Nanaimo Bhaktapur Hospice Palliative Care Twinning Project - Site Visit, Octo ber 19th through Nov ember 11th, 2010
- Dr. Robin Love teaches at the bedside with Nepali doctors, and Nepali and Canadian nurses. Photo Credits: Richard Tran Venetia Mah.
- A comfortable patient in the palliative care unit at Bhaktapur Cancer Hospital.
A palliative care team from Nanaimo, Canada, led by Dr. Robin Love who serves as a consultant to INCTR’s PAX program, made their 4th site visit to Bhaktapur Cancer Center (BCC), Nepal from mid-October to mid-November in 2010. This visit was made as part of the Partners in Compassion Project – also known as the Nanaimo Bhaktapur Hospice Palliative Care Twinning Project. The primary focus of the trip was to assist in teaching a palliative care course hosted by BCC’s Palliative Care Program.
The major purpose of the visit was to conduct a two-week course in palliative care. This course was attended by 47 participants, including 7 physicians and many nurses from the Kathmandu region. The course included a variety of topics - challenges in palliative care, ethics, pain and symptom management, palliation in cancer and noncancer diseases, psychosocial aspects of care, development of a palliative care service including home care, care of the caregiver, and the roles of surgery, chemotherapy and radiotherapy in palliative care. Practical workshops and bedside clinical teaching were an important part of the course.
- Dr. Robin Love and some of the doctors and nurses from the palliative care program at BCC. Photo Credits: Richard Tran Venetia Mah.
Separate workshops related to patient handling, transferring and positioning were held – not only during the course given at BCC, but also at four other hospices and cancer care programs. This is for patient comfort but also for teaching the staff safe patient handling to reduce the risk of injury to nurses and family members. It was very well received, and was entertaining as well as useful.
The visiting team spent time working alongside medical and nursing colleagues in the palliative care unit at BCC in order to continue mentoring and teaching at the bedside. Discussions about the development of a palliative home care nursing service that will be part of the BCC program have been held and will continue.
Another new initiative is a research project that explores the impact of the Partners in Compassion project and consists of structured interviews with some of the partners including Nepali physicians, nurses, patients and families, and some partners here in Canada including physicians, nurses, administrators and nursing students. The main objectives of the project are to explore how this partnership has shaped end-of-life care in the host community, to determine whether the goals and vision of this project are being achieved, to document the experiences and outcomes of the friendship built between Nanaimo and Bhaktapur, and to identify the potential needs and barriers that still exist for the dying and their families in accessing quality and compassionate comfort care at BCC. The information obtained will be utilized to develop a tool to increase awareness in the medical and general community of the concept of twinning and its utility in meeting global needs, in particular the development of palliative care internationally. The information will be presented as a documentary film.
The team was encouraged by the progress made in the further development of the Palliative Care program at BCC. The Medical Director, Dr. Sudip Shrestha, remains committed to improvement, and Dr. Chadani Vaidya has been designated as the palliative physician for the unit. Laxmi Shrestha is the Matron of the Hospital and Nursing Leader of the PCU. Her leadership and commitment remain key features of the program. The PCU staff are more comfortable with the use of morphine and other medications and techniques for symptom management. Their role in developing and hosting the two week course helped to increase their sense of identity and responsibility as a “center of excellence” for palliative care in the Kathmandu Valley.
The team looks forward to their next visit in 2011.
The team consisted of :
- Dr. Robin Love, Palliative Physician and INCTR PAX Program Consultant
- Isabel Flood, Palliative Care RN
- Lisa Engel, Occupational Therapist
- Diena Abdurahman, Physiotherapist
- Jennifer Wade, Kinesiologist
- Sue Overton, Home Care Nurse
- Karen Evans, Home Care Nurse
- Dr. Venetia Mah, Family Medicine Resident
- Richard Tran, Photographer and Film-maker.
