Published on: Wednesday 07 Oct 2015 at 09:16
For example, our team of St Clare Clinical Nurse Specialists (CNS) in Palliative Care play a pivotal role in helping co-ordinate the individualised care of our patients. By working in close partnership with GPs and District Nurses, they can help to deliver holistic care that supports the individual needs of each patient.
Here, one of our CNS’s, Gill, gives an insight into what the role entails…
8am – Arrive at the Hospice. Check any phone messages that have been left overnight and see what new referrals have been received ahead of the daily referrals meeting. Check the day’s caseload to see which patient visits are scheduled and make initial phone contact with new patient referrals that have been allocated.
8.20am – Go over paperwork in preparation for tomorrow’s Gold Standards Framework multidisciplinary case review meeting with healthcare colleagues from the Hamilton Practice in Harlow to discuss collaborative working and how together we can ensure best practice for all patients with palliative care needs.
9.15am – First visit of the day is to a lady in her 40s with breast cancer who has been suffering from severe vomiting and nausea. Carry out a full patient assessment to understand her medical history before advising on a change of medication to better control her symptoms. Call the out of hours GP to arrange a prescription and the pharmacist in Dunmow to ensure the correct medication is available. Also speak to the district nurse to update them ahead of their next visit. Before leaving, refer the patient to our Hospice at Home team for additional support.
11.45am – Arrive in Loughton to see a gentleman in his 80s who has just been discharged from hospital having recently been diagnosed with terminal lung cancer. Hospice at Home team has already visited this morning to help with personal care and make him as comfortable as possible. He is nearing the end of life, so speak to his wife and family to prepare them for what to expect in the coming days. Also discuss his final wishes within his Advance Care Plan and refer to the local End of Life Co-ordinator for extra support.
2.30pm – The next patient is a dad-of-three in his late 50s in Harlow who is undergoing chemotherapy having been diagnosed with pancreatic cancer. He had been very anxious about the treatment and possible side effects and how they may impact on his quality of life, particularly with regard to work. Had previously had a long discussion with him about the pros and cons of treatment, and after consideration he decided to go ahead. After his chemotherapy treatment he experienced extreme sickness, so arrange with his district nurse and GP to get an emergency drug box to be used prior to his second dose of chemotherapy to combat any further symptoms.
3.45pm – Final patient visit in Epping to see a woman in her 60s who has recently been diagnosed with motor neurone disease. She is very fearful of the future and is struggling to come to terms with her diagnosis. Refer her to St Clare’s Day Therapy team as she may benefit from attending our neurological group. Also speak to her about arranging for our physiotherapist and occupational therapist to visit her at home. Make a note to speak to our Patient & Family Support Team who may be able to provide the family with additional support and guidance.
5pm – Return to the Hospice to check emails and phone messages and make sure all patient records are up to date. Write letters to the GPs and district nurses of all patients seen today regarding their care before heading home for the day.
Interested to know more about the work of our St Clare Clinical Nurse Specialists in Palliative Care?
You can read Michael’s story for a personal account of how our St Clare CNS’s helped his family.