I have been fortunate enough to work with Karuna Hospice Service in Brisbane for nine years, and was recently equally privileged to travel to Khon Kaen in North Eastern Thailand for three months to work with Karunruk Palliative Care Service.
I have had a long love affair with Thailand, having visited many times over the last fifteen years, and always dreamed of working there in hospice care. The experience exceeded my expectations in every way. Although care of the dying has been anecdotally practised long term in Thailand, the notion of specialised ‘palliative care’ is relatively new. Thanks to a core group of champions, particularly my boss, the extraordinary and unstoppable Doctor Srivieng Pairojkul, and her incredible nurses, palliative care is now a growing phenomenon in beautiful Thailand.
Integrating spirituality and person centred care
Coming from Karuna, an organisation which values and promotes spiritual and ‘person centred care’ as integral components of health and palliative care, I was especially interested and amazed to observe the ease with which this is delivered in a Thai context.
Unintentionally and without deliberation, the Karunruk nurses’ practice is underpinned by a strong spiritual foundation, reflected in every aspect of their care, teamwork, and communication with patients.
As palliative care itself seemingly becomes increasingly medicalised and focused on ‘symptomatology’, it was humbling and inspiring to witness the integration of strong spiritual care and ‘just being’ principles into day-to-day nursing and medical practice in this part of the world.
This region of Thailand is predominantly Buddhist, so there were always monks on hand to pray with patients and their families within the hospital, and also in the community. It was wonderful to witness – on several occasions – whole wards stopping their day-to-day work, including other patients, visitors, staff (from senior specialists to cleaners), to pray with patients who were entering the final phase of their journeys. It was also incredible to see a whole ear, nose and throat (ENT) ward (patients, nurses, doctors and visitors) stop at the same time every week for song, dance and dress ups!
Put it in your rucksack for safekeeping
I intended during my time in Thailand to provide education to the Karunruk nurses, but unquestionably I learnt so much more from them that I could ever hope to have offered in exchange. It was an honour to meet so many beautiful patients and family members, and to witness the wonderful care the Karunruk team provided.
A colleague of mine recently referred to integrating those special and unforgettable experiences that those of us lucky enough to work in hospice or palliative care witness, as akin to ‘putting them in her rucksack for safe keeping’. Definitely many of our mob carry such moments with us as we journey through our professional and personal lives, and ultimately towards our own deaths.
The time I spent with Karunruk will be with me for the rest of my days in my ‘rucksack’, and every now and then I will take some time to stop and unpack it, before travelling on. Karunruk Palliative Care Service is trail blazing in Thailand now, and I believe that in the future the service will become an international benchmark of exquisite, holistic palliative care.
Camille Doyle is a palliative care nurse with the not for profit Karuna Hospice Service in the Queensland capital Brisbane. She holds a Graduate Certificate in Palliative Care through Flinders University and a Graduate Certificate in Health Promoting Palliative Care from Latrobe. Currently on sabbatical from a Masters in Spiritual Care at Latrobe, she is completing a Masters in Nurse Practitioner studies through the Queensland University of Technology.
Karuna, established nearly a quarter of a century ago, was the vision of Venerable Pende Hawter, a Buddhist monk, who identified the opportunity to provide comfort and support for the dying in Brisbane’s North. A small team of heath care professionals who believed in Ven Pende’s vision helped him set up a home hospice service which continues today from its base in suburban Windsor.
Each year, Karuna assists over 500 families affected by a life threatening illness, grief and loss.