Palliative care doctor shares highlights of working in Broken Hill

by Heather Wiseman, Palliative Care Australia, 6 September 2016

Ms Wiseman talks with Dr Sarah Denham, the sole palliative care doctor in Broken Hill, New South Wales, serving a population of 32,000 people spread across 195,000 km².

I learned as an intern you can make a difference from the beginning, by learning good communication skills and by connecting with — and really caring for — patients as fellow human beings. That is what has driven me to train and specialise in palliative care.

I got my first hospice job in 2001 and have worked in palliative care ever since.  I worked with Hospital Africa in Uganda for three months, in Sydney for six months, and then did my specialist training in palliative medicine in the UK.

We had a patient who wanted to stay out on his property until about a week before he died. He lived about 500km from Broken Hill.

We knew that as his condition deteriorated, he would need oxygen, suction, syringe drivers, injectable medications, an electric wheelchair, a recliner chair, and even a hospital bed. We planned well ahead of time, and sent equipment out to him on the mail truck.

One of the nurses and I flew to see him with the Royal Flying Doctor Service. We landed on the airstrip on the patient’s property.  We taught his wife how to give medications and set up a syringe driver. The nurse demonstrated on my arm to show her how to use a sub-cutaneous injection. It didn’t faze the wife at all. These people are all farmers and are used to doing this sort of stuff for their animals.

The nurse and I kept in touch with the patient and his family by phone, Skype and email.

He stayed on the property until a week before he died. Then he chose to come into Broken Hill because his elderly mother lives in town and he wanted to see her before he died.  We facilitated the Royal Flying Doctor Service to fly him from his station into hospital.

His only son’s partner was in the early stages of pregnancy at the time and they wanted to wait for a scan before telling the rest of the family. Because we have a small radiology department, we were able to arrange for her to have that scan early. That meant our patient was able to see a picture of his grandchild, and to tell his mother that she was going to be a great grandmother, which was pretty much the last thing he did before he died.

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