The reality of nurses completing their own research

Finding the resources for nurses to complete original research is not always easy but it is achievable. Allison Bentley, Specialist Palliative Care Nurse, St Nicholas Hospice Care, Bury St Edmunds, Suffolk, UK, and doctoral student, explains how and why she persevered.

Allison Bentley

Allison Bentley

I have been nursing for 30 years, but it is probably in the last decade I have been on a specific journey to gain academic and clinical knowledge in palliative care for those people with a non-cancer diagnosis. I was a district nursing sister originally (part of a primary healthcare team visiting patients in their own homes or in residential care homes), and the lack of equality in accessing equipment, services and good symptom control for those with long-term conditions in end of life care was very real at that time. Working with my community colleagues who are heart failure nurses, respiratory nurses, diabetes specialist nurses, neurological, dementia and mental health nurses we have made strides in the right direction. However, gaining additional research skills and knowledge as a community nurse has been challenging at times.

Whilst completing a BA (Hons) in Primary and Community Care, I was informed that completing original research was not part of the dissertation due to increasing difficulties gaining ethics approval for small-scale, individual projects. Not to be put off, a few years later I applied to my manager to be considered for the MSc Health Science (Palliative Care) at Warwick University. I explained the very merits of studying with colleagues from all disciplines, the need for nurses to develop palliative care skills and to develop research projects that would benefit patients we were working with every day. However, this was not seen as a requirement of my job and so no resources were available.

This was the time to be creative – I applied to many scholarships, charities, bursaries big and small, and got started slowly, one module at a time. I then decided to work as a community matron (ie a senior practitioner who provides case management for patients with long-term conditions living in the local community with deteriorating health), with the hope of caring for patients with multiple co-morbidities, as many spend the last few years of life in and out of hospital and care settings. For the patients I help support at home it is evident that many have multiple long-term conditions to contend with, and a complex array of burdensome symptoms. Working with elderly people has raised many questions about their end of life care planning and access to palliative care services. In order to help develop research in this area, I have been lucky enough to be sponsored by a Florence Nightingale Foundation Research Scholarship  to start a distance e-learning PhD in palliative care at the International End of Life Observatory (Lancaster University).

The reality of nurses completing their own research has been realised by scholarships and programmes such as the National Institute for Health Research (NIHR) clinical academic training programmes.  I hope the skills of clinician and researcher will benefit my new role at the local hospice in trying to develop partnerships and access for all patients.

To find out more…
Click here for information about the distance e-learning PhD in palliative care. 

 

EAPC congress 2015EAPC Early Researcher Award 2015 – online application now open!
Applications are welcomed from scientists and clinicians who are at an early stage of their research career in palliative care for the next award. Three award winners will be selected. The winner of the first place will be invited to present his/her work to an international audience by giving a plenary lecture at the 14th EAPC World Congress in Copenhagen in May 2015. Travel cost, accommodation and registration fee will be covered. Candidates who have already applied for the award in previous years are invited to reapply. Candidates can apply themselves, or be nominated by their supervisor or similar. Click here for full details and to apply online.  Closing date: 5 pm, November 30, 2014.

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Different kinds of meaning help us understand what’s going on

Malcolm Payne, Honorary Professor, Kingston University/St George’s University of London, Faculty of Health, Social Care and Education, UK, explains the background to his longer article that is published in the September/October issue of the European Journal of Palliative Care.

Why be concerned about ‘meaning’ as an issue in end-of-life care? I came to write about it in the European Journal of Palliative Care as someone who comes from a background in social work, and therefore started out with an academic training in sociology and social policy, leavened with a little psychology. Coming to work in palliative care about ten years ago, I found it strange that issues of meaning were seen as the province of spiritual care professionals.

Prof Malcolm Payne

Prof Malcolm Payne

An important strand of sociology is social construction: how we all interpret the world through coming to everyday unstated agreement with others about what we see and experience. The psychological end of psychosocial care reminded me of another understanding of meaning: how we perceive and process events around us and interpret them in accordance with our expectations. Colin Murray Parkes’s (1975) ideas about our ‘assumptive world’ in bereavement are an example. Bereavement disturbs our assumptions about how our life is, and in this view part of the process of going through bereavement is creating new assumptions.

