As we all know the beginning of any new endeavor never has an easy start. One has to struggle and strive hard to achieve any definite goals, and so was our journey, with baby steps we are moving ahead one day at a time to achieve a better tomorrow for our patients who have put their trust in us.
Just to give a brief outline of how we landed in the CTC3 programme and how our minds changed from just being pain specialist to pain and palliative care specialists. Our group comprised of five team members which included three doctors and two nurses: dr Nusrat, dr Arshi,dr Mubasher, Sister Saima, Sister Firdousa and myself. All three of us went for short-term training in pain management at AIIMS New Delhi and Tata Memorial Mumbai. We started our journey individually but little did we know that destiny had already conspired for the three of us to work together. We were approached by dr Sushma Bhatnagar about doing the CTC programme and without thinking twice, we gave our names along with the names of two other staff nurses.
During our training sessions, the elaborate interactions expanded our vision regarding patient was not just about alleviating one symptom but managing patients with a holistic approach. We learned how much communication skills were important in dealing with patients and that knowing their psycho-social and spiritual needs was equally as important as managing their symptoms. We came to know how important it was to have a dignified and peaceful death and what role we can play during the grief and bereavement period. In addition, we learned the art of giving honest opinions and realistic hope. During our field visits, we were able to experience the practical issues that a palliative care team needs to address.
Teamwork is essential to get any work done. As an individual, we can perform but as a team, we can deliver better services. After returning from the training, it was never a cakewalk for us. There were a lot of challenges that we had to face, some of which were:
- Convincing our department head of the need for a pain and palliative care setup
- Conducting an intra and inter-department awareness programme
- Involving the interdisciplinary departments
- Convincing the hospital head and administration of the need for a palliative care setup.
- Procurement of morphine
- As we all are anaesthesiologists, it was difficult to convince our heads of the need for separate OPD days dedicated exclusively to pain and palliation. To add on, there were numerous other problems that we had to face but as a team, we were able to cross every hurdle one by one with a strong belief that one day we will succeed.
As the training programme continued over a period of one year, most of the work was done through the suggestions given by our mentors; Dr Cynthia Goh, Dr Sushma Bhatnagar and Dr Anjum during our mentor visit. With their far-sightedness and elaborate discussions with our institution heads, lot of problems got sorted out.
Despite the COVID-19 pandemic, which resulted in everything coming to a standstill, our spirit to continue our work never ceased. We managed our patients in far-flung areas by getting in touch with the community-based centres working in those areas and continued our palliative services in our respective ICU’S simultaneously. After a gap of two years, we were once again able to restart our work in our own setup despite facing a lot of difficulties for past nine months. But as the saying goes, where there is a will there is always a way. Presently, we are running six days a week OPD with day care services whereas inpatients are managed in their respective wards. Simultaneously, we are training our fellow colleagues and postgraduates as well. All this would never have been possible if the CTC3 Training Programme had not trained us and helped us to set up our pain and palliative care unit in our state. We are highly indebted to our teachers who showed us the path of compassion for delivering our best to our patients. With all the knowledge imparted during CTC3, we learned that half of the care we deliver is medical and the other half is compassion and without compassion, our care is not balanced.
Thanks giving note for our mentor, Dr Cynthia Goh. A great visionary and a great teacher. An inspiration and the epitome of strength. Your selfless dedication and motivated desire to provide compassionate services to humanity. Your belief in us that we could do more and your unstinted support for us will always remain etched on our souls.
Article written by: Dr Nusrat
Edited by: Ms Trudy Giam
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CTC (Cancer Treatment Centre) Programme is a novel initiative to develop capacity to provide palliative care in cancer institutes in India that can be sustained beyond completion of the programme. This programme is a collaboration between the All India Institute of Medical Science (AIIMS) and the Asia Pacific Hospice Palliative Care Network (APHN) and sponsored by the Lien Foundation of Singapore. For more information, please visit https://www.liencollab.org/