Published on: Wednesday 28 Apr 2021 at 09:00
Here Anne shares her passion for caring for people in their own homes at the end of their life; how the Hospice at Home team continued to care throughout the COVID pandemic; and what the Nurses Are Needed campaign at St Clare will mean for more local people who need our support.
Anne’s career in nursing
“I have always had a passion within me to be a nurse, and knew that nursing was something I always wanted to do. But I didn’t actually train to be a nurse until after I had my children, and I started my nurse training as a mature student when my youngest child was a year old.”
“I’ve been a nurse for over 20 years now – and the majority of my career I have worked out in the community, nursing in people’s own homes. Going into nursing I thought I wanted to work in A&E, or as a midwife, and I never expected to be a community nurse. But after my first placement in the community, I just absolutely fell in love with community nursing.”
“I have got a major passion for, and am a great believer in, people being nursed at home.”
“I was a community nurse for around 18 years, caring for people with all sorts of conditions, and not just giving palliative or end of life care. Then for my last few years in district nursing I was a team leader overseeing the south of the Epping Forest area. Moving to my role in St Clare’s Hospice at Home team, 2 years ago, meant that I could go back to my roots as a hands-on nurse. I want to finish my career in the way in which I started – nursing people in their own home. Working at St Clare means that I also get to specialise in palliative, end of life, nursing and I am passionate about that.”
Caring for people at home is a privilege
“When I go to care for someone in their own home, I am a guest in their house. It is a privilege to be invited in, and to care for someone in their own home.”
“When I go to care for someone in their own home, I am a guest in their house. It is a privilege to be invited in, and to care for someone in their own home.”“I really believe that when someone is experiencing any kind of illness, but especially care at the end of their life, that they need to be empowered to make their own decisions about how they are cared for, and what their choices are. We need to really hear what the patient wants, and I think the home environment is a great place for that. People are more relaxed, and it is less stressful than being in a hospital environment, and that helps people to make these important decisions about their care. There is something about being in the comfort of your own home that empowers people. And that’s what I really enjoy about nursing at home.”
“I am driven by the fact that home, more often than not, is the right place for someone to be cared for at the end of their life.”
“In certain circumstances, when a family is unable to care for the person at home, another place may be better. But I often find that family members’ fear of caring for their loved one at home is just a barrier that can be overcome. When you see a person arrive home, it is so normal for their relatives to feel scared or anxious about caring for them there. But with the right support in place, and our regular visits and support throughout their journey, we can help them. I love to help relatives through that.”
“It is an absolute privilege to care for a person, at the end of their life in their own home, and so rewarding to be able to care for their family too.”
“On a hospital ward the family and visitors are coming and going, and you don’t get to build that sort of relationship. But when nursing at home, we are invited into that family, and caring for the loved ones of the patient is a massive part of our role.”
“The pathway that a person is taking at the end of their life, is a pathway that we cannot control, or stop. But we can make the journey as pain free and as dignified as possible.”
Caring for the families too
“For the family of the person who dies, that experience of death is one which is never forgotten, and will leave them with a lasting memory. To arrive at someone’s door, and see that they are petrified about their loved one dying, and to bring them through that journey, and through their grief after the event, is a such a privilege for me.”
“When I visit a family after their loved one has died, we often reflect on how far they have come. At the beginning they may have been scared to have their loved one at home at the end of their life, but we’ve supported them to do a wonderful thing – to care for them in their own home, as they wished, with our support.”
“I am an experienced nurse, but if I was in that position and had to care for one of my own loved ones, I know it would be completely different and I would feel scared and upset. So I can only imagine how daunting it must be for someone who does not have a nursing or clinical background at all, to cope with. That is why it is so rewarding for me, personally, to support families who are going through this journey – and to empower them to be in their own home.”
Giving holistic care from across the Hospice
“I love working at the Hospice, because it is more personal and intimate than working in other healthcare settings. You get to work face to face with a range of different professionals – from GPs and district nurses, to clinical nurse specialists, occupational therapists and physiotherapists.”
“There is a huge network of support and expertise in the Hospice, all gathered in one team in order to support patients at the end of their life.”
“We work in the same room together, not in separate buildings or departments, so we can deliver truly holistic care to our patients. Being able to bring that all-round care into a patient’s own home is very empowering as a nurse. If my patient needs help with complex symptoms, I know I can reach the clinical nurse specialist for them. If they need support from a physio, I know I can arrange that for them. Having that team, and that network of support for our patients under one roof, is very empowering as a nurse, and means I have the confidence that we can deliver outstanding care.”
Being a Hospice at Home team leader
My role as a Hospice at Home team leader, involves managing the case load of patients who are being cared for at home, and managing the team of Healthcare Assistants who go out and give personal care to the patients. As the team leader, I make the first visit to a person at home, to make an assessment of their needs and see what support we can put in place. I am also seeing how the other, varied services that the Hospice has to offer, can also support them. So that might be support from one of our social workers, clinical nurse specialists, the chaplain or occupational therapists. We look at all their needs, and how we can support them fully – signposting them on to other services if there is something we cannot provide ourselves.”
