Where are you based?
Arthur Rank Hospice at Shelford Bottom is my base but most of the time I’m out in people’s homes across the county. My patients could be based anywhere in Cambridgeshire, including down in Royston, or up in Wisbech. Occasionally I might travel up to 150 miles each night! We will go to great lengths to make sure we see our patients whenever possible but there is also a district nursing out-of-hours service in each of the areas. So, if we need backup, then they will usually be able to help.
The Hospice at Home service has grown with demand as the pressures on our health service have increased. Our on-call role has evolved because we offer very specific expertise and because the range of conditions our patients have, has increased hugely over time.
The Healthcare Assistants
like to have us On-call Nurses, on-hand, where possible, because of our specialist knowledge and the fact we have a bit more time available. Unlike some of the other healthcare professionals who are being pulled in many directions, we are able to stay for a little while, so we can assess the situation with a patient in more detail and help support them further.
What do you actually do?
My job is mostly assessing and responding to symptom problems. The Healthcare Assistants call me and say they’re worried about someone for such and such reason. I come into the home where they are based, assess the individual patient’s need and then give them medication or help as necessary. The Healthcare Assistants usually make a very good assessment but if there is anything alternative required, I might also need to liaise with the out of hours GP service, like if there are any issues with medications.
The healthcare assistants are very good at communicating, but sometimes they might need support explaining what’s going on to the family. The family are often up and very worried about their loved one, so if I’m there I can help explain why things are happening and how we will proceed. It’s very much about hearing their needs, listening to how they are feeling and then responding appropriately to support them.
Sometimes I might visit six or seven homes in one night, and some of these might be revisiting patients who need extra support. It’s very often the case that one patient needs more assistance. We are a specialist service and we are able to respond as quickly as possible to sort out symptom problems. In most circumstances, we are also able to verify death, assuming that one of our team was there when it happened. This is often very much appreciated by families because it can really help speed the process up and allow them the space and peace they need to begin the grieving process.
What’s special about your role and what keeps you doing it?
The job satisfaction is huge. As the On-call Nurse, you know that when you go out, you can improve things. Even when medication isn’t needed, we can listen, support and help someone communicate how they are feeling. You know that you are needed when you are called in and that you can make a difference and that is extremely satisfying. That’s the bottom line really.
I feel exceedingly lucky that I’m still able to work at my age and there aren’t many jobs where you know you can have that sort of effect, but I feel like every day I’m able to make a difference. It’s a privilege, going into people’s homes, seeing into their lives and being welcomed in. You see all their photos. I’ve learnt how to live, watching other people live.
Equally, it’s very rewarding supporting the Healthcare Assistants in their role within family’s homes, because they’re out there on their own. There’s very little contact with anyone else and they’re entirely responsible for really huge stuff. Of course, they get training, but it’s a very big and important job, so I try to do whatever I can do to support them professionally and personally.
The relationships we have between each other in the Hospice at Home team
are very personal and that’s what keeps us delivering this service to the best of our ability. It’s amazing really: I think everyone’s purpose is for the patient and the family and that gives us all a mutual point of contact. We know we’re all working towards the same aim and that can be said of absolutely everybody. When you’re out there, you know you can do something to help and make a difference, but I really think that we get so much more back than we give.