By Nurse Clinician Chuah Pei Fen
Ward 48 – Medical Oncology
Singapore General Hospital

Dealing with the knowledge of impending death can be agonising for not only the patients facing terminal illnesses, but their loved ones as well.

Palliative care aims to relieve this suffering through managing unpleasant physical symptoms and providing psychological support to patients and their families. It involves a multidisciplinary team of clinicians who are focused on improving their quality of life.

With a renewed emphasis on palliative care in Singapore, I hope to prepare and empower our nurses with the knowledge, skills and attitude to provide quality palliative care.

My team and I conducted a study to explore inpatient Oncology nurses’ experiences and perceptions of palliative care.

Palliative care nurses play the role of the educator and resource person who provides essential information to patients and family members. They deliver end-of-life care by alleviating physical suffering and providing emotional and spiritual support.

This can be challenging, especially with limited public awareness and understanding of palliative care in our country.

For instance, the participants in our study mentioned the difficulties of dealing with family members who have an ingrained negative perception of pain relieving medications.

Another challenging aspect was discussing hospice options with the patients' families. Many of them perceive hospices as a place to die or a nursing home without much medical and nursing care. Some even view hospice referrals as an abandonment of their loved ones.

The nurses also found themselves in a dilemma when the patients do not want their families to know about their condition, or vice versa.

In view of this, the nurses have recommended the importance of introducing palliative care as a core module in their academic training. We also found that an immersion or attachment programme with palliative care experts will be more effective then classroom teaching in preparing our nurses for the role.

Our research has not only allowed us to identify the barriers in palliative care nursing, but also to address the educational and training needs.

 It is our hope that this will encourage and empower acute care nurses to take on the palliative care nursing role. As clinicians, it is our duty to provide care and support for our patients – and especially in times when it is most needed.

The team who conducted this study on Palliative Care Training consists of NC Chuah Pei Fen, Choo Seow Ling, Lau Keat Yeng, To Hiu Kwan, Woo Guan Yi, Chen Juan and DDN Lian Siew Bee.