Ms Anne Tan:

Yes, and that is the unfair part. That was the point made by the Deputy.

Deputy Sandra McLellan asked what type of training should be provided to public health nurses working in the community. Two types of nurse work in the community: the community registered general nurse and the public health nurse. One could say there are three types if one includes the specialist palliative care nurse.

There are many different education programmes available. I feel that a multidisciplinary approach to education is greatly needed. It is something we are considering as time moves on.

Earlier we talked about decision-making in palliative care. A multidisciplinary approach is required, but it can only be done through people knowing and understanding how to do the work. They need to know how to make such decisions and to communicate in a multidisciplinary fashion.

There is a need for carers at all levels to have a better understanding of palliative care and how to communicate within the sector. They need to know how to communicate with patients and convey their needs and wishes to others on the palliative team. There is a higher award in palliative care but there are many different higher education courses available, both formal and informal. Specialist services also play a role in providing education for the general services, either by the community nurse or on a one-to-one basis in a practical situation during a public heath nurse visit. Centres of nursing education also provide educational training. The important thing is that we operate in a multidisciplinary fashion.

Senator O'Donnell mentioned that due cognisance must be taken of the role played by the public health nurse. She also asked what help and support is provided by my colleagues who work in specialist palliative care. For many years the specialist palliative care services developed in an ad hoc manner. The roles of most of the community specialist palliative care nurses developed, in years gone by, through the hospice home care services. Now, more nurses with a background in either oncology nursing or hospice units are joining the service. They have a different approach and a different take on how to provide support to people in the community. The specialist palliative care nurses should act as our role model and bring their knowledge and expertise to us. They can help and guide us. That would give us the confidence to be competent in what we do. That can be achieved by providing support and education on a one-to-one basis in a practical situation.