#PallANZ tweet chat

PallANZ 201511

And we’re back for another round!

Following on from the highly successful inaugural #PallANZ tweet chat last month, we are delighted to announce that we will be hosting another tweet chat in November! Join team Palliverse (@Palliverse) and Liz Callaghan, CEO of Palliative Care Australia (@PCACEO), and “Let’s talk about death, baby!” Share your stories and reflections on having THE conversation with your family, friends, patient, doctor, nurse, spiritual counsellor…

Date: November 5th 2015

  • 7pm AEDT (Canberra, Sydney, Melbourne, Hobart)
  • 6:30pm ACDT (Adelaide)
  • 6pm AEST (Brisbane)
  • 5:30pm ACST (Darwin)
  • 4pm AWST (Perth)
  • 9pm NZDT (Wellington, Auckland, Christchurch)
  • Other time zones 8am GMT, Hong Kong/Singapore 4pm

Hope to see you all there!

beautiful essay on a doctor’s perspective on end of life care

This really resonated with me… well worth a read.

A young doctor describing her developing perspective on a “good death”; on dying and end of life care in our healthcare system.

http://www.vox.com/2015/10/19/9554583/doctor-good-death

Sonia

World Hospice and Palliative Care Day 2015

WHPCD15

World Hospice and Palliative Care Day is a global day of action organised by the Worldwide Hospice Palliative Care Alliance and held on the second Saturday of October every year. It aims to:

  • Raise awareness of the needs of people and families living with a life-limiting illness
  • Create opportunities to talk about the issues around improving access to hospice and palliative care around the world
  • Raise funds to develop and support hospice and palliative care services around the world

The theme this year is “Hidden Lives, Hidden Patients” – focusing on people whose palliative care needs are often not recognised, such as children, indigenous people, those living in rural settings, prisoners, soldiers, and lesbian, gay, bisexual, transgender and intersex individuals.

To help to raise awareness about “Hidden Lives, Hidden Patients”, Palliverse and Palliative Care Australia invite everyone to join us for a tweet chat on Thursday, October 8th using the hashtag #PallANZ  Continue reading

Palace of Care – My kingdom for a horse…

Stig Nygaard Pårup  Christmas 2010

Stig Nygaard
Pårup
Christmas 2010

A few years ago I had formulated a plan to reunite a patient, who had been in inpatient care for a number of months, with his horse who I had been informed, he missed dearly. Something had been lost during the clinical handover – the patient had actually sold his horse some months prior. Instead I arranged for him to receive the Trackside horse-racing channel, and assured him that he could do phone-betting. I filed the plan away in the recesses of my brain, and looked forward to bringing it out again if the opportunity ever arose again to make use of it.

Continue reading

Renal supportive care weekend

St George model

[Prof Mark Brown discussing the renal supportive care model at St George Hospital]

21-23rd August, 2015 | St George Hospital, Sydney

It was the fifth annual symposium but the first master class. A truly multi-disciplinary audience comprising nephrology, palliative care, geriatrics, trainees, specialists, nurses, social workers, dieticians, et al met on a warm and wet weekend at the St George Hospital in Sydney. All shared a commitment to making life better for individuals with advanced kidney disease. Continue reading

Palliative medicine training in Australia

books-552607_1280

Following up from Michael’s post a few days ago about palliative medicine training jobs, here are a few more useful links for Palliverse readers thinking about enhancing their medical careers through further training in palliative medicine:

  • An overview of advanced training (three years), which is required to become a palliative medicine specialist in Australia and New Zealand
  • Information about the clinical diploma (six months), which offers all medical practitioners an immersive experience in palliative medicine
  • List of accredited palliative medicine training sites in Australia and New Zealand
  • Registrar and clinical research fellow positions in Sydney (applications close August 13th)
  • Registrar positions in Canberra (applications close July 31st)
  • Registrar and fellow positions in Victoria (applications close August 10th)
  • Information about palliative medicine training in Queensland
  • Apply for palliative medicine training in South Australia (applications close July 31st)

I couldn’t find much stuff online about palliative medicine training in New Zealand, Western Australia or Tasmania. If you know of any good resources on these topics, please share them with the rest of the Palliverse community! Thanks in advance 🙂

Shifting the focus of care from disease to people – heartfelt article about dying in acute hospitals

This article is going a bit viral on social media. Does it mirror your experiences? It certain does mine, having worked for a long time in consultation services in acute hospitals. There have been a number of comments and letters to the Age supporting the message of the article, written by a senior doctor about the death of his father. http://www.theage.com.au/comment/hospitals-must-shift-focus-of-endoflife-care-from-disease-to-people-20150707-gi6joz

I think therefore I am? – Alcohol hand-rub and the clinical application of Mindfulness

Mindfulness in recent years has become increasingly fashionable throughout the world and is popping up as part of treatments in Psychiatry, as part of the rehabilitation of prisoners, and even in the Palliative Care world. Is it really all that new or is it the repackaging and re-marketing of what Buddhists have been doing for thousands of years? What follows is my own personal experience of Mindfulness and how I apply it to my practice of Palliative Care.

