Jeanette, a resident of Kigali, was diagnosed with cervical cancer last year.
The mother of five says the cancer was in its late stage where treatment was impossible. Because of her condition, she was depressed, and developed psychological disturbance to the point that she couldn’t eat.
"I was going to die of starvation at that point, and not the disease. Although I was under medication, I was unable to cope and accept reality,” she says.
But with holistic nursing care, she says the ordeal has been made more bearable.
The Ministry of Health has integrated holistic nursing for patients under palliative care in 42 district hospitals across the country to help patients with incurable diseases.
Holistic nursing focuses on promoting wellness by removing physical suffering and healing the whole person.
Diane Mukasahaha, the national coordinator of palliative care at Rwanda Biomedical Center (RBC), says this kind of approach has seen a number of patients who were bedridden become liberated, and some even still work to provide for their families.
UNDERSTANDING HOLISTIC CARE
She says that research shows that when there is no holistic care for a patient, at least three people in the family are affected.
"Imagine three people in the family being affected because of the pain of one person, these people do not sleep because of depression and there is a lot that can’t go on because of this,” she says.
Mukasahaha says that when one is suffering from a curable disease, the illness is attend to and treated.
However, when it comes to an incurable disease, focus is no longer on the disease, because it is not treatable.
Because of this, she says, they focus on holistic care.
"If someone is very sick or has a complicated life condition, they are not just in bad physical condition, but also bad emotional, social, spiritual and psychological,” she says.
James Tuyizere, a trained health practitioner on palliative care, says it starts with the assessment of the patient, and that this is not just about the physical aspect.
He notes that although the physical aspect is there, emotional assessment is also required.
For instance, he says, if one has stage four cancer and one part of their body is going to be amputated, they are not just suffering physically, they also have emotional pain.
He explains that the emotional pain is linked to the disease and the outcome of the treatment, the background as well as the loss, and that’s why multidisciplinary support is required for the patient.
He adds that when a patient loses a body part, they are thrown into despair; some even end up refusing to take their medication.
OTHER ASPECTS
When it comes to social aspects, Vedaster Hategekimana, a senior officer at Pain-Free Hospital Initiative at RBC, says some people close to a patient may think that they have done all it takes for the person to get well, and when nothing changes, they give up—like the person is dead already—because there is nothing that can be done to for them.
According to Practical Nursing,a medical information website, illness has the power to strike down the mightiest of individuals; no one is immune. Nurses must be knowledgeable about how diseases affect patients. Due to the high patient load and often intense time constraints placed on nurses, it can be easy to simply treat the physical being and move on to the next patient, resident, or client.
It is important to care for the whole person and to see them as just that; a whole person, not just a patient or diagnosis. Holistic nursing care involves healing the mind, body, and soul of patients. It involves thinking about and assisting patients with the effects of illness on the body, mind, emotions, spirituality, religion, and personal relationships. Holistic care also involves taking into consideration social and cultural differences and preferences. Every person is their own individual.
There are many easy ways to improve relationships with patients and promote a healthy psychological, emotional, and spiritual environment.