Voluntary assisted dying (VAD) became available in NSW in November 2023, following an 18-month implementation period. The Lamp looks at the introduction of VAD at Nepean Hospital in Western Sydney.
Elizabeth McKervey is the VAD clinical nurse consultant for Nepean Blue Mountains LHD based at Nepean Hospital.
She coordinates the LHD’s VAD team, provides clinical education, and supports patients, their families and ward staff.
The Nepean Blue Mountains LHD VAD team includes an admin assistant and several doctors in part- time roles.
Patients in the Nepean Blue Mountains LHD who request VAD support are referred to the VAD service.
Elizabeth has 35 years of nursing experience, including many years in cancer care. As the clinical nurse consultant, she assists with coordinating the patient’s pathway to accessing VAD.
She talks with the patient to make an initial assessment of whether they are eligible for VAD, and assigns a coordinating practitioner to do a clinical assessment.
This is followed by a series of mandatory steps before the coordinating practitioner can apply to the independent Voluntary Assisted Dying Board for a medication authorisation.
NURSE EDUCATION
Elizabeth educates nurses on the legal and clinical aspects of VAD – complementing the online education available via NSW Health’s My Health Learning page (course code: 501951057).
“My role is to provide continuous support for nurses and staff on the ward, whether it be education or pre- briefing and debriefing,” she said.
“That applies to all nurses, whether they have a specified role in VAD, or they are a ward nurse caring for a patient who has made a request.”
She pointed out that nurses are allowed to have a conscientious objection to VAD.
“This means a nurse can have as little or as much involvement in the VAD process as they feel comfortable with.
“Any nurse can legally provide information to a patient who asks about VAD.
“It could be the phone number for the VAD service in their LHD, or 1300 802 133 for NSW Health’s VAD Care Navigator Service.
“Nurses can talk to the patient about the process and support them and their family as they go through the process.
“If the nurse has been caring for a patient for a period of time, the nurse might feel comfortable supporting a family right through to post-death care, as they might after the death of any patient.”
Elizabeth said the presence of a dedicated VAD team has been a source of comfort for patients and families.
“In my role, I aim to spend as much time with patients and their families as they need,” she said.
“There is a lot of gratitude from both patients and families. They say the presence of the team in Nepean Blue Mountains LHD has made them feel supported to pursue the option of VAD.”