The Satisfaction—and Joys—of Providing Palliative Care

By IAHPC Lifetime Member John Haberecht, RN

Like many of the things that happen in life, including becoming a nurse, I fell into palliative care by accident—or perhaps it found me.

John Haberecht. Used with permission.

I thought I wanted to work in oncology: when Margie, the charge nurse of the oncology ward at the Prince Charles Hospital in Brisbane, came and spoke to the RNs where I was working, to talk about how she had introduced a palliative care philosophy into her oncology ward. At that moment, I knew I wanted to work there.

The ward was an inspirational place to work for many reasons.

A welcoming environment

Margie had converted a two-bed room into a family room with a night bed and relaxing furnishings. Family members could stay there anytime, day or night, if they wished. We had a small group of dedicated volunteers, who might sit with and read to a patient, take them to the canteen for a walk and snack, or help staff by keeping the sun room clean and tidy. The staff were hugely committed, including even the wardsman, whose antics kept patients, family, and staff doubled up with laughter. He once appeared in a four-bed patient bad holding a garden hose and broom, saying he was there to give a bowel washout! We had a visiting art therapist and staff who helped patients record their life stories: this is not unusual today, but it was revolutionary 35 years ago.

One day Margie invited me to a public meeting to discuss setting up a Buddhist-based hospice home care service in Brisbane. Her friend Pende Hawter, an Australian Tibetan Buddhist monk and physiotherapist, was scheduled to speak. The home care service sounded like a great idea, and I raised my hand to be on the steering committee for what became Karuna Hospice Services, which continues to provide a hugely needed service to this day.

"But, isn't your work depressing?"

A strong memory for me, amongst many, is that when people discovered I worked in palliative care they would comment that it must be so depressing. "On the contrary," I would reply. "It's the most rewarding area of health care I've ever worked in."

When I reflected on why that was, I realized it was because I could see that I was working with teams that made a difference in people's lives. Helping people get home from hospital for their last days, when others told them they were too sick to go home, was an important and meaningful act.

Supporting patients in many ways

As I would tell patients, "At this stage, there's nothing that can be done in hospital for you that can't be done at home," while alerting them to the fact they would need at least two or three able-bodied adults to help provide care.

Part of palliative care was providing information about support services in the community: financial, spiritual, and psychosocial. People would say, "We had no idea all this support was available."

In my community work, I was able to help people stay at home by, for example, contacting their doctor for symptom management consults, giving injections, or changing the medications in a continuous subcutaneous infusion. Again, in the community, after providing care to the patient, I would sit and have a cup of tea with the carer, providing an opportunity for them to talk about their difficulties in caring for their partner/child/parent. Because our tiny service on the Sunshine Coast, north of Brisbane, had no social workers or counsellors at that time, counselling was very much part of our role, as was liaison with the person's GP.

I realize this could be much longer, but it's a brief snapshot of the joys and rewards of working in palliative care, and the autonomy one has as a registered nurse in the community.

John Haberecht is a registered nurse with a 30-plus year background in palliative care. He has been president of both Palliative Care Queensland, the peak body for palliative care in the state, and Palliative Care Nurses Australia. He is currently chair of Australasian Palliative Link International.