My unexpected foray into palliative care

My unexpected foray into palliative care

– Ms Surabhi Mondal, New Delhi

I walked into palliative care in a totally unexpected way. I did not have much idea about palliative care until I was posted into the palliative care unit. I am now confident to share that each of my experiences while working in a palliative care unit has completely changed my view about palliative care.

One of the most important changes was the change in my mindset towards ‘Death’. I knew that ‘Death’ brings along with it sadness, and that it is inevitable. However I now realise that while we cannot take away the sadness it brings along with it, we, the nurses, and the other members of the palliative care team can definitely ensure that we provide a dignified death to our patients by providing simple measures of comfort and also offer support as needed to the patient and their caregivers.  

Of the several incidents that positively changed my perceptions about palliative care, I wish to share here two incidents that moved me a lot.

Ms Manisha (name changed), was a 43 year old patient with Ca Gall Bladder, who got admitted to our palliative care unit last year due to severe pain. Despite receiving many treatments, she was never relieved of her pain. While talking to her, we learnt that she had lost her husband a year before, and that both her children were unemployed. It was quite evident that there was a financial crisis in the family due to this situation. We immediately realised that her emotional turmoil was probably the reason why she was never truly relieved of her pain. Though not easy, yet, with support from our social workers and other members of the team, we helped Ms Manisha’s daughter who had completed her graduation, get a job. When Ms Manisha’s daughter began earning and contributing towards the family’s financial needs, we could see Ms Manisha slowly relaxing and feeling satisfied. Her pain was now controlled. A few months later, Ms Manisha expired with peace and dignity. Post Ms Manisha’s death, her daughter visited us. We realised that all our hard work had paid off when we saw Ms Manisha’s daughter so positive and convinced that her mother had indeed had a dignified death!

The next incident was from during my time while I was posted in the Wound and Stoma clinic. One day, as we were wrapping up for the day and beginning to close the clinic, a young boy came running towards the clinic and requested us to help with the dressing of his mother’s wound. Though we were about to leave, we decided to care for the young boy’s mother, Ms Mala (name changed) as she was crying in pain. We took our 51 year old Ms Mala inside the room to dress her wounds. The moment we removed the cloth over Ms Mala’s breast wound, we saw innumerable magots all over her wound. We immediately began cleaning her wound and removing the maggots. As we were doing this, Ms Mala began to feel relieved and she stopped crying. Within a couple of days of periodic wound management and dressing sessions, Ms Mala was magot free. After a few days, Ms Mala and her son rushed to the OPD just as they came in on the first day we met them. Our first reaction was that of worry and concern as we didn’t know what had happened. They shared that they only wanted to thank us for helping Ms Mala smile again and be pain free, and that they were in a rush to catch their train to return to their home in Vihar. It was at that moment, we realized that our small effort, which we do on a routine basis without even truly understanding the magnitude of it, had such a positive and powerful impact on Ms Mala and her son, that their eyes were filled with tears when they thanked us and said goodbye to us.

Both these incidents completely changed my perspective towards the importance and impact of good quality palliative care on the well-being of both our patients and their caregivers. I pursued a few training programs in palliative care nursing to empower myself with this much needed knowledge and skill set. I now realise that palliative care is one of the areas which is of utmost importance and which provides comfort and dignity to our patients and their caregivers.

I am proud to share that from having very limited knowledge about palliative care, I now enjoy my journey in palliative care, which I don’t wish for to end. For those colleagues who haven’t yet walked the path of palliative care, I urge you to join me so that we can provide holistic and improved care for our suffering patients and their distressed caregivers.