Esther Schmidlin, EAPC board member, and a nurse consultant, Equipe Mobile en Soins Palliatifs, Plateforme Santé Haut-Léman, Vevey, Switzerland
The final part of Esther’s summer holiday trip to Poland
At my visit to Hospice St Lazarus, Dr Tomasz Gradalski, head of the department, also talked about the difficulties in finding physicians who are willing to work within the hospice as the salaries are lower than average. Most physicians need to supplement their income by holding additional part-time jobs in other hospitals or clinics. Government funding, as well as donations from charity and fundraising, have been going down over the past years. (Interestingly, new financial policies have the effect that palliative care for children is receiving more funds – leading to the creation of four children’s hospices in Kracow over the past few years, mostly for chronically ill children. These policies do not seem to take into account the needs resulting from the demographical and epidemiological changes with the ageing population.) Aggravating the problem further, the well-educated healthcare professionals from Poland are invited by countries in Western Europe to work under better financial conditions, adding to the difficulties of staff recruitment. If physicians work at Hospice St Lazarus, they do so often for philosophical and altruistic reasons.
On the other hand, continued effort to attract and train volunteers has proven to be a successful endeavour, contributing at least in part to maintaining a good quality of care. Hospice St Lazarus offers regular activities and educational opportunities for and with volunteers. Piotr Krakowiak explains:
“The hospice movement in Poland originated from voluntary-based home care teams. Recently, with emphasis on the medical side of care, many centres had diminished numbers or resignations from volunteers. Therefore, the national programme, ‘I like to help’, has been developed by the National Chaplain of Hospices to encourage multidisciplinary teams to consider volunteers as a valuable part of caring teams. More than 100 hospice-palliative care units in Poland have developed and improved training and coordination of volunteers in their teams recently.”
The daffodil, a symbol for Fields of Hope and the hospice-palliative care movement, as well as social education activities through foundations such as ‘Hospice is life, too’ have received major support from the media in Poland and helped to recruit volunteers and financial support. Public awareness is impressive, as I found when talking to a few young football fans at the fan zone in Warsaw. “Of course I know about the hospices – every spring they give away daffodils and make us aware oft the needs of people who have an incurable illness.” said one of them. There is hope that new ways of community involvement and advocacy will continue to support the vibrant hospice community in Poland. On reflection, I see more similarities than differences among most other European countries in terms of needs and goals in the development of palliative care.
I would like to thank Piotr Krakowiak for his valuable contribution and help throughout my visit and the writing of this blog, as well as everyone from Res Sacra Miser Caritas Hospice in Warsaw and the Hospice St Lazarus in Krakow for allowing me to visit their hospices and for their generous hospitality and time.