Introduction:

 1. What is your name?

Yvonne Jamela Tiva

 2. Which hospice do you work for?

CHoiCe Trust

 3. What do you do there?

I am a Palliative Care trained Staff Nurse.

 4. How long have you been there?

I have been with CHoiCe for 23 years and 4 years in the Palliative Care Program.

In-depth:

1. Why did you decide to focus on palliative care?

In 2013 I did a certificate course in Palliative Care. I came back and did nothing with the skills and knowledge acquired from the training. Though I continued training Community Care Workers in basic palliative care and supporting them with caring of their patients, it was not enough for me. Then, in September 2017 when I was asked how I feel about the Palliative Care Program, it was like God has answered my prayers because my passion has always been in caring for patients and I wanted to implement what I learned from the Palliative Care training. I like the holistic care approach in assisting patients and families which is a gap identified that is not really happening in the caring industry.

2. What gives you the greatest fulfilment?

• Seeing my patients pain free after two to three days and passing on pain-free fulfils me.
• Patients recovering from being bedridden and able assist themselves and not depending on their family members.
• Families coping with the life-threatening illness of the patient because they understand the diagnosis and know how they can assist.

3. What do you find the most challenging?

• Shortage of medication from the local hospital because that causes my patient living in agony due to pain.
• Patients who are not well cared for by their family members or patients who don’t have anybody to care for them with no Community Care Workers around their areas.
• During this Coved -19 period, patients missed their follow-up visits due to certain clinics or departments not operating for a long time and this resulted in their conditions deteriorating and eventually passing away

4. What do you think people find the most challenging about a life-threatening diagnosis?

• The most challenging is a lack of caring skills because they don’t know how to care for the patients.
• Lack of money to take patients to the clinic or hospital if they need to be in hospital.
• Denial that the patient has a life-threatening illness, they think it is witchcraft and want to use traditional medication.
• Talking about death and death preparation is not acceptable, even if they can see that the patient is very sick, they still have hope that one day the patient will be cured, that is why when you start with the pain medication and after two to three days the patient is free from pain and able to walk, they think the cancer (if the diagnosis is cancer) is gone.

5. What do you think that you personally bring to your job that reflects who you are as a person?

• I am passionate about my work. I find it very difficult seeing my patients in pain. That is why I immediately communicate with the IDT Doctors while in the patient’s house, and arrange for pain medication, go and collect and come and give the patient. I make sure that they don’t sleep without the pain medication. I personally think I bring relief to the family and patient.
• My kindness and willingness to go an extra mile allows my patients and their families to be open with the situations that they are facing. They feel free to contact me anytime if they need any assistance or if the condition changes and don’t know what to do.

6. How do you take care of your own health and balance?

• I am a Christian and put my trust in God. I pray about any situation or difficulties that I come across including the suffering of my patients. That makes me feel better.
• I also receive support from my supervisor or social worker when sharing with them the situation of patients and families, including losing a few of my patients.
• In my work place counselling or debriefing sessions with FAMSA is booked for me and it helps a lot because after the sessions I feel better.

7. What is your advice to anyone else wishing to join your profession?

• My advice is to have the heart of Florence Nightingale. Remember your pledge to help the patients no matter what. Always put yourself in the shoes of the patient and the family and in that way, you will be able to holistically assist the patients and their families.
• Develop yourself and update yourself with new health information.
• Know your limit and acknowledge that you cannot do everything – you sometimes need help from those who have knowledge and skills above you. Always work with the IDT Doctors – it makes our job easier.

8. What is your advice to anyone given a life-threatening diagnosis?

“We often hear people saying we were told that there is nothing that we can do for us.” I don’t believe in this saying. In Palliative care there is a lot that we can do for the patient and the family. Our goal is to ensure that the patient is pain free and dies in dignity. We are always holistically there for our patients. We attend to every need of the patient and family by involving the multiple disciplinary team. We know when and where to refer.

 9. What is your advice to the loved ones of anyone who is given a life-threatening diagnosis?

My advice is to understand the meaning of the diagnosis so that they have a clear understanding of what the life threatening diagnosis is all about. To be there every step of the journey with their loved one and be able to prepare for the worst when the time comes.

To create memories of their beloved one as a remembrance when the patient is no more (Memory box or the will).

10. How do your loved ones feel about the work that you do?

I don’t work in isolation; my family knows what I am doing. I often communicate with my patient when I am at home and they can hear me speaking to them. They feel it is good to help people who are sick and not able to cope with their sickness. They support me and encourage me when I feel down about the condition deteriorating or loss of the patient. They also get interested in knowing how my patients are doing.

 11. What do you like the most about the hospice that you work with?

It is a privilege for our Hospice to have a team of family Doctors who are supporting the program. This makes our programme run smoothly because they are always there to support with the care plans and initiation of pain medication and assisting with disability grant application.  They are easily accessible mostly through Whats-app, cell phone calls and we meet on a monthly basis in our IDT meeting.

 12. Do you have a “motto” that you tend to live by that you would like to share?

No matter how difficult the day may get, don’t forget the reason you became a nurse.