Training of ‘Link Nurses’, a programme of the Palliative Care Service at Christian Hospital Chhatarpur, Madhya Pradesh – a model developed by Dr Mhoira Leng and Dr Julia Downing at Makerere University, Kampala, Uganda.
This 150-bed hospital located in Chhatarpur District has provided compassionate care to the people of Chhatarpur and the surrounding villages for more than 80 years. The total population of the district in 2011 census was 17,62,857 with 64.9% literacy. Village folk are socially and economically backward with little knowledge about healthy life styles or access to good quality health care.
Started in 1930 as the Elizabeth Jane Bell Stephenson Memorial Hospital, it presently has 182 staff, of which 74 are nurses, 8 are doctors, and a dentist. It also runs a School of Nursing and a vibrant community health and development project. The palliative care service was started in May 2014, supervised by a trained MSc nurse and run on a daily basis by 2 IAPC trained dedicated nurses with valuable input from the community project manager. Although it is mainly a home-based care service, doctors are available for out-patient and in-patient care. Tutors from the Nursing School assist in practical family training. Large scale awareness programmes are held in village communities, with village leaders and in schools. Some of the initial comments such as, “Please start this service as soon as possible”; “This is the first time we heard about such an opportunity for the terminally ill”; and “If a person has cancer, he will die anyway” have now been dispelled by sharing information and providing subsidized care.
Dr. Ann with CHC Link Nurses 3
Palliative Nurses Ankit & Roop Maya with a Patient
Awareness at Angor High School
MCH Preraks Meeting
Since the in-patients are scattered in different wards, a ‘Link Nurse’ training programme was initiated whereby senior ward nurses had a 3-day training session in palliative care. The model was first piloted at Baptist Christian Hospital, Tezpur, Assam. The aims are:
- To improve palliative care provision within the hospital.
- Improve links between the palliative care staff and the wards.
- Equip nurses with knowledge and skills that can help to provide care to patients admitted on the wards.
- Distribution and use of clinical protocols.
- Use of categorisation system for patients
Level 1 – General needs met by ward nurses
Level 2 – General needs met by link nurses
Levels 3 & 4 – Specialist needs by PC staff
Our hope is that improving accessibility to palliative care in a large hospital through link-nurses will improve care and that knowledge about palliative care will increase in the hospital so that more patients will have access to this service.
~ Dr. Ann Thyle
