Last August, I was very privileged to be given an opportunity to participate in my first palliative care workshop organized by Hospis Malaysia. It was held at Wijaya International Medical Centre and was facilitated by Dr. Susan Marsden, a Palliative Care Specialist from New Zealand and Ms. Liese Groot-Alberts, a professional Grief Therapist also from New Zealand. Participants comprising mainly of doctors and nurses came from various parts of the country.
I was a little anxious when Eleanor, another volunteer who was supposed to attend this workshop with me couldn’t make it. I would be the only volunteer there. Later, I was relieved to meet some familiar faces: Harbans Kaur from Kasih Hospice, Mei Queen from Breast Cancer Women’s Association and all the nurses I knew from Hospis Malaysia.
Understanding Grief and Suffering
This workshop dealt with understanding the process of grief and suffering, the risk factors, managing anticipatory grief, dealing with patients as well as our own response to loss. Grief Therapist Liese shared with us her experience on grief when she lost her 3 year old daughter just 3 days after the arrival of her baby boy. Do friends congratulate and send you condolences at the same time? How does one actually cope with such a complex situation?
“If you want to help people who are grieving, you must first deal with your own grief.”
The morning was spent on understanding the human personality (ourselves). Dr Susan Marsden divides the human personality into 4 quadrants:
Physical – as how we know or interact with the world with our 5 senses.
Emotional – as how we know or interact with the world with the self and how relationships are developed.
Intellectual – as how we know or interact with the world with reason.
Spiritual – as how we know or interact with the world with our intuition and how we know our purpose.
Burn out and Compassion fatigue
Many times, we get too involved or engrossed with patient’s problems that we tend to forget about our own self. Compassion fatigue comes when we became burn out and too tired of being compassionate.
Sometimes, too much pain gets in the way and we can’t stay in the truth anymore.
We can also get burn out by the administration or structure with patients.
We went on to discuss the symptoms of compassion fatigue from the 4 quadrants:
Physical – bodily aches, allergies, migraines, tired, itchy eyes, sleep disturbance, low energy etc.
Emotional – temperamental, angry, aloof, stressed, anxious, frustrated etc.
Spiritual – negative, hopelessness, despair, confused, curious, lack faith, spiritual war, lack inner peace etc.
Intellectual – forgetful, lost focus, lack passion, under perform, procrastination etc.
The caregiver’s journey
More than an hour was spent reflecting on the journey of the caregiver. Doctors and nurses shared their experiences on their journey as care-givers. Their hopes and dreams. Their encounter with their first patient, remembering an important lesson and the impact or difference it made in their career. Later, they were asked to picture that patient writing to them reflecting on the care-giver they have become today.
On the second day of the workshop, we stormed our brains on understanding and exploring suffering. Suffering of families and others. The practical aspects of working with patients and families, and at the same time learning some communication skills.
Towards the end of this session we were required to discuss and ponder over the following questions:
1. What if the suffering is related to treatment decisions?
2. Does treatment increase suffering?
3. Does cure and increased survival reduce suffering?
4. Does over treatment and investigation cause more suffering?
It is absolutely apparent that although many healthcare workers are trying their best to deal with illness, they do not receive sufficient exposure in dealing with the aspect of grief and loss. Like me, I’m sure the rest of the participants have benefited from this module. Personally, I find this workshop extremely enriching and stimulating as it has opened my eyes to see the world at a different perspective. It has also taught me that the heart never lies – I have to learn to listen to my heart more. With this, I hope to be able to serve and help those terminally ill at Hospis in a more professional manner.
“What is as important as knowledge?” asked the mind.
“Caring and seeing with the heart.” answered the soul.