In one of his thoughtful discussions of spiritual care, Peter Speck (2004) points out that the spiritual care concern with meaning is mainly about existential meaning: why do I exist (since I’m told that soon I will cease to exist)?

So I went off to look in more detail at wider concerns about meaning in the palliative care literature. One of the reasons that early thinking focused on spiritual meaning, for example in Dame Cicely Saunders’s (1964) writings, is the perception that searching for meaning in our lives as we approach death will guard against fear of death and demands for assisted suicide and euthanasia.

However, research on searching for meaning at the end of life suggests that while some people faced with adversity do search for existential meaning and gain satisfaction from their thinking, not everyone reacts in this way. More recently, several interventions, using both group and individual treatments, to help people explore meaning have been tried at different stages in end-of-life care.

These include mainly medical and nursing interventions concerned with patients and relatives’ understanding of their symptoms and the progression of their medical condition at the outset of palliative care. Other interventions have been concerned with helping people cope with reactions to impending death and with bereavement.

In the paper, I have classified different approaches to meaning based on different disciplines contributing to end-of-life care and drawn together a number of the interventions that have been evaluated. I argue that we need to have a broader and differentiated view of meaning and how to deal with it.

References
Parkes, C.M.1975. Determinants of outcome following bereavement. Omega, 6, 303-23.

Saunders, C. (1964[2006]) The depths and possible heights. In Saunders, C. (2006) Cicely Saunders: Selected Writings: 1958-2004. Oxford University Press, Oxford, pp. 67-70.

Speck, P. 2004. Spiritual concerns, in Sykes, N., Edmonds, P., Wiles, J. (Eds.) Management of Advanced Disease, Arnold, London, pp. 471-81.

EJPC215cover-2To read a copy of the full article…
This post relates to a longer article, ‘Meaning in end-of-life care practice’, by Malcolm Payne, which is published in the September/October 2014 issue of the European Journal of Palliative Care (vol. 21.5).  If you have a web-based subscription to the journal you can download this issue, plus all articles in the journal archive. You can also browse the archive and download articles by taking a 10-minute or 30-minute subscription. Members of the EAPC receive discounted subscription rates to the journal – click here to subscribe online.

 

Posted in Bereavement, European Journal of Palliative Care, Publications, Spiritual care | Tagged , | 2 Comments

The human rights-based approach to children’s palliative care in Belarus

Katherine Pettus, Advocacy Officer, Human Rights and Palliative Care, International Association for Hospice and Palliative Care (IAHPC), explains how she has been working with staff of a children’s hospice in Eastern Europe to help them advance children’s palliative care through closer links with international human rights bodies.

Dr Katherine Pettus

Dr Katherine Pettus

Entering the Belarusian Children’s Hospice (BCH) on the outskirts of Minsk the visitor is welcomed into what appears to be a large family-friendly home. A home dedicated to the highest standards of clinical excellence and alignment with international human rights law!

Belarusian Children's Hospice

Belarusian Children’s Hospice

In order to maintain its high standards as the only provider of palliative home care to seriously ill children and their families in Belarus, BCH has to do ongoing national and international fundraising. Director Dr Anna Garckova, and grant writer Elena Anasimova, are politically savvy women who asked me to help them learn more about how to interface with international human rights treaty bodies to advance the cause of children’s palliative care. Interestingly, their Ministry of Foreign Affairs and Ministry of Health asked them to collaborate in writing the Universal Periodic Reviews for Belarus that are presented to the Human Rights Council in Geneva. As a result of one of these reports, the concluding observations of the Committee on the Rights of the Child to the 3rd and 4th Periodic Reports of the Republic of Belarus cited the country for lack of political commitment and insufficient involvement of state institutions in the provision of palliative care for children. This then prompted the Ministry of Health to issue an order determining general conditions for palliative care service development in Belarus and stipulated the creation of palliative care wards in hospitals and children’s homes.

