Rationale This abstract describes postgraduate-level teaching for newly hired nurses at a community-based home hospice service in Singapore. This project is intended for the continuous professional development of in-service staff and faculty and is implemented during the probationary phase of employment for new staff.

Background Palliative home care nurses undertake the arduous responsibility of caring for the sick and the dying within the comfort of their own homes. The nature of the job necessitates healthcare providers to practice in a space outside their comfort zone, which adds to the already emotionally and mentally demanding work within the field of palliative care. New nurses joining a community-based hospice service require comprehensive and holistic training to face the challenges.

Summary of Work We developed a novel training programme that emphasised person-centred learning, anchored on the relational elements of learning. In a job that mostly sees nurses independently visiting and managing patients alone, we focused on building a strong sense of community within our new hires to guard against the solitude of independent practice. A group-based training format was developed, with regular in-person sessions, and new staff were encouraged to share their struggles and successes for advice and affirmation accordingly. This allowed for mentorship beyond the traditional preceptorship model of nursing education. It gave new nurses access to a multidisciplinary team of seniors they could turn to, focusing on sharing narratives from daily practice to demonstrate and affirm each nurse’s learning and progression. Specific aspects of mindfulness in the workplace are deliberately introduced as part of the training sessions to foster a culture of open communication and to establish a psychologically safe space. Key elements of mindfulness, such as non-attachment, equanimity and non-reactivity, are referenced and modelled during class discussions, as these have been observed to be particularly relevant to the field of palliative care, where burnout and empathy fatigue can be particularly challenging and intimidating to new hires.

Summary of Results The feedback received from our new hires was overwhelmingly positive in favour of the group-based training format. Cultivating a safe space wherein new nurses could bring their doubts and queries was a clear positive point, with some stating that it was less stressful than having to report all activities to a single mentor. Multiple new hires reported that the prospect of having a safe space to return to regularly, during the transition from supervised to independent practice, was validating and reassuring.

Discussion and Conclusion The group-based discussion uses tools similar to those employed in group therapy. It has proven useful in allowing individuals to better reflect on their learning and to process issues specific to palliative care, such as transference from a grieving caregiver or empathy fatigue.

Take-Home Message The challenges of home hospice care are manifold, and the training of new staff must include holistic development of the person alongside their clinical skills. Employing a group-based format cultivates a strong sense of belonging and trust that facilitates reflective and collaborative learning. Creating a workplace culture that normalises staff learning from each other, given the heterogeneity of our training backgrounds and experiences, improves the tendency for prosocial thinking and behaviours and fosters open communication and interpersonal respect at work.