My motivation to participate in PEPA arose from self-doubt in my ability to effectively care for the palliative clients in the community setting. I have been a community health care nurse for the past ten years and although I have been involved in the care of many palliative clients, I have often felt that I could do better in managing their needs. Another reason for my interest in PEPA was to explore the issue of self-care when involved in the care of palliative clients which can be emotionally draining. I recognise that self-care is imperative in order to avoid feeling stressed or emotionally overloaded.
My first placement during PEPA was with Community Palliative Care Service. My learning experience was assisted by attending home visits to both stable and unstable clients. Each client was assessed with an holistic approach and symptoms identified and managed. The next day on Whittle Ward I “buddied up” with a different RN. I attended a multidisciplinary meeting and it was obvious that each person present was solely concerned with the well-being of the patients and respected the others and their field of expertise. I also participated in the doctors’ round where each patients’ care was evaluated. This helped to improve my knowledge in symptom control and medications. I became more familiar with and more confident in the use of the Niki T34 syringe driver. My final placement was with the palliative care nurses at the RHH. I attended the weekly palliative care meeting which included the oncologists, RHH palliative care resident, a nursing representative from 1BS oncology, community palliative care nurses, oncology intern from Whittle Ward and social workers. The ongoing care and treatment needs of all palliative inpatients, as well as all community palliative clients known to the RHH palliative care team were discussed, enabling input from all involved in clients’ care to promote optimal care provision. It was interesting to observe the interaction between the disciplines and to recognise some of the community clients I had met previously. In the afternoon, I accompanied the oncology registrar on her round as she visited palliative clients, evaluating their ongoing care. I was impressed by her bedside manner which was both professional and relaxed and it was obvious that she has established a good rapport with her patients, taking time to listen to their needs and concerns. She involved me by encouraging me to discuss their care and I felt comfortable seeking clarification about medications and their use.
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. I am currently working on information I have gathered regarding self –care and compassion stress and will distribute it to the members of the Hobart Community Health Nursing team.