Head Nurse, Palliative Care Unit, Caura, Trinidad, Trinidad & Tobago, W.I
Throughout the nursing school training, nursing students are taught the holistic approach towards nursing care. They are taught that the care of the patient encompasses not just the physical needs of the patient, but also the psychological, emotional, spiritual and social needs. The nursing student is trained in developing assessment skills, inter-personal and observational skills in these areas, and also strategies to formulate a plan of care in order to meet these identifiable needs. This training prepares qualified Registered Nurses to work in any assigned clinical setting they desire, to enhance their personal and professional development.
Palliative Care is very much the type of clinical setting where a Registered Nurse can practise everything s/he has learnt during nursing studies. In the Palliative Care Unit at the Caura Hospital, Trinidad & Tobago, West Indies, holistic approach to care is quite evident on a day-to-day basis. The patients’ needs are so extensive; not just physical (symptom control), but one can bear witness to some grave existential stresses in the lives of the patients.
These stresses can be emotional, spiritual, psychological and social, and hence, it is paramount that a multi-disciplinary approach to care should be available as well. In this respect, other than clinician health providers, a medical social worker, pastoral care (via our resident ministers/pastors) and dietician are engaged at weekly multi-disciplinary meetings to address these stressors. It also, most times, requires the involvement of the families.
Families play an integral role in the Palliative Care process and they must not be forgotten. Very often, the nursing personnel, who are there around the clock, observe the dynamics between the patient and their family, and are able to offer counselling when necessary.
Palliative Care is an extraordinary kind of nursing because it is a vital partnership between the patients, nursing-medical personnel and their families. It is an area of care where it can be rewarding, even though every stakeholder has the understanding that death is inevitable. It is also rewarding because of the care, compassion, communication, courage, competence, and commitment – the core elements in nursing practice are individually translated into practice.
The positive feedback from bereaved families has always been expressed through these elements of nursing and this remains the unique job satisfaction for the nursing personnel in palliative care.