| Popis: |
One of the current challenges in paediatric palliative services is to improve the quality of care. However, improvement requires a review and better understanding of our relationships with children and their families, as these relationships are the main source of their dissatisfaction at the end of life. We need to shift the restricted focus of our attention from the assessment and management of patient and family needs, to the reciprocal influence among those who seek and those who provide paediatric palliative care services. This ‘relationship-centred’ approach illuminates how the quality of care is determined by what transpires in a large network of relationships which are affected by the reality of childhood death. It is concerned with the establishment of relationships that are potentially enriching and rewarding for both care seekers and care providers. Through this process it seeks to understand not only the subjective views, needs, and experiences of the patient and their family, but also the subjectivity of the professionals, the teams, and the organization. One of the benefits of the relationship-centred approach is that it sheds light on the private worlds of care providers, and incites them to seek a balance between their personal and professional life and practice by engaging in what Renzenbrink has described as ‘relentless self-care.’ Relentless self-care must always be associated with relentless team care — a responsibility assumed by the service or organization to which we belong. If the work setting does not recognize the challenging and demanding nature of paediatric palliative care, and has no policies in place for adequate staff support, then our personal efforts for self-care will remain limited. By contrast, if the culture of the organization fosters collaboration, solidarity, and mutual support, along with regular feedback and supervision, then an ethos of genuine care will permeate all relationships. Self-care is not — and should not — be an individual affair, but rather it should be a collective pursuit, which promotes mutual support in times of distress, and the sharing of rewarding experiences that derive from our encounters with children and their families. |
