In the month of August and September 2016, an “Introduction to Paediatric Palliative Care” training was given to Vietnamese local staff working in an orphanage, in Ho Chi Minh City, Vietnam. 50 local staff attended the training in total, including nannies, nurses, a physiotherapist, and the director of the orphanage.
The training material was based on the International Children’s Palliative Care Network’s (ICPCN’s) resources, and covered an introduction to children’s palliative care, holistic care, symptom and pain management and end of life care.
In the first session “Introduction to Children’s Palliative Care”, a basic introduction was given that explained, what palliative care is, who it is for and what is the need.
Holistic care
Holistic care was covered in the next section, which involved how to care for all aspects of a child, and practical ways to care for the child’s physical, emotional, social and spiritual needs. The staff participated and enjoyed various activities, including a sensory activity where staff were deprived of one of their senses (eyes were blindfolded so they could not see) which allowed them to get a glimpse of what it might feel like to have an illness, disability or life limiting condition. This activity highlighted the importance of empathy in care and respecting the child by speaking to them and involving them as much as possible in all aspects of their care.
Other important aspects of Palliative care were covered including symptom and pain management. Examples were given of many symptoms that children living with a life-limiting illness commonly experience, and how best to treat these symptoms, including basic pharmacological methods and some non-pharmacological methods. Symptoms included chronic headaches and increased cranial pressure in hydrocephalus, nausea and vomiting, constipation, seizures, malnutrition and pain. Case studies were given, and staff were given opportunities to discuss treatment plans for these cases.
Caring for a child at the end of life was the last topic that was discussed. Here we spoke of how best to provide quality end of life care, and the importance of this sacred time. Tied in with end-of-life care we also discussed the grief that often is associated with working in palliative care. We gave the staff opportunities to share their personal experiences around what was important to them in end-of-life care, the grief that they have experienced, and what helped them cope with their grief.
Receptive
The staff were very receptive to the training given. The head carer stated that the training was “very helpful, necessary and relevant”. Many of the staff wrote notes and enjoyed participating in practical activities, case studies and reflective exercises. Although the orphanage already provided some aspects of palliative care to the children at the center, there are many aspects of care that needed improvement. The importance of a collaborative, multidisciplinary approach was highlighted, and the nannies were encouraged to advocate and speak up for the children who have no voice of their own. This was the first training that they had received specific to paediatric palliative care.
The training was written by Kate Loring, Ella James, and Jacqueline Riddell, three professionals who have backgrounds in health, child care, child welfare, and all whom have completed palliative care training themselves. They are founders/ members of Little Feather Foundation who funded and organized the training. The training was presented in English and Vietnamese, all staff were given printed handouts of the material and presented with an ICPCN certificate from the facilitator, Jacqueline Riddell, Registered Nurse.
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