I came to know palliative care in 2017 after studying it as a course unit where I qualified as a general diploma nurse. It did not really seem that serious – at least not until I came to work with Hospice Africa Uganda.
I joined HAU in November 2017 as a locum nurse and, being that I first worked in a curative setting as an enrolled nurse, I used to fear morphine. I thought that it was restricted to ward inpatients and I knew that it was only given to those patients in pain who were going to die.
On my first day at Hospice the first thing that touched me was the Hospice Song! It made me think deeply about what patients go through, especially at end of life. This was new to me and I learnt that even if someone is to die they should receive love, understanding and dignity so that they can die in peace.
Later in June 2018 I was employed as a full time palliative care nurse and I decided to study for a degree in palliative care. However, in April 2019 my contract was terminated due to a financial crisis at the Hospice. However, I came back to volunteer as a nurse at the Hospice for another year up to March 2020 when I was again fully employed as a palliative care nurse.
I had always longed to care for patients who are very sick and I was already attached to palliative care patients but I did not know how and here Hospice showed me the way. Every student should not only learn the theory of palliative care but should have hands experience in order to fully understand and appreciate the palliative care study unit.
I have really experienced a lot as I care for patients but one outstanding occasion was when I went for a home visit. We had gone to review a patient who had cancer of the cervix, HIV and Recto Vaginal Fistula (RVF). This patient was really very sick, wasted and dehydrated and was regularly vomiting. She needed end of life care and morphine had helped to control her pain. Her main carer was her daughter.
When this lady met us, she told us that she was tired of eating dodo, she wanted to eat meat. She said, with a winning smile on her face, that “even if you just put for me a bone in water and make soup, I will be happy.” I really felt pain deep in my heart because according to the family assessment it was a very poor family. So we called the daughter and we took her to the nearby trading center and we bought her meat using comfort fund money. We took her back home and told the patient that we have bought for her meat and we then returned to Hospice
After 2 days the daughter called and told us that her mother had died but she also told us that at least she ate the meat and was very appreciative.
As for me I really felt that this patient died in peace because we addressed her need – and in the time she wanted it. The comfort fund really helped in this situation and this took me back to the Hospice song:
When my life is finally measured in months, weeks, days, and hours
I want to live free of pain free of indignity, free of loneliness
Give me your hand
Give me your understanding
Give me your love
And let me go peacefully and help my family to understand.
Thank you, Dr Anne for putting a smile on patient’s faces and their carers. They are really appreciating Hospice.
The lead photograph is of PC Nurse clinician and morphine prescriber, Harriet, taking the history from a new patient in the Covid era.
Hospice Africa global website home page: https://www.hospice-africa.org/