Knowledge Base

Last Saturday was a difficult day for us. We were scheduled to be with the oncologist and take part in a palliative care workshop starting at 9am. We did not know much before we arrived except that there were specialists coming from TATA hospital in Mumbai, the largest cancer center in India.

The day started off badly and then got worse. Each morning breakfast is brought out to the dining area of our apt and on this particular morning it was late. Typically not a problem, but today it was really late. So we find ourselves eating quickly and scurrying off to the hospital so as not to be late for this conference. We arrive at 9:00 on the dot, to find we are the only ones there. Did we look at the schedule wrong? Are we actually suppose to be here today? Well not a moment later the oncologist enters with the team from TATA and some nurses trailing behind. Ok, at least we’re in the right spot, everyone else is just late.  It’s now 9:40 the first lecture finally begins. We are learning that nothing begins on time here, nothing!

We knew in advance that this conference was geared toward the nurses. No problem. But shortly into the first lecture we realize that this is an EXTREMELY basic nursing overview of “breaking bad news” and “pain management.” As PA’s we most certainly need to know how to do this and do it well, so a refresher can never hurt, but this was not helpful. Palliative care is not as readily practice as it is in the US and home care and nursing homes are almost completely unheard of, but we still felt these lectures were likely too basic for the nurses here.

This brings us to a dilemma. Do we tell them this is very basic for us and ask to go round on patients in the oncology ward instead? We quickly realize that this could easily offend them, so that’s not an option. This gives us no choice then but to sit through it. The worst part of the whole thing was that a large portion of the lectures were spoken in Marathi. This was likely the most frustrating part, especially since earlier in the week they make it a point to be certain we were attending. At lunchtime we were able to spend some time with the oncologist. We discussed what a PA is and he proceeded to describe the dynamic of the oncology department and cancer outreach program at the hospital. We thought our discussion helped him better understand, but it didn’t.

After lunch we return to the conference where we are asked to take part in a role play scenario, ok. The scenario is provided for us and we are asked to act it out as it would occur in the US. The only problem is that with the dynamic of the scenario, it wouldn’t occur in the US this way, but we make it work. After our ‘performance’ the rest of the role play groups perform, but again, they are spoken in Marathi. 3 groups have now performed their skits, and the nurses are handed a written exam to complete. At this time we think the role play is over and we get up to leave while they take their exam. The oncologist then informs us that there are still more groups left to perform after taking their exam. We politely asked if we could be excused to see patients on the ward since everything was in Marathi and we could not follow along any way. He seemed to understand and let us be excused. Coming here we did not expect them to fully understand what a PA is, and knew we would have to be “pioneers”, but it was more difficult to deal with than we expected. Hopefully, at the very least, when we come across these misunderstandings, we can leave people with greater knowledge about what a PA is and what we can do.