“The key to understanding Palliative care is education”

During our visit to Groote Schuur Hospital we had the privilege of having a chat with Aghmat Mohamed, who is the head of nursing at this prestigious hospital. Mr. Mohamed grew up in Manenberg which is situated on the Cape flats, and it is wherefamily of his still reside.

Background

“I matriculated at Manenberg High School, and then worked for a year. After that year I wanted to specialize in something, and as a kid when growing up you are always influenced by the common jobs of becoming a nurse, doctor or dentist, and for me becoming a doctor was a passion and desire that I had”, he said.

However, that all changed for him when he came to standard 8. That was the first time he had interaction with a nurse. “We had neighbours who were nurses, and I always admired their image whenever I would see them going to work. The smart attire, the smiles on their faces, the professionalism and just the way they interacted with each other” he added.

When his grandmother, who had also raised him, fell ill he then saw how the nurses interacted with her firsthand. The relief, the compassion and caring they brought into her life sparked a moment in him which made him realise that one day, this is exactly what he wanted to do for other people.

Educational background & experience

  •        4 year Diploma Course

  •  Red Cross Hospital – where he worked and studied further after that
  •  Involved in management at Community health services

The first management job he was involved in was at the Green point community health services as a facility manager and from there he moved to Brooklyn as the facility manager. After that Mr. Mohamad ventured overseas to learn more about Hospice and Palliative Care because prior to his venture overseas he had heard very little of the practice, and even though he was a nurse it was something not spoken about much.

Lessons learnt in Ireland

In January 2004, he then ventured off to Ireland to gain experience in his field of nursing. He recalls there being many more “speciality” nurses compared to South Africa where he feels only now are we starting to get nurses that specialize in certain aspects of health.

“In Ireland, there was a speciality nurse for pain, for diagnosis, for palliative care, the list was honestly endless. What sparked interest for me was Palliative Care”  In the wards that he worked in Ireland there was constant interaction with sisters involved in Palliative care and he could see first-hand the positive impact that it was making on the patients and their families.

He then moved from the wards to a more educational field where he landed a teaching job. Part of the job was to research the needs in hospitals for certain fundamentals and following that research he then developed the “implementation of the Introduction to Palliative Care Course for all nurses” because what he realised from his experience in Ireland was that there were so many patients who were “palliative” however, the nurses in the wards did not know how to look after these patients.

“I learnt much more vigorously about Palliative Care in Ireland” – it was something that he recalls as very well supported and implemented and people often spoke widely about it, however, even though widely spoken about there were still common misperceptions about the practice, such as that it is only for cancer patients, for the last days of your life and that it is associated only with death and dying.

“The 5 day course on palliative care helped tremendously and made sure that everyone sang from the same hymn sheet. The course started in the hospital that I worked in called St. James Hospital in Dublin, and it proved to be a success since through just positive word-of-mouth regarding the program it was implemented across the whole of Ireland. People would send their staff to Dublin to do this program” he said.

People became more aware of palliative care and as the years went by the Irish Hospice foundation took the program to the next level and decided that it should be implemented across the board for all doctors and not only nurses. The implementation of this was because we knew that Palliative care is a multi-disciplinary approach and everyone had to get involved (physiotherapists, occupational therapists etc.)

“I stayed in Ireland for 10 years and my experience of what I had learnt and what I was able to implement was amazing. They have really managed to give strong support to Palliative care, the support from Government was tremendous, the awareness was great. I then ventured back to South Africa after 10 years of being away.” he said.

Motivated to spread my knowledge back in South Africa

After 10 years being away from South Africa, he arrived back in 2013, got a job as a nursing manager at a Private hospital, and was really motivated to spread his knowledge of what he had learnt in Ireland. He worked for two years at the private hospital and then found his way to Groote Schuur where he found out about Sr. Arendse who is a palliative care nurse. He recalls being really excited about the fact that 20 years prior there was no such thing as a palliative care nurse and now there he is, he was extremely positive about this aspect.

However, Mr. Mohamed was still shocked that after all these years there was only one nurse specialising in Palliative care.

Hospice Palliative Care Association – Palliative Care Course

However, on a positive side he was thrilled about a course that specialises in Palliative care from HPCA (Hospice Palliative Care Association of South Africa) had run with his nurses and which produced 68 nurses who have an insight into palliative care, who will hopefully share the knowledge they learnt through the one week program.

Challenges of getting a broad understanding of Palliative Care & Solutions

  •  Education is the biggest problem, however a simple solution is telling people what Palliative Care is really all about. 
  •  Challenge – associating the word “palliative” with the last few days on earth or cancer care, the solution Mr. Mohamed states is once again education.
  • ·     Same misunderstandings of palliative care in Ireland as there are in South after, solution – constant workshops, getting radios involved, training people who are involved in the hospital setting and making sure that the correct understanding of palliative care is reinforced.
  • Radios need to get more involved and media by interviewing people who are actively involved in hospices and with palliative care so that mind sets can change and the right message can be conveyed. He concluded by adding that the key is understanding Palliative care is education.