A challenge to those who care

BRIDGING THE GAP: The Generalist: Specialist Debate
Experience generally, is gained by practicing specifically but palliative care skills are not developed specifically by general practice. Therefore, education programs in specialised wards, units or centres need to be developed so palliative care workers can gain the experience required to meet client's needs. Although it may be a healthy balance for 'expert' staff to work in a general setting as well as in a palliative care role; dedicated training programs need to be established for the 'novice', where appropriate role models and support can be provided.

STANDARD SETTING: A National goal?
"There must be continuity of palliative/hospice care goals between all agencies involved in palliative care at a local level" (1989 Report on Palliative Care Services in Victoria). Has your health department designated a palliative care officer to liaise with hospitals, palliative care services and community agencies, in order to ensure the co-ordinated development of palliative care in your State?

RESEARCH = Credibility
Although this is the age of "the lived experience" and "contexts of care", in which the art of nursing is almost emphasised, as much as the science; it is also the age of technology. For any new branch of specialisation it is vital that documentation and research keeps abreast of the new field. Therefore we need to rise to the challenge of the computer age, and utilise the potential computers have to aid research in palliative care.

TEACHING MDELS AND METHODS FOR EDUCATON IN PALLIATIVE CARE

1.Acute Hospital Settings

• Appoint a clinical specialist to instruct and supervise pre and post graduate students. .Set up multi-disciplinary seminars and experimental workshops. For example: Different

• Approaches to Pain Control, or The Last 24 hrs of Life and First 24 hrs of Bereavement, involving Chaplains, Pastoral Care workers, Social workers, Doctors & Nurses.

2.Hospice In-Patient Programs

• Develop a preceptor/mentorship program for the orientation and training of each discipline.

• Facilitate experiental workshops and seminars, as above. Role play is a powerful teaching tool, but de-roling is vital. Allow time for open discussion.

3.Palliative Home Care/RDNS Teams

• Instigate inservice education days (off the road) involving team building activities and small group work. For example: philosophy formulation, brainstorming, discussion about difficult ethical/client situations, or communication tensions between General Practitioners, hospitals and health departments.

CONCLUSIONS
To care demands an involved stance. Creditable goals for standards of practice must be established. We need to be prepared to set the example; make opportunities for learning attractive and viable; and ensure that standards are met.