Career Guide

Being compassionate is paramount in palliative care

Palliative care is a type of medical care provided to people who are diagnosed with life threatening or life limiting illnesses.

One might think that this is associated with only the elderly, but that is certainly not the case. Quite a number of children are under palliative care as well. These life limiting diseases comprise of mainly cancer and organ failure conditions with kidney and heart failures being the most common ailments.

It is in this field that Emily Yap Lee Peng has chosen to channel her passion.

A true calling

From the age of 17, Yap was firm about building a career in the nursing line. She rejected an offer to further her studies in STPM and chose the Tun Tan Cheng Lock Nursing School to make her dream a reality.

This Kuala Lumpur-born lass was then attached with Assunta Hospital for five years before joining Hospis Malaysia as a palliative care nurse.

“I had a feel of palliative care when I attended a workshop while still working in Assunta Hospital. I guess that was a calling as I was truly attracted to this form of nursing. I then joined Hospis Malaysia. This was in 2006.

“The organisation truly helped mould my career as I was given training and education on professional ethics, working independently and the right practices on how to provide holistic service in palliative care.

“I obtained a diploma in palliative care in 2011 and was very lucky to be sent to the Hospice in the UK for two months to complete my clinical attachment,” explains this mother-of-two.

According to Yap, her job encompasses providing a better quality of life for both patients and their family members. It emphasises on relieving patients from physical pain and emotional stress. It also helps ease the burden of family members, as palliative care offers moral and emotional support to caregivers as well.

“As a palliative care nurse, I visit ailing patients at their homes. I am trained in skills to assess these patients according to their symptoms and to advise them on medication and the need to revisit the hospital.

“I also provide emotional support by listening and giving advice. Support is also provided to their family members and caregivers. Looking after a patient inflicted with a life limiting disease can take a toll on the caregivers. They need to be educated on ways to handle these patients,” she says.

Typical day

Yap’s morning on a typical working day starts early as she has a 10-month-old daughter. She gets ready and has a good breakfast before leaving for work.

“Once at my desk, I go through my patients’ files and set up my schedules. I currently have 70 patients under my care, so I have to slot them accordingly for each day throughout a month,” explains the soft-spoken mother.

At 8:30am, the team will have a report meeting with their doctor. This takes place on a daily basis. The nurses provide updates on their patients and share valuable experiences which may be helpful to their colleagues.

Doubts and questions are also discussed in the meeting and the doctor is briefed on the status of the patients. The meeting ends at 10am.

After the meeting, Yap is back at her desk to do paperwork. She goes through the list of patients that need to be visited for the day and prepares herself with the necessities. This time is also used on follow-up calls to patients and their caregivers on their well-being.

“At about 11am, I leave Hospis Malaysia for my visitations. The areas I cover are part of Cheras, Seri Kembangan, Balakong and Salak South. The duration I spend with each patient varies depending on his/her condition but on average, each visit takes about one hour.”

Yap’s training as a palliative care nurse is put to good use during her visits. She starts by checking them physically. Based on their symptoms, she provides advice on medication and the need for a medical check-up with their doctors. She then tends to their emotional needs by talking and listening to them.

“Some patients voice their concerns and fears while others tell me of their wishes on how they want to be handled. Then, I speak to the family members and caregivers as some of them do not know how to handle the emotional condition of the sick patient.

“Some of them ask me the details of the patient’s condition and the best care that can be given for their sick family member.

“There are also those who are stressed and want to just pour out their sorrows and worries. I listen, provide the best emotional support that I can and help ease their burden,” explains the 34-year-old.

Yap’s day ends at about 6pm. She sees five patients a day at various locations within her designated areas.

“It is a five-day a week job but we nurses at Hospis Malaysia take turns doing on-call duties on weekdays after working hours in case of emergencies. On weekends, we are on stand-by duty.”

The ups and downs

For Yap, her biggest challenge is lack of communication that sometimes arises between the Hospis and the hospital team. There are times when the patients’ doctors do not explain the mechanics of their referral to Hospis Malaysia clearly.

As a result, patients may be unaware of Hospis Malaysia’s services and do not know that they will be visited by a palliative care nurse to assist them.

“Besides that, there is also the situation where patients are not informed about their diagnosis, especially cancer patients. Their family members choose to hide their illness from them. This is quite difficult because as a nurse, if patients enquire on their conditions, I have to inform them the truth.

“There are cases where family members do not want to reveal the sickness but I cannot comply with their wishes if the patient wants to know.

“Prior to informing the patient, I will have an open discussion with the patient’s family members and explain to them the importance of informing their family member of their condition. This is because patients who know of their condition have their own wishes on where and how they want to be treated,” she explains.

Obstacles aside, Yap truly loves her job as she finds it very fulfilling to be of help to those that need her. She also feels liberated as she is able spread the knowledge of palliative care and educate people on its benefits.

“Many people lack knowledge on palliative care and my dream is to create awareness of this field not just in Malaysia but in neighbouring countries like Indonesia where there is a lack of this awareness,” says Yap.

What it takes

“Knowledge and skillset are definitely required to be a good nurse but I believe that these can be learnt. For me, a true nurse is one with a heart and compassion. Only with these qualities can you reach out and care for the sick,” says Yap.

The dedicated nurse concludes: “Patients are not people who only need physical care, but they have to be showered with emotional and moral support too. This can only be bestowed by someone who is compassionate and genuine.”

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