A Day in the Life of a Hospice Nurse

Alison Plumb, Deputy Manager of our Inpatient Unit, shares what it’s like to care for local people and families at St Clare Hospice.
Published on: Thursday 09 May 2019 at 15:31

I started at St Clare Hospice a couple of years after the Inpatient Unit opened in 2000, as a Bank Nurse to fill in shifts as needed. I was, at the time, working on Rowan Breast Unit as a night nurse. However, when the opportunity arose for a night position at St Clare Hospice, I applied, as I had two young children to care for at the time! I got the job, and started in a part-time position in 2002.

Since I qualified as a nurse, my passion has always been to work in a hospice and offer end of life care.

I am very fortunate to be able to do a job I love and help people die with the best care possible. I feel like I am able to make a difference, and sometimes I’m able to support people to go home if they want to, and have some quality time in their last weeks or days.

Dame Cicely Saunders, who founded the hospice movement during the mid-20th century, suggested that we should enable patients to live the way they want to, until they die.

That is what St Clare is all about; making every moment important.

In February 2019, 16 years after I first started at the Hospice, I begun a new, exciting challenge of becoming Acting Deputy Manager of the Inpatient Unit. Now, in May 2019, I have been promoted to the role permanently!

I usually work three 12-hour shifts per week. A ‘day in the life’ of my role at St Clare begins when I walk through the door and greet the team of the day and the night team at 7:30am. We usually start the day with a cup of coffee while we have a handover from the night staff, looking at how the patients have been overnight, and discussing their medication and how we can help manage their symptoms.

At 8:00am, I walk around and greet the patients. We can have up to eight people staying with us on the Inpatient Unit at any given time. Some may stay with us to get specialised symptom control so they can have an improved quality of life, whilst others may be in their last stages of life.

As I do my rounds, I check on our patients, giving them their 8am medication. The Healthcare Assistants help them with their breakfast and attend to any personal care they need. Through chatting and giving medications, you can ascertain what your patients’ specific needs are and how they are getting on; if they are improving or there has been a change in condition.

What matters is that you show you care for each patient and their family, and you make them feel important and valued.

At 9:00am, we have handover with the doctors, which is more in-depth on some days. Often, the multi-disciplinary team of occupational therapists, physiotherapists, social workers, clinical nurse specialists and the Hospice at Home team will also attend to see how we can best help our patients. The care of a hospice patient requires all of the team because we aim to treat people holistically; looking at them as a whole person, which means addressing their physical, social, emotional and spiritual elements of their condition.

After the meeting has finished at 10:00am, we find out if there are any admissions and referrals, or manage any current discharges on the Unit where people are returning home.

Throughout the day, there is a lot to organise, including ordering medication, planning discharges, preparing for admissions, as well as the care of patients.

Supporting families and finding out what their needs are is also a big part of the day.

Sometimes, they need lots of support and a lot of my time is spent being alongside family members as they come to terms with their loved one’s illness.

At St Clare, there are specialist family support services available, but our nursing staff on the Inpatient Unit are able to help by just being there in the moment. Often, that is all that’s needed at the time.

We also offer family meetings to assist in getting a patient home safely, which can require support from different hospice teams who may need to liaise with nursing homes or district nurses. Sometimes, our Hospice at Home team will also step in to support a patient between being discharged from St Clare and when their new care package begins.

We all come together to ensure that our patients receive joined-up care.

Medication and comfort rounds continue throughout the day to ensure the patients get the best possible specialist care. This includes setting up syringe drivers (a small pump used to gradually administer medication to a patient) to better manage pain or other symptoms, or help keep the patients who are at the end of their life peaceful and rested.

We work 12-hour shifts to ensure continuous care. The patient will have their own allocated nurse for the shift, which enables us to really develop a good rapport with people and their families.

We often have a laugh together, and tend to the small things that make a difference.

It could be things like being able to bring a beloved pet, having their hair done or relaxation therapy.

The shift ends at 8:00pm after the handover to the night staff. We have a great team on the Inpatient Unit, and we all support each other. I am very privileged to have been working here for 16 years, and even if I’m a bit tired at the end of a shift, I always go home knowing that I’ve played a part in making a difference.

There are sad times on the Hospice, but there are also celebrations, such as weddings and blessings. In the sad times, we are always there to support each other, which is what makes the hospice such a wonderful place to work; because of the care we have for each other.

– Alison

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