The noticeable gap, however, was lack of funds for medical equipment and medicines for home care and respite services. Since the majority of children and, of course, their parents prefer children to be at home whenever possible, BCH fundraises to fill that gap.

Some of the children who have received support from Belarusian  Children's Hospice

Some of the children who have received support from Belarusian Children’s Hospice 

In partnership with UNICEF and contract staff from the Ministry, BCH cares for at least 300 children annually, the majority of diagnoses being congenital and neurological disorders, and about 20% cancers. The hospice, which will soon move to new premises, has three bedrooms for respite and acute care, as well as a teaching room for clinical providers who come from other former Soviet republics to learn about children’s palliative care.

To find out more…

Little Stars – encourages universal access to children’s palliative care
Click here to view the trailer from ‘Little Stars’, a series of short films that aims to encourage governments around the world to do more to ensure universal access to children’s palliative care. Moonshine Movies, the film makers, are appealing for funds to enable them to have the film ready for a première at the World Cancer Congress in Melbourne this December – more information at Indiegogo

Posted in Advocacy, Children's palliative care | 1 Comment

Rekindling life skills


Cliquez ici pour la version en français

Catherine Proot PhD, Bereavement Coordinator, St Nicholas Hospice Care, Bury St Edmunds, UK, explains how bereavement activity groups are helping participants to learn new skills, feel more confident and renew their taste for life.

Catherine Proot

Catherine Proot

The hospice and palliative care movement considers bereavement care to be an integral part of their service provision. Emotional support is offered to help people express their suffering and make sense of their loss, in individual or in bereavement support groups. At St Nicholas Hospice Care in the UK, we have developed bereavement activity groups, alongside or in lieu of bereavement counselling, to address the practical and social dimensions of grief work. It all started with a cookery group.

The cookery group at St Nicholas Hospice Care addresses the practical and social dimensions of grief work

The cookery group at St Nicholas Hospice Care addresses the practical and social dimensions of grief work

Bereaved clients often wonder «How do you cook for one?» or «my husband couldn’t eat so I stopped eating too and I don’t know how to start again»… Hearing a therapist mention that for 40% of her clients eating disorder started in bereavement encouraged us to do something about it.

The hospice chef and bereavement volunteers welcome six to nine participants – as many as we can fit in the kitchen – in the evening when the hospice kitchen is free, for four monthly sessions. They cook together and then sit around the table to share the meal they have prepared. Participants appreciate the recipes and cookery tips, companionship and shared ideas for coping. At the last session they prepare a Christmas dinner or a summer buffet, adding the dimension of cooking for others.

The success of the cookery group encouraged us to develop other activity groups such as home and car maintenance. The groups provide knowledge – including knowing when and where to ask for help – and know-how in handling a drill or demystifying what is under the car bonnet… Needless to say, participants in the cookery group are mostly men while the home and car maintenance appeals more to women.

The groups provide knowledge – including knowing when and where to ask for help – and how to handle a drill

The groups provide knowledge – including knowing when and where to ask for help – and how to handle a drill

A very popular activity is our monthly walking group; an opportunity to come out of the home and grasp a breath of fresh air with people who ‘understand’. Two spin-offs vouch for the social impact of these activities: participants have created a monthly lunch club and some have been on holiday together and are planning a new one!

More groups have been created in St Nicholas Hospice Care involving participants across our service users. Patients, carers, bereaved, staff and volunteers meet for a crafts group, creative writing, ‘knit and natter’ and the men’s own group.

Brushing up skills or learning new ones in a safe environment helps participants feel more confident in themselves and bring back a taste for life. It would be great to learn about any similar projects in Europe and beyond. Please leave a comment below, or email me if you’d like to exchange ideas or would like more information on our activities.

Links and resources


Redonner du goût à la vie

Catherine Proot PhD, Coordonatrice de l’Accompagnement de deuil à St Nicholas Hospice Care, Bury St Edmunds, UK.

