I graduated in medicine in 1963, worked in the country for ten years before taking up practice in Collins Street for 22 years. In 2002 I began at the Rosebud Hospital Campus of Peninsula Health where I was initially the Clinical Supervisor of the Emergency Department. When the inpatient complexity expanded I moved into the inpatient wards and am now Site Medical Director of the Rosebud Hospital.
At Rosebud I was confronted by the palliative care of terminally ill patients sometimes from diagnosis until death, but mostly as referrals from the community for the end stages of the disease. We are under the direction of the Palliative Care Team of Peninsula Health led by Dr Brian McDonald who is of enormous help and support. Being the oldest medico in the hospital my advice is always sought by the caring relatives on the progress of their dying relative/friend and so I felt it was important to improve my skills in all areas of palliative care in order to up-skill the junior doctors and enhance the capabilities of our small Palliative Care Unit.
The Victorian PEPA program is very capably run by Ellen Sheridan. I enrolled in the four day PEPA program at Peter MacCallum Cancer Centre, East Melbourne. It involved pre-course reading, lecture attendance, multidisciplinary meetings, attendance at consultancy ward rounds and ensuing discussions regarding care, one on one discussions with palliative care physicians, education on the use of opiates and other non-narcotic substances in pain relief, counselling techniques with patients and relatives, and the full understanding of palliative care in all circumstances and religious settings.
On completion, I felt much more confident in my ability to perform palliative care on my patients and to fully support and inform the concerned relatives regarding the process, the progress and the great value from this end of life supportive treatment.
In 2011 I used my sabbatical term at the hospital to gain further experience in palliative care at St Vincent’s Hospital, Melbourne and Caritas Christi Hospice, Kew. The latter is also an educational facility for professionals doing a post-graduate palliative care course.
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.
Rosebud Hospital continues to offer palliative care services (inpatient) in the region of an ageing population. Public transport is not at all user friendly and so our grieving elderly patients have great difficulty in attending the palliative care centre in Frankston and I see this increasing considerably in the coming years. Dr Brian McDonald continues to provide us with great consultant advice from his Golf links Road Unit and attends us when requested.
(Reproduced with permission from Dr Richard Ward and the Peninsula GP Network)