Australia’s only free health placements in palliative care services and free palliative approach workshops.
The Program of Experience in the Palliative Approach (PEPA) forms part of the Palliative Care Education and Training Collaborative (the Collaborative). As a national palliative care project, the Collaborative takes a strategic approach to education and training of the healthcare workforce and delivers programs for priority healthcare provider groups across primary, secondary and tertiary settings.
PEPA provides an ideal opportunity to learn from experienced specialist staff to enhance skills, knowledge and experience in the palliative approach.More about PEPA
IPEPA provides high-quality, holistic and culturally-responsive palliative care to Aboriginal and Torres Strait Islander peoples and their loved ones.More about IPEPA
Palliative care is very valuable, we only get one chance to get it right. Whether people choose to die at home or in a hospital or RACF the emphasis is on providing good quality end of life care and having the knowledge and confidence to carry it out effectively. These placements provided me with a greater insight into all aspects of palliative care in different settings and social situations, the care of the client, the family and the carers.
Upon completing Program of Experience in the Palliative Approach I have gained insight into a service that I was not entirely familiar with before undertaking this placement. I feel this experience was very worthwhile as I am able to now understand when a client would be referred to palliative care and what palliative care can do to help support and assist the patient and their family/carer at end of life care giving quality of life. Palliative Care is often an overlooked service as community are not aware or educated on how the service can help with end of life care. This service can help reduce hospitalisations by caring for the patient in community and assisting with end of life care in particular keeping the patient comfortable and out of pain so they can still enjoy good quality of life. On this placement I was also made aware that there is an under representation of Aboriginal patients using Palliative Care in our local area on the Central Coast. This made me realise that I could help educate and promote this service to our Aboriginal community so that they are aware that this service exists and is there to help. I was given education on this placement, as well, about Advanced Care Directives and Advanced Care Plans. I was not overly familiar with these documents and was happy to receive education so that I am able to pass this knowledge onto patients that I assist so that they are aware they can put these documents in place to help with End of Life Care. I was exposed to both patient palliative care in a hospital setting and in a community setting. It was a great opportunity to see the way they both worked. I was able to see a couple of patients that were newly referred and how an initial assessment with these patients was conducted in the community setting and how the palliative care service can support these patients through end of life care with pain management, Occupational Therapy and physiotherapy assessments to establish equipment to help patient at home, such as hospital beds, wheelchairs, ramps etc. Some of these conversations around end of life are difficult to conduct so it was a worthwhile exercise seeing how the CNS would discuss with patients. I can take this experience back and utilise in my current role as Aboriginal Hospital Liaison. I am often dealing with patients, families and carers at end of life stage and now feel more comfortable promoting this service and educating patients, families and carers on ways this valuable service can help support and assist them. I was extremely happy to be able to undertake this placement and learn more about palliative care, a service that would certainly be beneficial to patients entering end of life and offering quality of life to these patients. I am happy to advocate for patients to refer, register and utilise this very worthwhile service.
The benefit I have gained from my PEPA program and the sabbatical in palliative care is greater confidence in performing the palliative care of an accurately diagnosed and prognosticated patient in all aspects of their palliative care pathway. I can confidently explain the pathway and objectives of the pathway to concerned relatives and friends and take the responsibility of prescribing appropriate medications. I believe I am now able to both empathise and sympathise with these situations and act in a better way as a true patient advocate in their proper care. I would definitely recommend the PEPA program as an excellent, interesting and informative program for all GPs.
Thanks to PEPA I have already started improving palliative care in the ED! First shift back in the ED and I have... a patient come in actively dying from the nursing home... Unfortunately the son wasn't told about the dying process or symptoms... Because of my PEPA placement I was able to confidently discuss the end-of-life process with the patient's son, what symptoms to expect and the management etc.
I hadn’t realised that patients with all illnesses could be referred to the palliative care team; I thought that only patients with cancer had access to palliative care... I was able to meet some of the patients and was truly blessed to see how my mentor interacted with the patients. She was soft spoken, gentle and caring. I noticed that she also allowed time for the patient to talk and ask questions. This is important when dealing with our mob as we need to allow time and space for questions or reflection.
I am a Palliative Care Clinical Nurse Specialist, currently based in Orange (rural) NSW and for my 4 day PEPA clinical placement I was keen to see a couple of specialist units in the Sydney metropolitan area. My first area of interest was Motor Neurone Disease (MND). MND is a challenging disease and made more so in rural NSW. The disease is rare enough that health professionals across the board get very little exposure and therefore little experience caring for someone with MND. My goal was to see what services the city units offered their patients, and to see how that could be adapted to a rural setting. I returned home having exhausted my poor brain, but very grateful for having had the opportunity to see and do so much in such a short time.
I have found the PEPA program to be invaluable, giving me insight into the hospital system and community provision of palliative care. My confidence has increased as a result of the knowledge I have gained. In each of the placements I was welcomed and encouraged to attain my learning needs. Resource material was supplied to provide further information. I would encourage all my colleagues to seek the opportunity to participate in this program of experiential learning.
One of the highlights of my trip was meeting Bev Derschow who developed and designed the Northern Territory Aboriginal Palliative Care model. Bev was able to share her experience in ‘spreading the word’ about palliative care and how finding the ‘right’ person to talk to when conducting a family meeting is imperative to culturally appropriate practice. I learnt that the Territory Palliative Care is a specialist program which provides a consultative service throughout the Northern Territory for clients with a life limiting illness. TPC is multidisciplinary and, while there are differences in staffing in Central Australia and the Top End, the full team includes specialist physicians, specialist nurses, social workers, occupational therapist and a pastoral care worker and volunteers.
...just like me, before attending the PEPA program, my colleagues also thought of palliative care as being limited to the care given to the terminal and actively dying person. This view has now changed and we now know supportive and palliative care starts long before that stage. We now realise that all the patients under our care need supportive and palliative care considerations as they are living with a life-limiting illness and a huge burden of symptoms and psychosocial problems which make quality of life poor... We are now aware of when to refer a patient to the renal supportive care clinic (RSCC) and how to do it.