Catherine Proot

Catherine Proot

Les hospices, centres spécialisés de soins palliatifs en Angleterre, incluent l’accompagnement de deuil dans leur offre de service. De manière générale une aide émotionnelle encourage les personnes endeuillées à exprimer leur souffrance et accompagne leur travail de deuil que ce soit en entretien tête à tête ou en groupe. A St Nicholas Hospice Care, nous avons développé des groupes d’activité qui, en complément ou en lieu d’un accompagnement émotionnel privilégient les dimensions pratique et sociale du travail de deuil. Tout a commencé par un cours de cuisine.

Le cours de cuisine a St Nicholas Hospice Care

Le cours de cuisine a St Nicholas Hospice Care

Des personnes endeuillées que nous rencontrons s’interrogent «Comment cuisiner pour une personne?» ou «Quand mon mari ne pouvait rien avaler, je me suis abstenue de manger moi aussi et je ne sais comment m’y remettre»… Entendre une thérapeute dire que pour 40% de ses clients souffrant de boulimie ou d’anorexie, les difficultés avaient commencé en période deuil nous a encouragé à tenter quelque chose.

Avec la complicité du chef de cuisine et de bénévoles d’accompagnement nous invitons six à neuf participants à se retrouver le soir, lorsque la cuisine de l’hospice est libre, pour quatre sessions mensuelles. Ils cuisinent ensemble puis partagent le repas qu’ils ont préparé. Les participants apprécient les recettes et idées pratiques, le compagnonnage et le partage. La dernière session inclut la préparation d’un repas de Noël ou d’un buffet estival, ajoutant la dimension de faire quelque chose pour autrui.

Le cours de bricolage dans la maison

Le cours de bricolage dans la maison

La réussite du cours de cuisine nous a encouragé à développer d’autres activités tel des cours de bricolage dans la maison et d’entretien de la voiture. Ces groupes allient savoir – y compris savoir ou trouver de l’aide – et savoir-faire par exemple en forant une brique ou en démystifiant ce qui se trouve sous le capot … Faut-il préciser que les participants au cours de cuisine sont souvent des hommes et que le bricolage de la maison et l’entretien de la voiture intéresse surtout les femmes?

Une activité particulièrement prisée est notre groupe de marche mensuel, une raison de sortir de la maison pour prendre un bol d’air avec des personnes qui ‘comprennent’. La dimension sociale de ces activités est importante comme en témoigne deux ‘spin offs’ : des participants ont monté un club de déjeuner et certains sont partis en vacances ensemble et prévoient de récidiver.

Exercer leurs capacités ou apprendre du neuf dans un environnement où ils se sentent en sécurité aide les participants à se refaire confiance et redonne du goût à la vie. Merci de penser à nous partager si vous avez des projets similaires en Europe et au-delà. Vous pouvez postez un commentaire ci-dessous ou m’envoyer un mail si vous voulez échanger des idées ou souhaitez davantage d’information sur nos activités.

Pour en savoir plus…

 

 

 

 

 

 

 

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Taking it all back home: Reflections on the 8th World Research Congress of the European Association for Palliative Care

Dr Andrew Olagunju, Lecturer/Consultant Physician, College of Medicine, University of Lagos, Nigeria, received a special commendation in the EAPC’s Early Researcher Award category at this year’s congress. Here he reflects on some important learning points from the congress and how they may impact on his work in Nigeria.

It’s been a few weeks since the 8th EAPC World Research Congress was held in the beautiful city of Lleida, Spain. For many reasons, this congress certainly lived up to expectations – not only did it bring together researchers from all continents of the world, but it offered rich sessions traversing various aspects of palliative care research.

Dr Andrew Olagunju at the EAPC 8th World Research Congress, Lleida

Dr Andrew Olagunju at the EAPC 8th World Research Congress, Lleida

To start with, my reflections wouldn’t be complete without mentioning the recognition of our work in Nigeria with a special award by the EAPC. This award was the main reason for my attendance at the congress and I am very grateful to the EAPC for the award, as well as the privilege to participate in this historic world research congress.

