Student placement in Student placement in Palliative CarePalliative Care

Presented byPresented byJahnvi SinghJahnvi Singh

44thth Year Social Work Student Year Social Work StudentThe University of SydneyThe University of Sydney

Braeside HospitalBraeside Hospital

Study in ContextStudy in Context

The challenges and anxieties students face in a placement in PCThe challenges and anxieties students face in a placement in PC

Anxiety is built around:Anxiety is built around:communication, coping with physical suffering, type of death and communication, coping with physical suffering, type of death and personal experience around death and dying. (Parker, 2005; personal experience around death and dying. (Parker, 2005; McDonald, 2007).McDonald, 2007).

Good learning practice should change the learner in some wayGood learning practice should change the learner in some way

The World Health Organisation defines PC as: The World Health Organisation defines PC as: An approach that improves the quality of life of patients and their An approach that improves the quality of life of patients and their families facing the problem associated with life threatening illness, families facing the problem associated with life threatening illness, through the prevention and relief of suffering by means of early through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.other problems, physical, psychosocial and spiritual.

Case StudyCase StudyMary was a 51year old patient admitted to the palliative care ward at Mary was a 51year old patient admitted to the palliative care ward at Braeside Hospital in 2011 diagnosed with Sigmoid Cancer. She was Braeside Hospital in 2011 diagnosed with Sigmoid Cancer. She was an Australian citizen of Argentinean decent and a single mother of an Australian citizen of Argentinean decent and a single mother of two children Jane 22 and Ben 18. Her daughter had suffered a two children Jane 22 and Ben 18. Her daughter had suffered a stroke at the age of 18 and though she regained physical mobility stroke at the age of 18 and though she regained physical mobility was left mentally impaired needing full time care. Mary’s sister Maria was left mentally impaired needing full time care. Mary’s sister Maria came to Australia on a bridging visa to look after the children but the came to Australia on a bridging visa to look after the children but the bridging visa didn’t enable her to work or be eligible for social bridging visa didn’t enable her to work or be eligible for social supports. The family experienced severe financial and emotional supports. The family experienced severe financial and emotional stresses. Mary’s ex husband didn’t provide the children with support stresses. Mary’s ex husband didn’t provide the children with support – financial or emotional. Mary’s son found it very difficult to see his – financial or emotional. Mary’s son found it very difficult to see his mother at the hospital and would see her when she returned home mother at the hospital and would see her when she returned home for overnight visits when possible. for overnight visits when possible.

How could I (as a student) positively impact Mary and her family? How could I (as a student) positively impact Mary and her family?

Practice Learning in Practice Learning in End-of-Life CareEnd-of-Life Care

Care through understanding psychosocial Care through understanding psychosocial issues issues

Understanding that anxiety often stems Understanding that anxiety often stems from fear of caring rather than fear of from fear of caring rather than fear of death (Cooper & Barnett, 2005)death (Cooper & Barnett, 2005)

Re-shape attitudes about ‘skills deficit’ Re-shape attitudes about ‘skills deficit’ (McDonald, 2007)(McDonald, 2007)

Practice Learning in Practice Learning in End-of-Life CareEnd-of-Life Care

There is an increasing tendency for people to die at an old age of There is an increasing tendency for people to die at an old age of chronic illness and in a hospital or institution (Gomes and Higgins, chronic illness and in a hospital or institution (Gomes and Higgins, 2008)2008)

Work with communities and carers can often help in easing anxiety:Work with communities and carers can often help in easing anxiety:

builds awareness of how a patient is affected within an ecological builds awareness of how a patient is affected within an ecological model of workmodel of work

Broadens perspective to influence holistic / psychosocial Broadens perspective to influence holistic / psychosocial frameworks of careframeworks of care

Allows for work that delivers immediate results Allows for work that delivers immediate results Community development allows result driven work to be carried out Community development allows result driven work to be carried out

ConclusionConclusion

A successful placement is thus dependent on:A successful placement is thus dependent on:

Supportive clinical environment and team Supportive clinical environment and team The relationship between field supervisor and studentThe relationship between field supervisor and student Supervision structuresSupervision structures Models for placement learningModels for placement learning Broad range of learning opportunitiesBroad range of learning opportunities

(Parker, 2007)(Parker, 2007)

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