Clinician Profile - John Haberecht, Director of Learning and Development, Centre for Palliative Care Research and Education (CPCRE)

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Palliative care is an approach that improves quality of life of patients and their families facing problems associated with life threatening illness, through prevention of suffering by early identification, and impeccable assessment and treatment of, pain and other problems, physical, psychological and spiritual. The Centre for Palliative Care Research and Education (CPCRE) was established by Queensland Health to enhance palliative care services in Queensland through education and research. Today we speak with John Haberecht who is Director of Learning and Development at the Centre for Palliative Care Research and Education (CPCRE). John has worked as a clinical nurse in palliative care with community services such as Karuna, Cittamani and St Vincent’s Home Care. He has also worked in consultation liaison services at Princess Alexandra and Mater Adult hospitals. 

The Centre for Palliative Care Research and Education is a state wide activity of Queensland Health, hosted by Metro North Hospital and Health Service at Royal Brisbane and Women’s Hospital. Headed by Prof Patsy Yates, Centre Director, and Head of School of Nursing at QUT, its purpose is to foster research, to promote palliative care workforce development and to provide education to health professionals around the state about palliative care. 

For non-specialist palliative care staff there are a number of professional, communication and information challenges that are faced every day.

Firstly it is important to have a clear understanding of what palliative care actually is. Many clinicians believe that palliative care either hastens or postpones death. In reality it is about excellent symptom management, keeping the patient as comfortable as possible, and providing support to family and carers. In fact, there is good evidence that people receiving palliative care actually live longer and have better quality of life. Part of the education we provide is to help staff understand that palliative care doesn’t replace the care provided by the treating team. It can sit alongside ‘usual’ care and add another layer of support for the patient and family. 

One of the main challenges for non-specialist staff is “the difficult conversation” – discussing with a patient and family that their prognosis is limited. Palliative care medical, nursing and allied health staff need to have such conversations on a daily basis, but it can be scary for any health professional not accustomed to it to engage in such a conversation. Unfortunately, that often means the conversation doesn’t happen, with the result that patients may not have the opportunity to make the most of the time they have left, and/or needlessly end up in ICU or coming back to hospital when they could be cared for quite well at home. 

Understanding that palliative care is appropriate as soon as a person is diagnosed as having a life threatening illness from which they are unlikely to recover is very important. A palliative care team can provide tremendous support in dealing with complex symptoms such as pain, dyspnoea, nausea and vomiting, constipation or many others. The palliative care team often includes counsellors/psychologists and chaplains/spiritual carers to help deal with the inevitable psychosocial issues that may arise for the person. 

Evidence based practice is essential in palliative care, as in every clinical area. Our Director, Prof Patsy Yates has secured many research grants for QUT to improve the evidence base in palliative care. CKN is a vital resource in enabling evidence based care. I probably use it every week to help me check that the information I’m accessing is current, to access a journal article, a Cochrane Review etc. The Therapeutic Guidelines: Palliative Care are the “bible” for most palliative care clinicians, and while most of us have a hard copy on our desk, it is really helpful to be able to access the electronic version through eTG Complete (electronic Therapeutic Guidelines) on CKN. Similarly, access to journals and to medicines information such as MIMS or the Australian Medicines Handbook helps ensure health professionals are providing patients with the best care possible.

I love the CKN search tool because it often takes me in directions I hadn’t considered by coming up with unexpected results such as a study in a related area of which I was unaware.

CKN is a fantastic resource for Queensland Health staff to have at their fingertips – to have free access to so much knowledge about health care and health policy, to make sure the care we deliver is the best possible for that patient and family at that time.