Once upon a time, competencies were developed for health care providers in palliative and end of life care. There were competencies written for nurses, health care workers (nursing assistants, personal support workers, hospice aides), physicians and social workers, and others. There were competencies developed in many lands, in Ireland and the United States, in Nova Scotia and Alberta, in Ottawa and Vancouver, to name just a few. After creation, competencies struggled to be heard and adopted and too often were not used to inform curriculum or education development.
It takes a village to raise a child, (and my mother added, “It takes a community to care for the dying”).
I often think of this quote and celebrate the people who helped me to raise my kids, and those who contribute to the development of hospice and palliative care education resources.
This past week I received some beautiful, inspiring, testimonials about our new nurse’s text, Essentials in Hospice and Palliative Care: A Practical Resource for Every Nurse. I want to share those testimonials, but do NOT want to share the testimonials until I acknowledge the people who contributed to the development and inspired or influenced or assisted with the writing of the text.
A bunch of years ago I met with a group of HPC leaders several times over a number of months. Each month George Eisler from the BC Academic Health Counsel, would ask the question, “How do we prepare the workforce for the coming tsunami of dying?” At the end of the series of meetings a project was developed for educating physicians and medical office assistants. As important as that was, I was concerned about the needs of the front line workers, in particular the health care workers and the nurses, who would be providing care for the dying.
We just attended the Hospice Palliative Care Ontario 2016 Conference in Toronto. Wonderful event with nearly 800 attendees.
Much talk about PAD (Physician Assisted Dying) or MAID (Medical Assistance In Dying). The following day there was an interesting opinion piece in the Globe and Mail by Dr Tom Koch, a gerontologist and ethicist, who provides chronic and palliative consultations. The title of the article, “The next court challenge, the right to better care“.
Koch asks the question, “If the Supreme Court decision enshrines choice as a principle of Canadian justice, then what choice are we to be offered? If it is between constant pain and an early death, most of us would prefer the latter. Expert palliative care can mitigate physical suffering in, according to experts, perhaps 95% of all cases. But at present, that level of pain control is unavailable to many Canadians. Without its surety, the choice is limited, if not empty, and justice therefore denied because a real full choices is withheld. Similarly, all agree that end stage home care and hospice care can make the last stage of an illness more than bearable. But many Canadians who would choose this, can not, it is not available. And without its insurance, the choices they are offered to care to the end are limited.”
Advance Care Planning Day in Canada, and National Healthcare Decisions Day in the USA, is quickly approaching. On April 16, 2016, it’s time to speak up – and have discussions with friends and family members about your wishes for end-of-life.
Life and Death Matters created Care Planning Cookies, edible cookies with a message inside, each one intended to stimulate conversations about living well and dying well. One hospital in Ontario is ensuring that each patient receives a cookie on their meal tray, and that family and staff are given cookies with their food and beverages in the cafeteria, leading up to April 16th.
Guest post by authors Pat Porterfield, Kelli Stajduhar, Rick Sawatzky, and Cara Pearson of iPANEL. A recently published article by the iPANEL team is the focus of this blog post. The goal of this research was to clarify the meaning of a “palliative approach” to healthcare for people who have chronic advancing life-limiting conditions. Read the full article for more information about a palliative approach and prominent care delivery models.
Palliative care … palliative approach … hospice palliative care … end of life care – Phrases and terms often used interchangeably, often misunderstood, and often the cause of extended discussions among those of us interested in the care of people who are living with and dying from serious illnesses.
Over the past few years I have cited the iPANEL research (Initiative for a Palliative Approach in Nursing: Evidence and Leadership) as one of the most important research projects in hospice and palliative care today.
Today the iPANEL team announced the publication of their latest article – Conceptual foundations of a palliative approach: a knowledge synthesis. The article can be found here.
Please distribute this article widely! This is an open access journal, so SEND people to the LINK instead of sending the PDF. The number of hits impacts the ranking of the article on the journal’s website!
It has been an incredible month. We attended conferences in Texas, Ontario and California. We are home now, absorbing the learning, and trying to integrate what we learned into our beings. Most profound for me was the opportunity to attend sessions addressing Physician Assisted Dying.
The debate is over. Physician Assisted Dying has been legalized in Canada. Health care professionals and administrators in hospices and palliative care (HPC) now need to develop policies outlining what services their HPC program will and will not provide. Physicians need to decide how to respond to requests, whether or not they are willing to provide a “hastened death” and if not, then decide who to refer people to. Nurses need to decide how they will respond, both within their formal work setting, but also, how they will respond as a family member or friend when the questions about hastening death are raised.
Guest blog post by Jennifer Buchanan of JB Music Therapy – a Canadian company based in Calgary, Alberta. “Our mission at JB Music Therapy is to transform lives through excellence in clinical practice and education by bringing music into the foreground. JBMT has been providing music therapy services since 1991. We offer personalized programs for individuals coping with brain injury, mental health issues, learning challenges, dementia, palliative care, addictions, long-term care, autism, as well as youth at risk.”
And most exciting for me is the section on Palliative Care!
Have a look at the new Competency Profile for Licensed Practical Nurses, in particular (document) pages 142- 146 for the Palliative Care Profile. I was honoured to be asked to provide input in the development of these competencies, and am thrilled with the outcome of this document. These are the most specific palliative care competencies for LPN/RPN practice that I know of.