Beyond the renewed impetus that my attendance at the congress has had on my work in palliative care, I’d like to mention a few key lessons that are particularly relevant to my professional involvement with palliative care: research, training and the care of people with palliative care needs.

First, the importance of the role of caregivers in palliative care and the impact on their wellbeing caught my attention. Of course, caregivers in Nigeria, and in most African settings, are typically made up of relatives who are often responsible for decisions about pathway to care, patient navigation, out-of-pocket payment, and psychosocial support; aside from being directly involved in the care of family members. It became clear to me that enough attention has not been paid to the wellbeing of caregivers in the context of clinical services, research and training despite their playing a cardinal role in palliative care. Consequently, I am developing a protocol to assess the magnitude of the gap in the psychosocial needs of caregivers, which will be translated into practice.

Another important lesson borders on the need to integrate the measurement of outcome into clinical practice of palliative care. This was reiterated in many sessions, including Professor Paul Glare’s presentation and the plenary lecture given by Professor David Currow. I am convinced this will provide answers on the quality of work we are doing, by pointing out its direct benefits to the patients and families as well as indicating areas for improvement.

Lastly, the importance of networking and research collaboration was exemplified in many ways in presentations. The breaks and other free periods were a great opportunity to collaborate, and contribute to ongoing works. Such networking among professionals across various boundaries encourages me to envisage a promising future for palliative care.

Links and resources…

  • Selected presentations from the 8th EAPC World Research Congress are now on the EAPC website
  • You can read other posts about the 8th EAPC World Research Congress on the EAPC blog
  • Read an interview with Dr Andrew Olagunju in ehospice.

EAPC congress 2015EAPC Early Researcher Award 2015 – online application now open!
Applications are welcomed from scientists and clinicians who are at an early stage of their research career in palliative care.  Candidates who have already applied for the award in previous years are invited to reapply. Candidates can apply themselves, or be nominated by their supervisor or similar. Click here for full details, and to apply online. 
Closing date: 5 pm, November 30, 2014.

Posted in EAPC Congresses, EAPC Early Researcher Awards, Education and training, Research | Tagged , | 1 Comment

The effects of advance care planning on end-of-life care

Arianne Brinkman-Stoppelenburg, MSc, researcher in the department of Public Health, Erasmus MC, Rotterdam, The Netherlands, explains the background to her longer research article that has been selected as Editor’s Choice in the September edition of Palliative Medicine.

Advance care planning is the process of discussing and recording patient preferences concerning goals of care for patients who may lose capacity or communication ability in the future. It enables patients and their families to consider what care and treatments might or might not be acceptable, and to try and make plans in line with their wishes. In our recent review to be published in Palliative Medicine, we investigated the effects of advance care planning on end-of-life care. 

Arianne Brinkman-Stoppelenburg

Arianne Brinkman-Stoppelenburg

What was the motive for performing this review?
In our department of Public Health at Erasmus MC, it’s good practice to start your PhD-trajectory by writing a review on a relevant (end-of life care) topic. Reading more about the topic, I became interested in advance care planning because it is a broad concept, involving a range of interventions and outcomes. Over the past years, the focus of advance care planning has shifted from the completion of written forms, to the social process. Advance care planning is now considered as an important aspect of end-of-life care. This made me curious about the effects of advance care planning on end-of-life care.

What was the aim of the study?
The aim of the study was to get insight into different forms and programmes of advance care planning, and to explore the effects on end-of-life care. In this review, we wanted to give a broad overview; therefore we chose to include different types of advance care planning and outcomes. We checked whether the search strategy covered studies from different countries, as not all countries use the same terminology.

What were the main findings?
We conclude that there is evidence that advance care planning positively impacts on the quality of end-of-life care. Complex advance care planning interventions may be more effective in meeting patients’ preferences than written documents alone. Few studies have been performed on the effects of advance care planning in the Netherlands and in Europe. More studies are needed with an experimental design, in different settings, including the community, also in the Netherlands and other European countries.

