Nurse, Palliative Care Project (Consultancy)

Background

Médecins Sans Frontières/Doctors Without Borders (MSF) provides life-saving emergency relief and longer-term medical care to some of the most vulnerable and excluded communities around the world. As an independent medical humanitarian organisation, we deliver care based only on need, regardless of ethnic origin, gender, religion or political affiliation. Around 40,000 patients die in MSF’s Projects every year. Despite the valuable efforts of Palliative Care clinicians working with MSF, we have not yet been able to address quality of death and dying for most of these.

Medical managers in charge of MSF projects need a simplified tool (algorithm / decisional tree) allowing them to identify specific service needs and integrate Palliative Care tools and resources appropriately from a programmatic / operational perspective.

Gap analysis

In previous years, MSF developed Palliative Care guidelines, toolkits, and training material for our Project Medical Managers. However, despite these and a few pilot projects, quality palliative care needs remain unmet in most projects.

Pilot projects to date, required high intensity specialist input and produced poorly adaptable tools which are non-user friendly. We need high-standard tools to support our medical staff to prioritise quality of death services.

MSF wishes to integrate palliative care services in more structural and sustainable ways in all its projects to improve quality of death and dying.

Objective

To further refine, adapt, pilot, and endorse palliative care training resources tailored for nursing staff across various departments and care levels, with the goal of supporting decentralised high-quality palliative care in MSF projects globally in line with our decision-making algorithm and holistic model of care – minimum viable product (MVP).

Key Responsibilities

1-Training Material Refinement, Adaptation, and Finalisation

• Refine and adapt the existing toolkit and palliative care training materials initially developed for neonates, paediatric (Inpatient Therapeutic Feeding Centre – ITFC, General Paediatric), and adult (chronic and inpatient) patients.
• Ensure these materials are adapted for the three levels of care services provided by MSF: home-based, primary, and secondary care settings.
• Pilot and test the adapted materials in selected MSF projects (Kenya, Malawi, Somalia, and India), ensuring usability and alignment with each project’s needs.
• Oversee the process of finalising and endorsing these materials with MSF management to ensure validation and approval for project-wide use.

2- Collaboration on the Development of a decentralised holistic Palliative Care model

• Partner with the Project Manager to co-develop (further refine/design) the decision-making algorithm and holistic model for palliative care, (MVP) ensuring it is:
• practical and feasible from a nursing perspective
• adapted to the realities and unique field challenges of MSF programs considering level of services (home base, primary and secondary health care)
• implementable in various care settings while aligning with the goals of nursing care for patients with advanced illnesses.

3-Networking and Collaboration for Palliative Care Support

• Map existing networks and partnerships relevant to palliative care within MSF and among external healthcare providers
• Facilitate collaboration and build relationships with other organizations and providers to support the integration and quality of palliative care in MSF projects.
• Engage with external stakeholders to ensure shared learning, support, and resources that benefit the MSF palliative care -mentorship etc.

Expected results / Deliverables

• A simplified decision-making and holistic care model of care (MVP) for Palliative Care.
• Task-shifting support provided to selected MSF countries of operation. (Nursing care in advanced illness)
• Development and implementation of a user-friendly repository Palliative Care toolkit. (determine how to set-up Palliative Care activities in existing care offers)
• Identification and formation of external Palliative Care partners. (Map. networks – nursing, providers).
• Development of a dissemination process with clear direction on use, adaptation, and feedback.

Activities

• Collaborate with the Palliative Care Project Manager and stakeholders.
• Lead the process of ensuring person-centred care and adaptation to essential social dynamics surrounding death and dying, including the role of families, community, spiritual leaders, and local healers.
• Ensure that the project maintains a strong focus on Paediatric Palliative Care in its multi-dimensional aspects.
• Accompany task-shifting processes centring on Nurses when possible and necessary in any MSF service.
• Create partnerships and formation within and outside MSF ensuring the availability of specialised support for projects.

Methodology

The consultancy will:

• collaborate with the leadership and management of the Palliative Care Project aimed at designing, prototyping, implementing, and evaluating adapted and customisable solutions to integrate Palliative Care in all MSF Projects
• develop and improve MSF’s understanding of the challenges and barriers to MSF Project service implementation
• revise MSF’s and external guidelines and toolkits with the aim of ensuring user friendly and adapted ingredients that provide necessary supportive material for nursing project staff
• network with MSF Nursing Care Advisors, Nursing Project Manager, and Nursing Association to ensure buy-in in the implementation of the projects’ outcome
• network with Paediatricians, Health Advisors, and external associations or organisations working on Paediatric Palliative Care to develop children and family-centred services
• represent MSF with associations and institutions specialised in Palliative care, particularly those located near MSF projects
• share with the specialist support for existing projects providing palliative care.

Assumptions made

MSF is a complex and ever-changing organisation, composed of a variety of medical and operational structures. The consultant will be required to navigate this complexity while creating generalised buy-in for the project implementation.

Nurses represent the majority of MSF’s staff in country projects but are often under-represented in operational decision-making structures. The consultant will be required to identify and make recommendations to bridge these gaps, in collaboration with the Project Manager.

It is presently unclear what percentage of the consultant’s time will be required in the support of existing projects.

In / out of scope

The initial focus of the project concerns patients who are dying and their families. Broader aspects of palliative care, although very important, are out of scope at this stage.

Profile of consultant

• Nursing qualification.
• Prior work experience as Nursing Manager of Palliative Care projects / activities.
• Strong knowledge and in location work experience in humanitarian settings.
• Proven skills in Paediatric Palliative Care, both from a medical and management perspective.
• Good understanding and knowledge of person-centred care.
• Teaching capabilities and evidence of experience.
• Strong communication and interpersonal skills including clinical person-centred communication, communication with families and communities, and communication among medical colleagues.
• Proven networking and representation skills.
• Ability to complete work within specific timescales.
• Fluent English language abilities.
• Research experience is advantageous.
• Commitment to the aims and values of MSF.