Since palliative care is not included in the curriculum of undergraduate nursing education in Bangladesh, there is an urgent need to develop programmes to train practicing nurses in palliative care. Additionally, there are very few nurses in Bangladesh who have appropriate knowledge and skills to be able to deliver training on palliative care.
The Palliative Care Nurse Leadership Program aims to develop a palliative care training course which will provide practicing nurses with the knowledge and skills of the practices and principles of palliative care and to establish a core group of palliative care nurse educators who will become experts in nursing education and can provide palliative care education
The course was developed after a review of existing training programmes and the relevant literature on palliative care training. An expert working group was formed to provide further input into to the course content, based on their experience teaching and providing palliative care in Bangladesh. The following topics are covered in the training course. Each topic is a standalone module which can be delivered individually or as part of a larger workshop.
- Palliative Care: Definitions and Core Concepts
- Pain Assessment and Treatment
- Non-pharmacological Pain Management
- Gastrointestinal Symptoms
- Respiratory Symptoms
- Skin Care and Pressure Ulcers
- Specialized Nursing Skills in Palliative Care (Colostomy care, Lymphedema)
Pilot testing and refinement of the course curriculum has been performed and the course is now in the final phase of production and will be published soon.
Palliative care nurse educators training
We identified local nurses who showed a strong interest in palliative care and showed leadership potential in nursing education. The expert working group developed of a series of training modules which would equip nurse educators to provide adult professional education and training. Topics covered by this course include:
- Role of nurses as teachers and leaders
- Effective presentation skills
- Interactive lecturing and teaching techniques
- Role playing
- Small group learning
Nurse educators are also assigned a faculty mentor with experience in palliative care education who provides one-on-one coaching and support. The nurse educators are able to practice their teaching skills by participating in the Palliative Care Education Courses as trainers, paired with their mentor. The mentors reviewed the topic with their mentee and provided opportunities for them to practice their teaching before the workshop.
Nurse educators also participated in the development of the Palliative Care Training Course modules, to increase their skills in developing evidence-based curriculum and to ensure they had a strong theoretical background in core palliative care topics.
Outcomes of the programme
A palliative care education course for nurses has been developed which is suitable for training nurses in Bangladesh. The curriculum is adapted to the local situation, and provides practical nursing training which is appropriate for Bangladesh. To increase the effectiveness of education sessions, the curriculum incorporates the principles of adult learning, and uses problem-centered learning which provides opportunities for learners to apply the knowledge and skills through clinical cases, role playing and small group sessions.
A second outcome is that a dedicated and enthusiastic group of nurse educators has been trained. These nurse educators will become the first group of expert palliative care nurses in Bangladesh.
The Expert Working Group who developed and implemented this program was led by Dr. Megan Doherty from the Children’s Palliative Care Initiative in Bangladesh and included Ms Erin Das, Palliative Care Nurse Lead Content Developer; Dr. Shahinur Kabir, Hospice Bangladesh,Dr. Farzana Khan, Fasiuddin Khan Research Foundation
Additional feedback about the palliative care educational needs of nurses was provided by: Prof. Nezamuddin Ahmad, Dr. Rumana Dowla, Dr. Zohara Jameela Khan, Dr. Momena Begum, and Ms. Salma Chowdhury.
Organisations who have participated in pilot testing of the Palliative Care Training Course include ASHIC Palliative Care Unit, Dhaka Medical College and Hospital, Hospice Bangladesh, Shanti Oncology and Palliative Care Unit, National Institute of Cancer Research and Hospital, and the Centre for Palliative Care (CPC) at BSMMU.