Yastremska S.O. was on training from 13 November to 12 December 2001 in town Misisaga, Ontario, Canada. She was invited by Sharlota Koso, the general program manager from planning and integration of palliative care, Care Partners agency, Toronto (Canada). Yastremska S.O.  also had a support of Lishchenko Nataliya Olexandrivna and Boychuk family.  

The purpose of this training was to explore the features of the palliative care for incurable patients and become familiar with functional responsibilities of nurses of different educational levels (junior specialist, bachelor, master).

The main task of the Canada health protection is to reduce the period of hospitalization to three days. The further care is provided by the state organization CCAC (Community Care Access Centre).

         CCAC is the organization that monitors, regulates, directs and controls the process of treatment. The information about the discharged patients from hospital comes here.

There was a meeting with Mrs. Olive, general manager who treats the palliative patients. She gave a general description of their institution and explained the overall care scheme of palliative patients.

The meeting with general manager of the Community Care Access Centre (ССАС)

Working on solving general questions about the palliative care

There are special agencies which practice the immediate treatment and care. In one of such agencies (community nursing organization, CarePartners), where the general managers are Mrs. Charlotte (Charlotte Koso) and Mrs. Roberta, I had to work on training.

General program manager from planning and integration of palliative care, Sharlota Koso

In this agency works only nurses (there are 600) of two categories: RN (bachelor degree) and RPN (junior specialist degree). The nurses of this agency take care of patients at home in the town Misisaha near Toronto.

Palliative care at home of the patient

Nurse disconnects IV system after chemotherapy at home

Paper work in hall of the patient’s house.

CCAC sums up the work of its employees each year and honors the best. In the nomination "The Best Nurse of 2011" was our colleague Lishchenko Nataliya.

Nataliya Lishchenko gets an award from the state agency ССАС, which coordinates the palliative care at home

Honors the nominees of the CCAC awards at the festive party in CarePartners agency

I visited the Trent University as part of expanding the partnerships with nursing schools of the world. One of the directions of preparation in the University is the preparation of nurses-bachelors in the nursing school. As a result of negotiations with dean of the faculty Dr. Kirsten Woodent and academic staff (Dr. Sandra White and Dr. Beryl Cable Williams) we agreed to work together, share some curriculums and in the future to arrange the student exchange.

General view of the Nursing School in Trent University

Visiting the practical-skills lab with the dean of Nursing School and lecturer of the discipline “Palliative care”.

Rooms and equipment for practical skills

“Palliative care” lecture for nurses-bachelors of the 3^rd course

During my investigation of different ways of palliative care for incurable patients I visited and become familiar with the work of nurses in the inpatient hospice, in the home of nursing care and in the hospice department of the hospital.

At the hospital Credit Valley

With the duty nurses of the hospital palliative care department

One of the wards of hospital palliative care department

Discussing with Katie Kitley, MSN, which provides an independent reception of patients in the hospital polyclinic.

The Dorothy Ley Hospice

The wall of thanks for financial help to Hospice from patient’s families

With the stuff of Hospice: manager Karina and volunteer Sandra

The cooking process for hospice patients is regulated by volunteers under nutritionist control.

Equipment for weighting the bed-patients

Trolley-chair for personal hygiene procedures for palliative patients

Equipment for moving the patients

Means for palliative care

One of the rooms in Retirement Home, where Ukrainian emigrants (which need assistance) stay.

Meeting with the direction of the Retirement House: director, chief economist and manager

Dinning room in the Retirement House

General view of the room for rest and communication

I express a sincere appreciation for promotion and organization of the trip to Leonid Yakymovych Kovalchyk, the rector of Ternopil state medical university named after I. Ya. Gorbachevskyy. The result of this training is a clear understanding of palliative care in Canada, the acquisition of new practical skills of nurse-bachelor and the inclusion of elective course "Palliative Care" to the curriculum of nurses-bachelors (distant as full-time form of education). There are also made the first steps to cooperation with Trent University in Canada.