Nurse practitioner Anita Wild dreamed of bringing new life into the world, not being witness to its passing. But as is the case with best-laid plans, life had other ideas.

“I never saw myself working in palliative care. As a six-year-old, I set my sights on becoming a midwife, and this was always my life’s ambition.”

Then, one day, as an undergraduate nurse working in Melbourne, the spark of a new passion took hold.

“I fell in love with oncology nursing. I had some patients in rural hospitals dying of cancer, and I nursed them during their terminal phase of care.”

Inspired by years of experience in oncology and armed with a Post Graduate Diploma in Oncology/Palliative Care, Ms Wild decided it was time to go home.

“I enjoyed five years of oncology nursing before moving back to Bendigo to spend more time with family and friends.

“When I first returned home, I wasn’t sure what I wanted to do. So, I started a causal position with Bendigo Health working between the Day Oncology Unit in the Cancer Centre and the Community Palliative Care Service.

“It was there I realised the true value of palliative care nursing. It cemented my passion for helping one of our most vulnerable population improve their end-of-life experience.

“Before working in palliative care, I never understood the complexities that these patients deal with both physically and psychologically due to their disease burden, multiple co-morbidities, incurable disease and the psychosocial burden on their health.

“I always saw palliative care as a fluffing the pillows type of nursing, and I cannot believe how wrong I was!

“Specialising in palliative care has been nothing short of rewarding, and I’m so grateful I made this decision.”

The decision to become a palliative care nurse practitioner again changed her career trajectory and brought a holistic approach to patient care.

“I recall being amazed at the level of clinical expertise and knowledge of nurse practitioners, and I envied their increased autonomous practice and ability to prescribe.

“Since being endorsed as a nurse practitioner, I feel I have excelled by being able to assess, plan and treat patients appropriately.

“I now provide a more holistic approach. I apply advanced practice knowledge to ensure patients are assessed critically, tests ordered as required, timely diagnoses made, and patient-focused treatment plans.

“I have a strong focus on early intervention and timely access to care, which also incorporates anticipatory prescribing to ensure patients achieve their preferred place of care and death.”

While not a new concept, palliative care is still not routinely treated as a specialist area, which is challenging, explains Ms Wild.

“I still see that other specialities do not routinely refer patients or recognise palliative care as a speciality in its own right, which impacts patient care and leads to increased symptom burden that otherwise may have been avoided.

“Palliative care continues to be seen as a speciality that provides end of life care for patients in the terminal phase of care.

“Although palliative care does and will always continue to provide this care, palliative care is much more than the terminal phase of care.

“A ‘palliative patient’ if you like, is seen as someone in the last twelve months of their life and can include patients from all walks of life.

“More education needs to occur to promote palliative care in all aspects of life. We need to shift the focus from terminal care to improve our patients’ quality of life – as this is what most of my role entails.”

Many myths abound about working in palliative care, explains Ms Wild, but one of the most tiring is that it’s boring.

“I’m always asked if I’m bored working in palliative care. So, I just chuff and refrain from eye-rolling.

“I know palliative care doesn’t seem exciting in that bright lights of emergency or ICU way…but it brings the joy of getting to know somebody on a profoundly personal level.

“The patient is aware they don’t have much time left on earth. So, they’re generally more accepting of their diagnosis and want to live as well as they can for as long as they can.”

Palliative care has its difficulties like any nursing speciality, but, surprisingly, it not what you might think.

“In palliative care, having conversations around death and dying is a lot easier because patients are aware they’re dying.

“They just live in the hope that they’ll live a happy and fulfilled life for as long as they have left.

“I honestly believe the one power we have as a human being is to listen and give somebody our time.”

The emotional toll is easier on difficult days with the support of colleagues, but self-awareness and self-care are vital in palliative care, says Ms Wild.

“I have a great team around me, and we share the burden. We understand that we’ll find cases challenging in one way or another.

“Occasionally, there are patients who have an emotional effect on me. They might remind me of my elderly grandparents or be a child just beginning their life with so much potential and so much to look forward to.

“Going for walks, looking after your mental health, catching up with friends and family – it’s the work-life balance that’s the most important thing.”