In 2006, Government of India formed a committee involving experts in palliative care from various parts of the country to create a national policy for palliative care. These experts found that health care curricula had inadequate inclusion of palliative care content, skills, and minimal inclusion of end-of-life content in healthcare textbooks. They also identified a need for training and continuing education in palliative care with a special focus on undergraduate medical and nursing courses.
The expert committee understood the need for a curricular and policy reform to educate a future generation of health professionals who can provide high-quality palliative care services. The initial attempts to integrate palliative care into the Undergraduate curriculum was started in 2006 -2007, followed by the submission of a Public Interest Litigation (PIL) WP (C) 76/2007 before the Supreme Court of India. But, even the representations to the Medical Council of India and Indian Nursing Council (INC) for incorporating palliative care into the undergraduate curriculum were unsuccessful during that decade.
In 2012, with the participation of the INC, the Ministry of Health & declared the National Strategy for Palliative Care for the five years. An essential aspect of this strategy was the appropriate inclusion of palliative care in the undergraduate nursing curriculum.
In 2013, Pallium India spearheaded drafting a palliative care curriculum for the UG Nursing course in collaboration with WHOCC, Calicut and other palliative care organisations in the country. Members of the drafting committee Mrs. Roselin V. Rhenius, Dr Nandini Vallath, Dr. Vidya Kumarasamy, Dr Lulu Mathews, Dr. Rajashree K.C, Prof Joann M. Eland, Mr Jayakrishnan Kalarickal, Mrs Alice Stella Virginia, Mr Prince Verkey, Mr Jochen becker- Ebel, Mrs Shakila Murali, Mr Swarup I and Mr Shamnad S. This drafting committee has prepared Modules on Principles of Palliative Care, Communication Skills, Symptom Management in nursing care, end of life nursing process, Palliative Care nursing Procedures and facilitator manual. Representing the drafting committee, Dr M R Rajagopal requested Indian Nursing Council to accommodate the above modules with due consideration to the existing syllabus.
The commitment towards this mission is evident by multiple in-person representations by the members of the drafting committee, especially, Dr MR Rajagopal, Dr Nandini Vallath and Sr Alice Stella Virginia, to the INC and MoHFW several times. They stressed the necessity of integration of palliative care into the UG nursing curriculum, pointing to the lack of adequate palliative care nursing skills. Attempts to facilitate implementation of the request were also followed up several times by Dr Sushma Bhatnagar, Sister Hanife McGamwel, Mr K.V. Hamza, Mr Suresh TP and Ms Anu Savio Thelly. The happy news is that INC recognised the need for training and continuing education in palliative care in 2021. A 20-hour mandatory module on palliative care was added to second-year BSc Nursing. This is undoubtedly a significant milestone.
(This report has been prepared by Ms Anu Savio Thelly, Nurse Consultant, Dept of Palliative Medicine, Mahatma Gandhi Medical College and Research Institute, Pondicherry)