The Romanian nurses at Hospice Casa Sperantei have been unbelievable practice partners! Having formed a mentoring and collaborative relationship with them, both at a clinical practice and academic level, they continue to establish milestones including these areas and others, such as policy change. The New England Alliance of Hospice of Hope was very active in every area that Nicoleta updates in the blog. Their organization is strong and self reliant; recently our involvement has been mostly at the academic level, designing goals and objectives fitting the needs of the organization within the structure of Romanian society and the politics and culture of medicine. Nursing, particularly palliative care nursing, can be well defined in Romania and Eastern Europe, specifically because of this pioneer group of expert nurses at Hospice Casa Sperantei. The strides and accomplishments mentioned in this update are no short of amazing considering the resources and support the nurses have on a daily basis, and the amount of time and giving they share from truly their clinical souls. Whenever I need a reminder of why I follow the life of a nurse, I connect with Nicoleta or a colleague from her team. I am transported from my daily routine into something deep and meaningful, difficult and rewarding, natural and easy. Palliative care in Romania is just that, accepted and practiced with ease, part of what is logical and expected in the course of one’s lifetime. As a palliative care NP practicing in the US, I spend much of my time describing what I do and listening to choices and forks in the road that usually lead to the same place. Some decisions include more pain than others, but the end point is the same. Fortunately for the Romanian people, supportive/palliative care is not considered an option but a necessity. Ten years ago, there was nothing written in the literature to even allude to the influence and professional practice of palliative care nursing. Now, however, there is a plethora of stories, articles, and multiple presentations for reference. Policy change is happening before our eyes! This update will excite you even if you do not know the individuals personally.
Thank you Nicoleta!
Dr. Julie Vosit-Stellar
Internal
The nurses at Hospice Casa Sperantei in Romania have had a very busy and productive year in 2013.
We’ve continued to care at high quality for our patients and their families and also find ways of enhancing our performance together with developing the hospice team and also promoting self-development.
A great accomplishment in 2012 of our nursing team has been the development of the professional competencies of nurses and assistant nurses in Romania. We’ve worked on this achievement together with nurses representing Palliative Care (PC) specialized services all around the country. In 2013 the document has been recognized as the plan for the professional development of nurses working on PC specialized service and as the instrument for yearly appraisal in Hospice Casa Sperantei.
As the result of the process of evaluation, we’ve managed to implement very specific training sessions, both theoretical and practical, for the improvement of our clinical outcome. Also, we are managing the use of our resources, consisting of nursing staff allocated to responsibilities and tasks, in ways that better suit each individual.
At the level of the entire organization, this year has been challenging throughout the development of our services, especially in the capital city of Romania, Bucharest. Here we are in the process of enlarging our team in general, the nursing team in particular. The process of recruiting and training the new nursing employees has been reviewed and we have learned many lessons.
Another important output of the evaluation process has been the establishment of professional developmental objectives for each nurse and assistant nurse. Many of them have chosen to work on reviewing the existing or developing new policies/procedures and clinical protocols. We consider this to be of high importance.
National
In regard to the professional competencies, by now, for the year 2014, other specialized services around the country manifested their openness to have their nursing staff evaluated by using the professional nursing competencies. One member of the evaluation team will be from our nursing team, as we are perceived as the most competent in the field.
More than ever before, the year of 2013 has come with the openness to develop new PC services in the country. Hospice Casa Sperantei is the accrediting institution for delivering PC training for nurses, having 16 certified trainers in Palliative Nursing. We have been traveling all around the country for formal Medical Education courses. We have held both introductory and advanced courses. We have been to more than 14 new locations in the country, meaning we have reached regions and nursing personnel that have never ever heard about PC. More than 650 nurses have been trained in Palliative Nursing this year in Romania.
This year our role as advocates and promoters of PC among nursing professionals has been tremendously implemented by having one of us elected as a National Counselor for the National Order for Registered Nurses – the Romanian professional accrediting body/forum/institution. The influence of our presence there is proven and demonstrated by the huge request for PC courses in the country. This lobbying process will continue in this manner at least until 2016, when new elections for members of the Executive Board and Counselors will take place.
Grace to the presence of our representative in the National Order for Registered Nurses, as there are many opportunities for the nursing trainers from Hospice Casa Sperantei to be invited speakers at conferences organized by the counties’ branches. Also, Prof. Dr. Daniela Mosoiu – the Hospice Casa Sperantei CEO for Education and National Development Department, has been invited as the plenary speaker at the National conference of the NORN.
This has been a landmark year in that a signed partnership between the Ministry of Health and Hospice Casa Sperantei has been established. We have presented the National Strategy for Palliative Care. This document structures the Palliative Care interventions on three levels: self-care, PC approach and specialized services, and the center of excellence represented by our organization. In regard to nursing, we have implemented the information center, which has a part time nurse working on developing informational/educational materials, posting new information on the specific website at a regular pace, and answering questions on a given phone number. We have been invited to be part of the commission, which is facilitated by one of the Ministry of Health counselors, for developing and implementing PC as part of community care in Romania.
As our supreme goal is to have PC recognized as a specialty for nurses in Romania, we consider our efforts this year to be rewarded with great steps forward and we are continuously hoping for the achievement of this goal in the near future as our influence is stronger than ever before. In addition, a few nurses in our team started to feel more confident and have taken on the challenge of research and publishing. Several materials have been published nationally in the Romanian Nursing Journal – ArsMedica, on the electronic PC journal – paliatia.ro, and in international publications (Oxford Textbook for Palliative Nursing – 2014 edition).
Internationally
This year other international groups have been visiting our facility for onsite clinical training. Nurses from different Eastern European countries (ex. Georgia, Moldova, Kirgizstan) have been mentored by us, the nurses at Hospice Casa Sperantei, to help them develop specific Palliative Nursing competencies.
There have also been requests for Palliative Nursing specialists from our team to go abroad to provide clinical training and teach PC in Albania, Armenia, Greece, Serbia, Kazakhstan, etc.
The feedback from our input has been very positive. We are enthusiastic and experience profound professional satisfaction as we manage to mentor Palliative Nursing, but more so on influencing the development of nursing and changing the socio-cultural environment for perceiving nursing as an autonomous profession.
With all the best thoughts and wishes,
Nicoleta Mitrea.