Hope against hope: Palliative nurse hangs on prayer in caring for patients

Palliative care nurses Sylvia Otieno (centre) and Jane Banda attend to a patient at Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu on Thursday. [Denish Ochieng, Standard]
Every morning when Jane Banda wakes up, she says a prayer: “Lord, may I not lose any of my patients today...” 

She is a palliative nurse at the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) hospice in Kisumu. 

Her typical day involves administering medication to terminally ill patients, holding them when they get overwhelmed and whispering words of encouragement to family members who face the uncertainty offering care.

Ms Banda has handled patients whose lives hang on a thread and she has gathered courage to tell them that they matter even in their last breath. 

She developed passion for end of life care after losing two sisters to cancer.

Her elder sister had cervical cancer. Banda says she died in pain as they helplessly watched.

A few years later, another sister was diagnosed with colon cancer and died soon after. By then, Banda was a general nurse. In 1999, she decided to join Nairobi Hospice for a two-year course in palliative nursing.

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She was posted to Kisumu and says the numbers were overwhelming. 

By 2006, carposi sarcoma (skin cancer), breast, cervical and esophageal cancers were the most common. They also handled people with end stage HIV.

Banda says in a week, they would get at least 10 patients. Currently, the team attends to at least 20 patients in a week and 70 in a month.

When Sunday Standard visited the facility, it was a clinic day. Banda and her assistant Sylvia Otieno were working to administer chemotherapy to seven patients. 

Late diagnosis

She says that in 10 patients, at least eight come from poor backgrounds which is testament to the late diagnosis as some present with cancer at stage three and four.

Banda explains that some of the patients come with undiagnosed conditions and she has to follow through to ensure they see a doctor before they are taken into the hospice.

“They come when they are very distressed. It is my duty to help them and make them feel better by all means,” says Banda.

She says with good management at home and in the hospital, patients with cancer at stage three and four can live long.

She believes being a palliative nurse is a calling.

“You must have patience and make quick decision. You should also be a good listener who empathises with the patient,” she says. 

Banda says many nurses are not willing to take up palliate care because its demanding. 

She says it is unethical for doctors to tell patients how much time they have left in their end days since this traumatises them.

Her worst nightmare is attending to a patient who needs urgent care when the facility has inadequate resources including drugs.

“Some come with wounds to be dressed and cleaned but at times, we cannot offer the services,” she says.

Banda gets fulfillment in her job when patients who are on their death bed bounce back to life. 

She admits that the job can be psychologically draining, especially due to the helplessness that comes with knowing that nothing more can be done to help a patient due to limited resources. 

Banda recalls how a patient with skin cancer was taken to the facility gasping for breath but there was nothing they could do. She died in her hands.

The region has three oncologists. Two are at JOOTRH, and one at the hospice. There are three palliative nurses, one at JOOTRH and two at the hospice.

Banda says she gets overwhelmed since she also visits patients at home.

Her assistant, Otieno, says being palliative nurses makes them advocates who have to speak up for patients at their time of vulnerability. She equates caring for a cancer patient to planting a seed which needs watering and close care.

“The worst moment is when you have hope and the patient succumbs. It is a constant reminder of the reality of death,” she says.

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Palliative nurseJane BandaJaramogi Oginga Odinga Teaching and Referral Hospital