Putting nurses at the heart of palliative care through education at every level

Minna’s story

Minna was 22 years old and had two children when she started her nursing education in the University of Applied sciences. While training, Minna was convinced her future lay in working with children or in ICU; most definitely not with cancer or dying patients. After a while in ICU though she realised she missed the communication with patients and their families.

Upon graduating Minna took a job at the ‘home hospital’, where she was providing specialist care to patients at home. Caring for cancer patients, often from soon after diagnosis until the end of life stage, gave the opportunity to develop long term relationships. “I realised that this was the best thing that a nurse could do. You learn a lot about life when you work with people at the end of their life, about communication, relationships and the meaningfulness of life. That’s when I knew that I really liked to work in palliative and end of life care.”

Minna has taken her passion for quality end of life care and dedicated the last five years to education and research. In her work she has been involved in developing a system that provides nurses and their clinical colleagues at all levels, including the educators themselves, with the tools and knowledge they require.

What drives you to make a difference?

Minna completed two Masters programs; the programme of Clinical Expertise and Nursing Sciences, as well as qualified as a teacher. When working on her thesis’ she got familiar with the provision of palliative care nationally. “I was still thinking about palliative care as a whole in Finland and about the fact that in some places it was well organised but in others it still needed to be developed.” She realised that it needed a national approach, and while the Finnish government was making plans for delivery and ‘starting to build the walls’ for a new system, teaching had not been factored in. “That’s when I had the lightbulb moment and I knew if we were going to build strong walls, we needed to change medical education and nursing education because physicians and nurses have a key role in palliative care provision.”

Convinced of her plan, Minna picked up the phone and called the professor running the government programme and told her of the need to develop palliative care education of nurses and doctors. There was a possibility to apply for funding for the development and so, together with a multidisciplinary team, they applied for and secured an almost €2m grant. “So now, the health ministry is building the system and we are developing the education for doctors and nurses.”

How do you inspire others ?

Minna’s vision is threefold: she believes passionately that there should be quality end of life care available for all. To provide the care you need an education system that prepares doctors and nurses for their work and, crucially, that the experience and expertise that lies in the nursing community must be heard.

Minna is on the way to delivering on her dream and leads by example, putting herself at the very heart of change. She leads a multidisciplinary project where the aim is to write the competencies and develop the education for both doctors and nurses. She has the responsibility of developing the palliative care nursing education, from undergraduate level to master’s level. In her team, a recommendation of palliative care education for undergraduate nurses has been made, a masters degree course has been built in palliative care nursing, and a specialist course in palliative care that is not as in-depth as the masters but is to university level, has been developed. She is also in the process of creating a course for the educators, building it around the recommendations of undergraduates, and so it will include everything they want and feel that it is important to be taught.

Minna calls on her colleagues to do more and push themselves further forward.  “My vision is that as nurses we have very good clinical expertise and we have to see that we are the experts. We should affect the system and be involved in making a difference. We should be more active in all levels of development and policy because we can make a difference. You are the changes of the future because you are the experts.”

How can nurses lead change?

“Nurses should see the pivotal role they have in palliative care and be proud of the expertise they have. They should speak up and share their expertise in many ways. Nurses have so much silent expertise which is not visible but has such great importance for the wellbeing of the patients and their families. If we don’t see that and develop it we will lose a very big part of the patients’ wellbeing.”

Minna says that nurses should be encouraged to value themselves and their expertise in nursing care, and that they should be a part of the development in all levels.

“I see that it is important to have nurses in, for example, committees building guidelines and making change to the future. When having multidisciplinary attendees, we can reflect all aspects needed and build guidelines which supports all.

We have to find a way to get visibility for nursing and how you can speak up. We should also be brave to speak about our research and come up with our results.”

Minna Hökkä
Kajaani Finland