What have you learned?
I have learned that it takes a lot of effort to perform a good review. The definition of a proper search strategy, including relevant Mesh-terms, and defining good inclusion and exclusion criteria takes a lot of time at the start, but it turned out to be very worthwhile later on in the process of selecting papers.

How can this study be used in practice?
The review was helpful in preparing the study proposal for the ACTION trial (Advance Care Planning – An Innovative Palliative Care Intervention to Improve Quality of Life in Oncology), a large cluster randomised trial in six European countries that assessed the effects of advance care planning on symptom burden and quality of life of patients with advanced cancer. I hope this review will provide a useful overview of the current literature and that it helps to identify possible gaps that could be addressed with further research.

Read the full article in the September issue of Palliative Medicine

Read the full article in the September issue of Palliative Medicine

You can download a free copy of the longer article…
This post relates to the longer article, ‘The effects of advance care planning on end-of-life care: A systematic review’ by Arianne Brinkman-Stoppelenburg, MSc, Dr Judith AC Rietjens and Dr Agnes van der Heide, Palliat Med 2014 28:9, 2014, Vol. 28(8) 1000–1025. Published online before print 20 March 2014, DOI: 10.1177/0269216314526272.
EAPC members and registered users of the EAPC website can download a free copy of this article and other ‘Editor’s choice’ papers from the EAPC website. (If you need to register or login to download this paper follow the instructions in the top right-hand corner of EAPC home page and scroll down to download the article). Click here to view other EAPC-originated papers.

Links and resources…

  • ACTION (Advance Care Planning – An Innovative Palliative Care Intervention to Improve Quality of Life in Oncology). 
  • The EAPC is currently preparing a new White Paper on Advance Care Planning. Check the EAPC website and social media links for future updates.
Posted in Palliative Medicine – Editor's Choice, Publications, Research | Tagged , | 1 Comment

Trying to make a difference: One medical student at a time

Clique aqui para ler a versão em português

Bárbara Antunes, Research Associate at Centro de Estudos e Investigação em Saúde da Universidade de Coimbra (CEISUC), Portugal, and Visiting Research Associate at Cicely Saunders Institute, King’s College London, UK.

Bárbara Antunes

Bárbara Antunes

Being a full-time researcher at King’s College London allowed me to acquire new skills, but it also meant I would be away from clinical psychology practice for a number of years.

In order to stay in the ‘real world’ I explored options. One of the best things I did was to facilitate role-playing communication sessions with medical students at King’s College London. From first years, on managing the clinical interview, to final years –almost doctors – on how to break bad news. These were the most challenging, but the most rewarding sessions.

All groups are different, and of the 10 to 15 students per group, two or three will get to role-play in each 30-minute session. My favourite bit is at the end of the role-playing, after everyone has had a chance to share their thoughts and feelings: when they realise that in that particular moment, with that particular person, the best possible medical care they can deliver is not CPR manoeuvres or a highly complex drug prescription… rather it is to bear witness to that life-altering moment. To be silent. To acknowledge the person’s reality has changed forever, because before that conversation they still had a mother, or were healthy or were not faced with extremely difficult choices. It is to listen, to support someone’s anguish and sadness and to let them know they are not alone. To offer a tissue, a glass of water, or ask if there is someone they would like you to ring.

“And we just stand there?’’
You’re not ‘just’ standing there, you are ‘with’ them. You’re not answering the phone or checking messages, nothing is more important than that moment. Because you cannot change circumstances or save someone from death when it’s their time. But you can make people feel cared for. When they go home they might not remember half of what was said, but they will never forget your attitude, possibly in years to come. ‘’That was the worse day of my life, but the doctor was really nice to me, just stayed there to make sure I was okay and offered help,’’ as opposed to ‘’Not only it was the worse day of my life but the doctor seemed like they had more important things to do, they just brushed me off. It’s not right!’’