“A major part of my role is to support our dedicated team of Hospice at Home healthcare assistants who are giving personal care to patients. If a patient needs nursing support we provide that, helping with symptom management and supporting the district nurses in providing nursing interventions. We work alongside our colleagues in the district nursing teams to ensure that our patients get the care they need. Often, when a person is nearing the end of their life, their condition can change rapidly and they need urgent support. So we are there to step in and support.”
“One beauty of nursing is that you never clock watch – the time just ticks away, which is a good sign to me!”
“I also still learn something every single day. After 18 years working in the community you would think that you’ve seen and experienced everything – but after just 2 years at St Clare I have had some major new experiences.”
“As a nurse, you always have to be open to learning – and to change your way of working in response.”
Working through the COVID pandemic
“I am so proud of the Hospice at Home team for how we have worked throughout the COVID pandemic. At no point did anyone in the team shy away from caring for patients, and it is true to say that we carried on as normal. We still didn’t say no to anyone, and we carried on running our service every single day – that’s what I am most proud of. We certainly had to change the way in which we work, and adapt to the situation, but we delivered the same care from day one of the COVID pandemic.”
“It’s been difficult to cope with the extra emotional load of caring for people during COVID, and the practicality of wearing all the extra PPE – but we’ve worked together as a team, and with our colleagues in the community – to support one another.”
“It hasn’t always been easy caring through the COVID pandemic, and there are certainly some very difficult experiences that come to mind when I reflect back on this time.”
“For me, personally, there is one family that I will never forget. It was right at the start of the pandemic and there was a lot of anxiety surrounding the situation at the time – so emotions were running high. A patient with COVID was being cared for at home, she was dying, and she refused to go into the hospital. As the team leader, I was the first person to go into the home and visit the patient to make an assessment.”
“I just remember her daughter opening the door to me, and being taken to see her mum in the bed. The mother wasn’t old at all, but her breathing was so bad, and it was clear that she was going to die – it was such a sad situation. It then unfolded that the patient’s partner also had COVID, and that he was dying as well. We found out that he was being sent home from hospital so that he too could be cared for at home.”
“In my 20 years as a nurse I have never, ever nursed two dying patients side-by-side in a double bed. That in itself was a huge challenge for us as a team.”
“The Hospice at Home healthcare assistants all stood up and agreed to help, proud to go in and do their job caring for this couple. It was very difficult, both emotionally and physically, and such a sad situation. Both patients had quite severe needs, and so we had to work closely together with the district nurses to care for them – but we did it, together. The couple died together, at home.”
“That same weekend we heard that other members of the family also died in hospital from COVID. We can all get quite complacent about COVID when the numbers begin to drop, but when a whole family dies from the virus, it really hits you.”
“We’ve had a few cases like that during the pandemic – not quite to that extreme – but certainly we’ve cared for many COVID end of life patients at home. We’ve never refused people our care because of having COVID, but we’ve had to know their status so that we can properly manage their care, and protect our staff.”
“I’m proud of our team that we have never refused anybody our care because of COVID, and we did as much as we possibly could throughout this pandemic.”
“As a team, each of us has gone through so much. A few years down the line I think we will look back on this time and get comfort from what we have achieved, and the way in which we continued to care for patients and their families through this pandemic. Even as a nation, we will look back one day and realise that our resilience is higher than we thought. I believe we’ll be able to take something positive away from this time.”
Nurses are needed for the future
The expansion of our nursing team is such a positive development for the Hospice. It is going to allow us to do even more of what we are currently doing – and to help us reach and support even more people than we currently are.”
“At the moment, there are only three trained nurses in the Hospice at Home team, so the more nurses with the skills and knowledge to support people at the end of life, the more people we can help. With more trained nurses we will be able to develop our service in order to support the needs of palliative care patients, and to take the pressure of the generalised district nurses delivering care to people at the end of their life. At the moment, the district nurses offer the main nursing provision for end of life patients in our area – as well as having to care for other patients with different illnesses. But as specialists in end of life care nursing, St Clare would be better placed to give that care.”
“Having more qualified nurses in the Hospice at Home team, throws the door open to a wider, bigger, more knowledgeable and experienced service – reaching more people. We are seeing much more complex cases now, and we need to be focusing on giving more in-depth care to meet people’s needs – and that requires more nurses.”
-Anne
Nurses Are Needed
Anne’s story is being shared as part of our Nurses Are campaign, as we fund more registered nurse posts across our clinical teams – supporting more local people to have the best possible death, pain free, in the place of their choice.
Find out more about our Nurses Are campaign here.
