Image, left to right: Julianne Brisbane MACN, Dr Kasia Bail MACN and Kristine Kealy MACN
by ACN Media Officer Jessica Pham
Dr Kasia Bail MACN is the Assistant Professor in Nursing at the University of Canberra. Her research interests include age and ageing and she has extensive experience in palliative care, combining her knowledge in research and practice in clinical roles.
I was given the chance to speak with Kasia and other ACN nurse leaders on their views and experiences for National Palliative Care Week 2018 – two of whom were working in the field currently and another who had spent a substantial amount of their career in palliative care.
One of the themes that came from each of my chats with the nurse leaders was that even if nursing was their vocation, it appears palliative care chose them, rather than each going out looking for a specialty. In the case of Julianne Brisbane MACN – currently Palliative Care Nurse Practitioner and Practice Lead Uniting NSW/ACT – she recounts that if someone had told her six months earlier that she would be working in palliative care, she would have laughed at them: “I’m a fairly emotional person and I find it easy to cry so it’s not where I thought I would be working, but once I landed here I just found that I blossomed, so it sort of picked me rather than I picked it.”
Kasia’s first day as a nursing student in hospital included the final wash of a patient who had died during the night. “It could have been confronting, except that the nurses kept speaking to the patient as if she was alive, and treating her body with such love and dignity while explaining to me what they were doing and why, and I realised then death and dying are such an essential, and potentially beautiful, part of nursing.” She then spent six months in the cancer and palliative care ward for her placement during her undergraduate studies and took that learning with her in all the other wards she worked on and students she eventually taught.
Registered Nurse at Agency Metropolitan Kristine Kealy MACN, had applied for a position to get past her initial fear – “fear of how to react to patients, what to say, what to do” – fears that are common in human nature on the topic of death and dying. Once she settled in the position, Kristine describes that she loved it straightaway, the fear went away very quickly and found it was one of the most honest and rewarding positions to work in.
On the theme for this year’s National Palliative Care Week – “What matters most?” – Australians are being encouraged to discuss their end of life choices with their loved ones and health professionals. The main thing that was reiterated between each of the interviewees was the importance of making sure that once those end of life wishes are made, it is important that they are respected.
Kristine explained that it’s discussing what matters to the patient and knowing their expectations. She said that nurses are best suited in these discussions by “actually sitting with a patient as they get admitted to respite and palliative care wards just to ask them what they want – what you can do for them not what you want to do for them, [because] it’s what they’re asking of you.”
Julianne expressed similar thoughts by approaching it from two sides: from an advanced care planning perspective – what matters most to you as you approach the end of your life; and from a health professional perspective to consider the person living with the illness and their treatment – what do they want?
Looking into the future of palliative care, Kasia noted that it is pleasing to see that things are changing in how palliative care is delivered but feels there is still more that can be done – “I think we’ll find that palliative care will become more consumer-led as people are living longer and the patients themselves can talk about what they want and need. We can already see a shift in how we talk about it and that it is being increasingly aligned with active and healthy ageing agendas.”
Julianne said that the role of nurse practitioners will be increased in palliative care to enhance public access, there will be more focus on advanced care planning and that there should be earlier involvement with palliative care teams.
When asked about their biggest career achievements in palliative care, the answer was unanimous about the number of connections that occurred between themselves and the patient in their final moments. This can be most aptly shared with words from Kristine: “You knew that they wanted you there and that they trusted you and wanted you there for the end. It was rewarding and to give them what they want in their final moments is a gift.”
We can be encouraged by the nurse leaders who are actively engaged about palliative care in order to provide better health care for Australians now and going forward.