organisation overseeing most of our projects and services. However, we also have separate entities for applying to multiple European projects.

While I'm always involved in deciding which projects we take on, I have an amazing team of professionals skilled at writing accepted proposals, ensuring we fully understand all requirements.

I also have a team of lawyers who conduct due diligence on the European projects and handle all reporting. Because these are public finances, tenders are mandatory—we cannot simply choose a contractor at random. My legal team manages all tenders. Once the tenders are finalised, a team of construction overseers manages the projects directly.

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I am convinced that to care for patients well, we must care for those who provide palliative care.

When a specialist feels supported and has the knowledge and resources they need, they can offer patients so much more—not just professional assistance, but genuine human warmth. For me, that warmth is the very foundation of high-quality palliative care.

Patients and their families often lack information. Sometimes families think that referring their loved one to a palliative care service means they have abandoned him. That isn't the case at all. Palliative care is essential, and the earlier it is involved, the easier it becomes to manage the situation.

Naturally, the sheer volume of work is a major problem. Here in Aktobe, we have only one team: a doctor, a nurse, a paramedic, a social worker, a coordinator, a psychologist, and a dispatcher. And only one car.

Katerina: How many patients are currently in your care?

Zhuldyz: Around 120.

Uliana: Goodness…

Zhuldyz: It is a tremendous workload. However, if a patient has pressure sores, needs a dressing change, or requires specific care, I visit them daily. We work eight hours a day, and I manage 9-10 home visits.

Katerina: Do you care exclusively for adult patients?

Zhuldyz: Yes, adults only. Exclusively oncology patients in clinical group four.

Katerina: If you could change one thing about the palliative care system right now, what would you change?

Zhuldyz: If I had the chance to change something about Kazakhstan's palliative care system, I would make it far more accessible and raise public awareness of it.

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Many people still don't fully understand palliative care and fear it.

And, of course, I would add more mobile teams.

Uliana: So you have a full-time job that is complex and emotionally draining, plus evening studies. Do you have children?

Zhuldyz: Five: four boys and one girl. The eldest son is already working, and my youngest daughter is four.

Uliana: How wonderful! But that entails a tremendous amount of duty and responsibility. Could you tell us how you cope with such a workload?

Zhuldyz: Of course, it varies; sometimes it’s very tough. You face difficult situations at work while your family waits at home. But for me, family isn't an extra burden—quite the opposite, it's my main source of strength. Conversations with my children and shared laughter in everyday family moments help me switch off and recover after a demanding day.

Zhuldyz (the second on the right) with a mobile palliative care team / Photo from personal archive

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Over the years, I’ve realised something vital: you must give your heart to the patient, but you cannot take their pain home with you.

It’s important to remain compassionate and caring, but also to look after yourself. I often tell myself, ‘I cannot solve every problem. But if I managed to ease one person’s pain or support one family today, my day was well spent.’ That thought is immensely helpful.

When I arrive home, I am no longer a nurse; I am a mother. My children are waiting for me and need my attention. That gives me strength too. So I strive to maintain balance: at work, I give my full attention to patients, while at home I try to be a mother and live my family life.

Palliative care has taught me to appreciate life and simple things deeply: time with loved ones, a conversation, a smile, the chance simply to be together. If someone were to ask me what palliative care means to me, I’d say: palliative care isn't about the end of life; it’s primarily about life itself.

Uliana: The ability to leave work at work and switch focus to family is something many people spend a lifetime trying to learn, without success. It’s wonderful that you’ve mastered it.

Thank you for sharing your story with us.

Quick-fire questions:

Question 1: Are you afraid of death?
Zhuldyz: No, I’m not afraid.

Question 2: What does Kazakhstan mean to you?
Zhuldyz: Kazakhstan is my motherland.

Question 3: Your favourite dish?
Zhuldyz: Beshbarmak.

Zhuldyz with a patient/ Photo from the personal archive

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