Kenya Hospices and Palliative Care Association (KEHPCA) carried out a Continuous Medical Education (CME) to Mbagathi District Hospital health care givers in palliative care and pain management.
Close to 70 health care providers took part in the training whose aim was to equip the various health professionals with knowledge in palliative care.
Pain management was the core of the training with a bit an introductory session on what palliative care entails.
During the training, it emerged that nurses are still fearful of prescribing morphine despite understanding the level of the patient’s pain level to be severe.
They said their knowledge of morphine being addictive keeps them from prescribing such a drug to alleviate severe pain that their patients may be suffering from.
They cited that this prescription is only entitled to doctors adding that no authority is bestowed upon them to prescribe opioids of this level.
Dr Asaph Kinyanjui, KEHPCA’s Education and Research Officer, said side effect such as contracted pupils, urinary retention and allergic skin irritations are not common among patients in need of palliative care.
Dr Kinyanjui said that research conducted by Joranson et al in 2005 indicated that less than 1% of patients with life limiting illnesses showed signs of addiction to strong opioids with proper administration of these drugs in accordance to the World Health Organization’s pain management ladder.
“Sedation, which is a common side effect, wears off after three days and this should not cause panic among health care providers.” Dr Kinyanjui said.
He added that other side effects such as contracted pupils, urinary retention and allergic skin irritations are not common among patients and urged the health care providers not to fear alleviating pain with correct pain assessment and application of the WHO pain management ladder.
The health care providers said they were interested to begin a palliative care unit within the hospital given the increased demand for the services.
Mrs. Rebecca Koech, the hospital’s nursing officer in charge, said there is good will among most nurses and starting such a unit will allow them to give these services in an enabling environment.
“I have discovered that there are some nurses who have actually trained in palliative care and having such a facility will enable them to put into practice more of their skills.” Koech said.
KEHPCA’s programs officer, Mr. David Musyoki said told the nurses not to wait for the palliative care unit to be established for them to put into practice their skills but embark on giving the essential services even at the bedside.
“Palliative care can be given anywhere as long as you understand the needs of the patient and how to go about them.”He said.
Mbagathi hospital is one of the district hospitals that KEHPCA and the Ministry of Medical Services aim to integrate palliative care services into soon.
Additional 19 health care workers at Githumu District Hospital received a similar training following the growing need for palliative care services.
The hospital director, Samwel Kiburi, said they receive cancer patients at a stage where palliative care is the most appropriate option.
“Old patients are in need of palliative care as well, and since we receive lots of them we have an obligation of starting a unit to attend to their needs at end of life.” Kiburi said.
This aims at increasing access to palliative care services to most Kenyans including the poor who are only able to access health care services at the district level.
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