80% of nurses working in rural areas have no idea of palliative care, 80% fear the process of breaking bad news, 55% feel it consumes time, 65% fear burn out after prolonged care while 50% fear prescribing morphine and causing addiction to patients.
This is according to a survey carried out by Ongata Ngong’ palliative care community based organisation between the month of September 2010 and September 2011.
The survey involved practising and student nurses and aimed at establishing if nurses have been avoiding end of life care.
Stella Mwari Rithara, a lecturer at Kenya Medical Training College (KMTC) says only 30% of nurses are willing to do home care as majority prefer hospital care.
Rithara says that student nurses are less aware of palliative care and there are less trained tutors in palliative care and clinical instructors.
This comes even as nurses stay with patients in need of palliative care 90% of their life hence increasing the need for palliative care services.
Despite increasing palliative care awareness in the country and short course trainings by different bodies/hospices, fewer nurses are willing to work in this field.
The survey indicates that majority of nurses are willing to do other specialties away from palliative care.
40% sited the course to be very expensive, 45% pointed out lack of motivation and 55% indicated having not visited hospices located in big towns.
“Therefore, there is need to offer encouragement and financial support towards the nurses willing to undertake the course.” Rithara says.
She says that there is need for the government’s active participation in palliative care delivery in support of private organizations which offer palliative care training like Nairobi Hospice.
According to the survey, majority of the nurses working in government sector at the rural set-up have no palliative care knowledge hence there is need for community awareness to support the nurses working in these rural communities.
“There is need for encouragement and financial support for willing nurses to undertake the palliative care course.” Rithara says.
Rithara says that the Ministry of Medical Services, Kenya Medical Training College, Kenya Hospice and Palliative Care Association (KEHPCA) and AMREF are working together towards a higher diploma in palliative care at KMTC.
KEHPCA’s Executive Director, Dr. Zipporah Ali says she is hopeful that the situation will change in the near future.
“Over the last two years KEHPCAhas been working intensively with all training institutions across the country to have palliative care integrated in Medical and Nursing curricula. This should be able to change doctors’ and nurses’ perceptions on palliative care.” Dr. Ali says.
She adds that career pathways need to be developed for those training in palliative care to motivate them.
“One course that will soon be available is a Post Graduate Higher Diploma in palliative care that will be offered by the Kenya Medical and Training College. The first intake of students will be in September 2013.” She says.