Personal reflection on Third Train the Trainers Workshop on Palliative Care

Workshop Facilitators

The workshop for palliative care training in Bhutan was facilitated by a team of three doctors and one nurse from the National Cancer Centre Singapore, a senior nurse palliative care practitioner from India and observed by the Executive Director of the Asia Pacific Hospice Palliative Care Network (APHN). 

Workshop participants

The diverse group of 31 participants consisting of doctors including senior onco-surgeons, senior anesthetists, general duty medical doctors, nurses and pharmacist representing both regional referral hospitals and remote districts, ensured a comprehensive representation from across Bhutan’s healthcare system. This allowed for the exchange of knowledge and experiences to benefit palliative care delivery in both urban and rural settings.

Workshop experiences

The five-day workshop on Palliative Care was a transformative experience that significantly enhanced my understanding and skills in providing compassionate care to patients with life-limiting illnesses. The workshop began with a comprehensive introduction by Professor Lalit, a seasoned consultant faculty from Singapore, who shared his expertise and diverse teaching methods with us. The insights and guidance equipped us with the essential skills necessary to train and educate others in Palliative Care, ensuring that we can effectively deliver high-quality care to patients in need.

The second day of the palliative care workshop began with an inspiring address by the Director for Clinical Services at the National Medical Service Bhutan. He stressed the significance of palliative care at the JDWNR hospital and throughout Bhutan.

Figure 1: Group photo session with the Management of JDWNR hospitals, workshop facilitators and participants.
Figure 2: Expert from National Centre Cancer Singapore facilitating the workshop.

Mr. Giam, the Executive Director of the APHN, shed light on the collaboration between APHN and the Lien Foundation, the primary financial supporter of the program. Mr. Giam expressed his commitment to further support the program’s sustainability and ensure its continued benefit to Bhutan.

Dr. Shirlynn Ho, the team lead for the Training of Trainers program in Bhutan, then provided detailed insights into the establishment of APHN in collaboration with the Lien Foundation and JDWNRH, under the dynamic leadership of the late Professor Cynthia Goh.  Dr. Ho elaborated on Professor Goh’s vision for palliative care in Bhutan and outlined her plans to advance this vision with enthusiasm and cooperation from the participants, supported by the Ministry of Health and National Medical Service.

Lesson learnt

Throughout the five-day palliative care workshop, the participants engaged in in-depth discussions on palliative care assessment and on various aspects of symptom management, with a primary focus on pain and dyspnea (breathlessness). The training taught us how to holistically approach our patient and understanding patient as a personhood including his/her genogram, fear, worries and strength and faith. The first bed side teaching was how to understand personhood of a patient and how we can effectively do palliative care assessment by bedside. The reflection sharing at the end of the session, witnessing the hearing colleagues share how they felt connected and realized how important the palliative care assessment and understanding personhood of a patient was testament of the successful training.

Figure 3: During bedside teaching in the ward.
Figure 4: Small group members visiting home-care

In addition to the classroom sessions, the workshop included valuable bedside teaching opportunities at patient’s home. Participants were divided into small groups, each led by a faculty member, who facilitated interactive sessions with both home-based palliative care patients and inpatients at the hospital.

Figure 4: Hands on training

This hands-on experience allowed the participants to apply the knowledge and skills they had acquired, further enhancing their competence in providing comprehensive palliative care.

Figure 5: Ending of workshop with celebration of Nurses day

The comprehensive training, encompassing both theoretical and practical components, equipped the participants with the necessary expertise to effectively manage the complex symptoms experienced by patients with life-limiting illnesses. This holistic approach to palliative care education will undoubtedly benefit the patients and families in Bhutan who are facing the challenges of terminal conditions.

Written by: Dr. Kinley Bhuti, MD-General Practitioner, Jigme Dorji Wangchuck National Referral Hospital, Thimphu Bhutan

Published on: 11 June, 2024 | Last modified: 11 June, 2024