On September 30th, VHA hosted its fourth Paediatric Interprofessional Education Symposium, also known as PIES Day. This year’s event took place virtually for the first time in its history. “The event has come so far in four years. Regardless of how we’re meeting, I’m personally delighted that PIES lives on,” shares Kathryn Nichol, Vice President Quality, Best Practice, Research and Education and Chief Nursing Executive at VHA.

“In our new world of integrated care and Ontario Health Teams, we are working together often, but it’s really nice to be learning together as well,” she added.

This year’s PIES Day theme was Resiliency: Creating an Environment to Thrive. In addition to VHA Client Partners, clients & parents, and VHA’s interprofessional paediatric team, keynote speakers from the Temmy Latner Centre for Palliative Care and SickKids Hospital were also invited to join in the day’s activities.

Countertransference & Palliative Medicine

Dr. Jennifer Shapiro is a home care physician with the Sinai Health System Temmy Latner Centre for Palliative Care. Dr. Shapiro joined PIES Day as our first keynote speaker to share her learnings about Transference and Countertransference in Palliative Medicine.

Dr. Shapiro explained that transference is a theory which was coined by Sigmund Freud, referring to the unconscious redirection of patient’s feelings, attitudes and desires onto the clinician, often deriving from close relationships earlier in life. In contrast, countertransference is the unconscious redirection of a clinician’s feelings and desires onto a patient or client.

“In many ways, countertransference is why we develop burnout and compassion fatigue, and we have a hard time recognizing our feelings and end up feeling less resilient,” she shares. “And these feelings are not exclusive to palliative care. This is a universal problem that everybody experiences at some point in their life.”

Throughout her presentation, Dr. Shapiro reviewed personal case studies to showcase to effects of countertransference and presented a model for self-monitoring and reflection to make more objective care decisions.

The Caregiver Experience

Laura Williams, Client Partner and Member of the Client and Carer Advisory Council at VHA also joined PIES Day to share her experience. Outside of her role with VHA, Laura also works as the Director of Patient Engagement with the University Health Network.

“Typically I’m on the other side of this asking people to share their stories so that we can learn and improve what we do as an organization,” she says, “but I’m really happy to bring you into my family’s world.”

One of Laura’s two sons is a paediatric client with VHA. She says her journey began when Bryson was three months old as her family strived to give him the best start at life through many types of recommended tests and therapy. All the while, her family was struggling with uncertainty surrounding the root cause of her son’s condition, which was undiagnosed for the first decade of his life.

Laura explained that it was through those moments that her family found the resiliency and hope for them that much of the world is now learning through the COVID-19 pandemic.

“Before the diagnoses, we simply weren’t our best selves. We were learning,” shares Laura.

“Our lived experience with medical complexity is similar in some ways to the world’s experience with COVID-19. In many ways, this is how we’ve lived our lives for many years because the world is often not accessible.”

Laura left the group with some thoughts to consider about what caregivers and families might be experiencing in their own resiliency journeys, like vulnerability, exhaustion and isolation. And she had one last kernel of wisdom to share with VHA’s Paediatric Team.

”For those of you who do home visits, you may not be aware of how much clients or families anticipate the doorbell announcing your arrival,” Laura says.

“Anyone who comes into our home has become a part of our family history.”

Striving & Thriving Together Across Transitions

The last keynote speaker of the day was SickKids Hospital’s Krista Keilty, Associate Chief of Interprofessional Practice – Connected Care & System Integration. Krista joined the group to share her learnings and insights about working together in transition from hospital to home, and across the pandemic.

Connected Care is a program that works to enhance experience with transitions and build confidence, competence and shared understanding among children with medical complexity, their families and health care providers. Funded by the Ministry of Health and Long-term Care and located at SickKids, Connected Care offers a range of services and partners across the continuum of care to coordinate, improve health and safety, spread standards of paediatric practice and deliver greater value across the health system.

“The invitation from VHA was very special to me,” Krista says. “I have been working in the SickKids to home care space for more than 30 years and I’ve appreciated partnerships with the many VHA nurses, PSWs, and rehab specialists I’ve met along the way.”

Krista kicked off her presentation by sharing how experiences early on in her nursing career working in home care led her to the role she’s in now.

“So, to fast-forward 30 years ahead, it’s my grand privilege to work with Connected Care to continue to work in the field that brings hospital to home and home to hospital, to build on shared understanding, ways of moving forward, ways of supporting each other to be strong enough and to bounce back when we have tough times together,” Krista says.

Krista also shared key focuses for Connected Care, including family caregiver education, and a case study about creating a bundle of care approach to ease transitions for families, as well as resources and tips for healthcare providers to stay resilient as they continue in their impactful roles.