I had been interested in meditation since the late 1980’s when I read in a Batman comic that when he was completely exhausted, instead of sleeping, Batman would meditate briefly. This would leave him refreshed and able to go out and fight the bad guys again in a few hours’ time. Having never been a fan of sleep in general, the idea of a sleep substitute really appealed to my younger self. Throughout the 1990’s I explored various types of meditation practice, but had largely given up by the 2000’s.

In September 2013 I had signed up, in my usual last-minute fashion, to a pre-conference workshop at the APHC 2013 conference held in Bangkok, Thailand. Having registered for the workshop very late I was left with only one option. The workshop entitled, “Mindfulness in Clinical Practice,” turned out to be the highlight of a very enjoyable conference.

Less than a week later I was in Montreal, Canada for the 1st Whole Person Care Congress in which a number of the sessions and workshops were devoted to Mindfulness. It really had become the flavour of the month on a global scale, but did it spur me into a programme of regular Mindfulness practice? Heck, no!

It wasn’t until October of last year that I decided to give Mindfulness meditation a proper go, via the Headspace app. This easy to use program of guided meditations has led to me doing 236 sessions and has had various benefits. A greater sense of calm, better observation skills, greater ease at falling asleep, and even benefits for my patients.

What is the connection to alcohol hand rub?

As a Medical Registrar the importance of clean hands was drilled into me by an Obsessive/Compulsive trait possessing Physician who went through 500ml of Alcohol hand rub per day in his quest to limit the spread of hand-borne contagion. Apologies for the next sentence…some of it rubbed off on me. As part of my own personal ritual, prior to knocking on the door of patients, I will douse my hands with a good squirt of the alcoholic jello-shot. While I am rubbing my hands together I take a deep breath in, and slowly release it. This brief amount of time allows me to centre myself so that I can be truly present in the clinical moment that follows.

Being in the moment with the patient allows me to “tune in” to what they are going through, and to gift them my full attention. I’m not thinking about what is for dinner, what my plans for the weekend are, what an interesting shadow is being cast on the wall, but instead I am able to focus on what they are saying, verbally and non-verbally. Of course this doesn’t happen with every single patient encounter that I have, but when I am “in the zone,” the patient’s situation becomes much clearer to me. I end up with a much better idea of what they want and need. This fleeting moment full of human mind connection still surprises me at times. It feels like it is a little piece of magic, something to be approached with wonder.

The patients seem to enjoy it too.

At the end of the visit I say my goodbyes and reverse the entry ritual. Another squelch of disinfecting viscous chemical is applied to my hands, another deep breath is taken and released. The ward round continues.

Continue reading

free smartphone app for GPs providing palliative care

There’s an app for that! ABC news writes that a new smartphone app can help guide GPs in management of patients approaching the end of life.

It’s free from iTunes and provided to you by the lovely chaps at Flinders University in SA.

We would love to hear from GPs or trainees  – what do you think?

Sonia

ASCO 15 – Early palliative care in an inpatient oncology setting improved outcomes and satisfaction

Sadly, I am not actually AT ASCO, the annual meeting of the American Society for Clinical Oncology which is taking place in Chicago this year.

However thanks to the modern day marvels of social media I was able to watch this lecture  by Dr Riedel and a team at Duke University Medical Centre.

Dr Riedel introduced  a model where palliative physicians ( “palliatricians”. What do you think? I love a neologism, myself….) co-rounded with the oncologists in the inpatient oncology unit.

Statistically significant reductions in length of stay (LOS), 7 and 30 day readmissions, and ICU admissions were demonstrated. Nurse and doctor satisfaction was increased. Nurses felt the quality of care was improved.

All the medical oncologists surveyed felt that the palliatricians added to the care of the patient and that they learned some stuff about symptom management. I know I learn heaps when I round with medical oncologists! Communication and collaboration was improved.

It was a shame they didn’t look at patient satisfaction, but hopefully that might happen in future.

Seen anything interesting coming out of ASCO this year?

Sonia