Kath came to hospice nursing as a child. She was introduced to it by her aunt, a nurse, and the family and community caregiver. She experienced the death of a number of friends and family in her teens and young adult years. Kath graduated as a nurse in 1980 and was later hired by Victoria Hospice in British Columbia, first in the in-patient unit and then as part of a community-based crisis response team, responding to people who were in crisis in their home setting.
In 1988 Victoria Hospice asked Kath to develop a palliative care course for the local college’s Home Support Workers’ programme.
When, a few years later, the college decided to stop the course, Kath and a colleague took it on themselves and started delivering workshops for home support workers across British Columbia.
After a brief pause to complete a Masters in Thanatology, Kath committed to help improve care of the dying and their families through education and established Life and Death Matters with a mission to improve such care through education of direct care providers and nurses. She wanted to improve her handouts, and so Essentials in Hospice Palliative Care textbook came to be published.
Fuelled by a passion to prepare frontline caregivers for what the Canadian Strategy for Cancer Control called a ‘coming tsunami of dying’, Kath then set to on a second edition of the book.
Kath’s impact on the training and skills development of support workers, healthcare assistants and practical nurses really started to snowball at this point. A companion workbook soon followed, as did PowerPoint presentations and an Instructors’ Guide. All told, more than 200 colleges across Canada embedded the materials in their curriculum.
Subsequently Kath worked with physicians, nurses, counsellors and personal support workers to write a text designed specifically for personal support workers, in the form of Integrating a Palliative Approach: Essential for Personal Support Workers, which was published with a companion workbook, PowerPoint presentation as well as podcasts and videos.
Kath then updated the text for nurses, and published Essentials in Hospice and Palliative Care: A Practical Resource for Every Nurse, as well as companion workbook, exam questions etc.
Most recently, Kath has collaborated with nurses, physicians and social worker to translate and adapt the nursing text and workbook for nurses in Mexico and Latin America.
What drives you to make a difference?
Kath’s early life experiences of death and dying had a profound impact. Combined with what she encountered in her early years of nursing and then her years at Victoria Hospice, particularly supporting patients and their families in their homes, Kath is inspired every single day to disseminate “delicious and digestible” (engaging and user-friendly) educational resources to help direct care givers provide the very best care.
“I continue to be inspired and pushed by those I have cared for, and those whose deaths continue to haunt me. I love working with people who are living/dying, and their families. I especially experienced this when I worked with the Palliative Response Team. I worked with such an incredible team of nurses, counsellors and physicians. It was incredible to work together as a team with the counsellor, with the family, and with the person to assess and develop, together with the help of a physician on the phone, a plan to address the needs, and then to help set up support or to educate the family to provide the care.”
Kath’s ongoing commitment to provide educational materials is inspired by the demand she sees on a day-to-day basis. “It is challenging caring for someone at the end of life. Those people who work in this field are wonderful, caring and dedicated people – seeking education, and grateful for education.”
How do we see the art and science of nursing expressed?
With the benefit of 40 years experience as a palliative care nurse and an overview of healthcare in a number of different countries, beyond just North America, Kath is able to reflect on the changes she’s witnessed, and the need to integrate a palliative approach in care.
“Palliative care has moved ahead. In Canada we once used the terms ‘hospice’ and ‘palliative care’ to mean the same thing. Now we are separating them. Palliative care is more upstream but can continue through to death, while hospice usually refers to programmes and settings that provide care in the last six months of life.
When I first heard the expression ‘end-of-life’ I thought that’s a great word for people who don’t like using the word ‘death’. However, most people think of end-of-life as the last weeks.
But now the conversation is all about how to integrate a palliative approach for people with any life-limiting illness, early in the disease process, and across all care settings. The good news is this is the message that is being taught in Mexico, in Latin America, and other countries. This is so important. I think that this is the most important change in the last decade and the most important message that we can carry forward.”
How can nurses strengthen their leadership and impact?
“Nursing is an incredible profession. Hospice and palliative care is a speciality. But the foundation of hospice and palliative care needs to be part of every nurse’s skill set. If I had a hope it would be that palliative care would be integrated in core curriculum for all nursing programs. I hope that all nurses could recognise the reality that death will come to us all, and consider how they can open discussions about dying, about personal preferences, about goals of care, in a way that helps people consider their own mortality. I wish that as a society we would not just talk about wellness but consider what ‘healthy’ dying might look like too.
My message for nurses is to be creative and think outside the box. Don’t get stuck. One of the reasons we’ve been able to do what we’ve done is that my spouse and I cared a lot – and were willing to take some risks. Feel the fear and do it anyway! See a need and strive to meet it. Shake it up!”