After the person leaves, it’s your turn to vent, if you need to – either with colleagues, alone, or with family and friends. And that is when, hopefully, I see the ‘epiphany’ look. Then I know they ‘got it’ and can only hope that they will remember when practising medicine: it’s about caring for another human being.

If you’d like to share your experiences of being part of an international research project please leave a comment below, or contact via email or Twitter: @B_CP_Antunes

Find out more…
If you’ve enjoyed this post, you might also be interested to read Dr Birgit Jaspers’ post on the EAPC blog describing a seminar for medical students where hospice volunteers act as patients.


Tentando fazer a diferença: um aluno de medicina de cada vez

Bárbara Antunes, Investigadora Colaboradora do Centro de Estudos e Investigação em Saúde da Universidade de Coimbra (CEISUC) Portugal e Investigadora Convidada no King’s College London, Instituto Cicely Saunders, Reino Unido.

Bárbara Antunes

Bárbara Antunes

Ser investigadora a tempo inteiro no King’s College London permitiu-me adquirir novas competências, ainda que tenha implicado ficar longe da prática clínica e, portanto, não exercer psicologia clínica durante alguns anos. Para ficar em contacto com o “mundo real” explorei opções. Uma das melhores coisas que fiz, foi facilitar sessões de role-playing em comunicação para os alunos de medicina da universidade. Desde alunos primeiro ano, sobre como realizar a entrevista clínica, até aos alunos do último ano – quase médicos – como dar más notícias. As sessões mais difíceis, mas as mais recompensadoras.

Todos os grupos são diferentes, e dos 10 a 15 estudantes por grupo, dois ou três terão a oportunidade de fazer role-playing durante cada sessão de 30 minutos. A minha parte favorita é no final do role-playing, depois de todos terem tido a oportunidade de partilhar os seus pensamentos e sentimentos: quando compreendem que, quando estiverem no mundo real, num determinado momento e com uma pessoa em particular, o melhor tratamento médico possível não será uma manobra de reanimação cardiorespiratória, ou prescrição complexa de medicamentos… antes, será testemunhar um momento preciso que para sempre alterará vidas. Estar em silêncio. Validar que a realidade daquela pessoa mudou para sempre, porque antes daquela conversa, a pessoa ainda tinha Mãe, ou era saudável, ou não estava perante decisões médicas complicadíssimas. Ouvir, suportar a angústia e tristeza daquela pessoa e permitir-lhe saber que não está sozinha. Oferecer um lenço, um copo de água ou perguntar se há alguém a quem gostaria que se telefonasse.

“E ficamos ali apenas?”
Não ficam “só” ali, estão com “com” aquela pessoa. Não estão ao telefone ou a ver mensagens, nada é mais importante do que aquele momento. Porque ninguém pode mudar as circunstâncias ou salvar alguém da morte quando chega a sua hora. Mas podem fazer com que sinta que alguém se preocupa. Quando aquela pessoa for para casa poderá não se lembrar de metade do que foi dito, mas nunca esquecerá a vossa atitude, possivelmente durante anos: “foi o pior dia da minha vida, mas o/a médico/a foi muito simpático/a, ficou comigo para se certificar de que eu estava bem e ofereceu-me ajuda.” Ao invés de “não só, foi o pior dia da minha vida, mas o/a médico/a parecia que tinha coisas mais importantes para fazer, simplesmente despachou-me! Não está certo!”. Depois da pessoa sair é a vossa vez de ventilar, se sentirem que é necessário. Seja com colegas, sozinho/a ou com família e amigos.

E é nesse momento, espero eu, que vejo os olhares de ‘epifania’. Aí sei que compreenderam e só posso desejar que se lembrem quando exercerem medicina: é sobretudo cuidar de outro ser humano.

Se quiser partilhar as suas experiências de fazer parte de um projeto internacional, por favor deixe o seu comentário abaixo, ou contacte via email ou Twitter: @B_CP_Antunes

Obrigada à Dra Sofia Vilar Soares pela revisão do texto em Português.

Posted in Education and training | Tagged , , , | 3 Comments