Partnerships in Care
Partnerships in Palliative Care Training
Effective training is the foundation of any palliative care program. Continuing education can increase knowledge, confidence, and competence, thereby improving the effectiveness of the care delivered to patients and their families. This is true for the community caregiver, professional nurse, social worker, and doctor.
It is imperative that training provides the knowledge and skills that can improve competence and confidence; for with confidence comes the affirmation of knowing that we are making a difference to our patients and families.
Palliative Care Training Programs Developed by the Patient Care and Education Committee of Hospice Association of South Africa
- Hospice orientation program
- Volunteer training: caregiver training and bereavement counseling
- Community caregiver training
- Certificate in palliative nursing
- Palliative medicine degrees.
Palliative Care Training
The Hospice Palliative Care Association of South Africa believes that palliative care should be an integral part of every health professional’s training. The reality is that in South Africa, palliative care training occurs in hospices. Hospice personnel who are fully committed to care programs must also be involved in training. This means that professionals run the risk of developing burnout. It is important that palliative care training be recognized is an occupation in itself and not be tacked onto the care program as an afterthought.
The resources required for providing effective training include funding, personnel, training venues, educational aids, and educational materials. Although we have been providing palliative care education for 20 years, further development of training skills would enhance current training programs.
Community Caregiver Training
In 1997, the Hospice Association of South Africa (HASA) was awarded three contracts by the South African Department of Health to accomplish the following projects:
- Develop a community caregiver training program and an auditing tool for evaluating the program
- Establish HASA Integrated Community-Based Home Care programs at seven different hospice sites and adapt the program to the needs of the communities
- Develop cost estimates for providing palliative care through a home-based care program.
Sources of material included the HASA volunteer training course as well as the Red Cross training course and St. John’s training course. Expertise was provided by hospice personnel. Infrastructure came from hospices, the Department of Health, community resources, and home-based care organizations. Recruitment of candidates for training was from individuals already providing informal care in the community. The training program was accredited by the South African Qualifications Authority. Applications for training were received via community health centers and community health forums.
The content of the training program includes basic health care (anatomy and physiology), AIDS awareness, basic nursing techniques and palliative care principles. The program lasts 3 months, as opposed to the original Department of Health suggestion of 9 days (3 days basic nursing, 3 days HIV awareness, and 3 days counseling). The Hospice Association insists that the community caregivers be provided with supervision and support from a professional nurse and social worker.
Integrated care is ensured by the involvement of the local clinic, community hospital, hospice, churches and community structures. Employment of community caregivers is provided by the hospice community-based home care program and the hospice in-patient palliative care unit. The Integrated Community-Based Home Care program is a model of partnerships in care.
Palliative Nursing Training
Palliative nursing training has been established within hospices for 10 years, and the HASA certificate course in palliative nursing is accredited by the South African Nursing Council. The duration of the course is 6 months. It is a requirement for nursing staff in hospices and is also offered to professional nurses from other types of care settings. Currently, 10 hospices in South Africa are recognized as training campuses by the South African Nursing Council.
Tech Palliative Nursing Training
A new development on the palliative care training horizon in South Africa is the degree program in palliative nursing to be offered in partnership with the Cape Technikon, a technical college. If the course is successful, it will be offered in other South Africa Technikons in the future. Expertise will be provided by hospice personnel who have developed the course content. Cape Technikon will provide the venue and infrastructure. The format of the course consists of four, 1-week residential modules complemented by a self-study program. All must be completed within 1 year’s time.
Programs in Palliative Medicine
With support and assistance from the University of Wales College of Medicine, the University of Cape Town offers two postgraduate programs in palliative medicine. The diploma in palliative medicine is an 18-month course. The masters in philosophy in palliative medicine is a 2-year course. Both are offered as distance-learning programs, with two 3-day residential workshops each year. Funding for the establishment of these programs was provided by the Diana, Princess of Wales, Memorial Fund. Expertise is provided by HASA, and the University of Wales College of Medicine. The University of Cape Town provides the venue for the program.
Palliative Nursing Training Content
- Development of palliative care
— Role of the palliative care nurse
— Legal and ethical issues - Psychosocial palliative care
— Effective communication
— Grief, loss, and bereavement
— Care of the carers - Clinical palliative care
— Disease process: oncology, HIV/AIDS, and chronic illness
The first group of candidates for the postgraduate program in palliative medicine consisted of hospice physicians. Applications have also been received from general practitioners, oncologists, and pediatricians. As a distance-learning program, this training can be offered to doctors from all regions of South Africa as well as those from neighboring countries. Study grants have been offered to physicians by Medical Education for South African Blacks.
Conclusion
The objectives for palliative care training in South Africa are that all health care professionals be trained in palliative care. The human resources to provide that training exist within hospices. Our vision is the development of hospice centers for palliative learning in the major hospices in South Africa in order to facilitate this increase in palliative care training.
Future courses planned by the education committee of the Hospice Palliative Care Association of South Africa include palliative care for social workers and pastoral workers. The association is working to continue international partnerships such as those with the University of Wales College of Medicine and the University of Cape Town.
There is a commitment to palliative care training in South Africa. By increasing the number of palliative care educators, we will increase the awareness and understanding of the discipline and training will become more accessible to all health care workers. This will result in a benefit to patients, families, and caregivers.
