Angie Hayes, Community Palliative Care Nurse in the West of Somerset describes her day and the difference she thinks St Margaret’s Hospice Care makes…
Can you describe your day?
The role of the St Margaret’s Hospice community nurse specialist is different from any other nurse to meet our patients needs and every day is different! Anything you plan tends to go out of the window! We start the day with a huddle, to discuss all the patients we are currently caring for as well as any new referrals and any queries that have come in overnight from the adviceline. We cover a large area, so we work to ensure we are covering that effectively with the right team members.
Having worked out our priorities and what kind of action is required for each patient we will start our visits, although throughout COVID-19 we have also been using video and telephone calls as much as possible to lessen the infection risk for our patients and their families.
This has proved effective, but you cannot always assess patients and the environment as well on these calls, people try to be brave, perhaps trying to mask symptoms, to not make a fuss. My patch is the Exmoor area and its surprising how much of the area struggles with mobile signal and internet connection. This is why for St Margaret’s it has been so important to continue our visits safely and appropriately, no matter what COVID-19 has thrown at us.
What has it been like during the pandemic?
I will be honest it has been scary, the first visit I went on, trying to put on my, apron, mask, and gloves at the side of a road. The unknown has been scary too, we know that we are doing everything we can to protect our patients, but we all have families and at first it was a worry.
We have had to reassure our patients and their families as this past year has increased the anxiety that everyone has felt, particularly those who are unwell or vulnerable. It has been so hard for family members who have not been able to see loved ones or support them in the way that they want to.
Social distancing is out of our comfort zone, we are used to holding hands, we are used to hugging people. Standing in a loved one’s living room with them upset because they feel helpless to see what's happening to their partner / mum / dad, my immediate reaction is to comfort. To show them it's ok to cry its ok to feel whatever they are feeling at that moment and we just aren’t able to do that in the same way now. Although we don’t say anything differently, I worry it's not as effective when we can’t hold someone’s hand, I can’t physically comfort them but we still try and we won’t stop until the day comes when we can all go back to our natural reactions.
What difference do you think you and the team make?
I think the fact that now many patients are having bad news told to them over the phone, perhaps on their own in hospital, is taking its toll. When I first make contact with a patient I do try to do this via a phone or video call before arranging to meet them. But it is not uncommon when I make that first call to hear in their voice that they aren’t ok, you can hear they are struggling. They could be muddled, they might not understand what is happening, being told a diagnosis over the phone or on your own doesn’t give you as much space or confidence to think of all the questions you should ask. Immediately I will ask if I can come and see them, the relief in their voice floods in instantly. I think many patients have been surprised that someone is coming to see them. It means so much to our patients to have a face-to-face chat in their own home. Even if this is through a mask.
Patients repeat it back to me, almost in disbelief that they will be able to talk things through. Over the last 12 months they just have not had that human contact, that confidence you have to ask questions that we see when people are in their own surroundings, their own home. That I think is where I make a difference, from explaining things properly, answering questions, encouraging them to start planning ahead, to looking at their tablets and explain what each one is for. It’s so important, it's what our role is and although its challenging at the moment it should always remain what we do. Why should we stop doing that because we’re in a pandemic, as long as we are keeping our patients and their families safe? For our patients we’re a lifeline.
What does it mean to you working for St Margaret’s?
I have a passion for palliative care and the difference it can make to a patient and their family, I love the fact that I can go into someone’s home and make their journey a little easier. I love building those relationships, getting to know about our patients, not just their illness. Hospice care and support is not the same as hospital care. Hospitals have a very important but different role to play. In a hospital setting, with the vast number of patients and departments, there is not the same opportunity to get to know patients as the people they are, like we know our patients, it makes a huge difference.
I’m able to do my job to my best ability because of my passion but also because of the team I work with. We support each other as well as our patients and those close to them. No matter what, you know that your colleagues all care as you do, when I have holiday, I know that someone will carry on so that patients will be cared for always. I think the whole of St Margaret’s works as a huge team and it means we can all provide the care that, as nurses with our passion, is the best possible palliative care. Our patients get the care and support they deserve at a time when they need it most.