Hospicecare at home - the role of community nurses
PUBLISHED: 13:00 13 July 2014
FOR 25 years, Weston Hospicecare has been providing end-of-life care in the community with a dedicated team of specialists.
Community nurse specialist Gwen Harding has worked at the hospice for 18 months in a team of eight other nurses.
On average, the community nurses spend 187 days with a patient – although this can differ greatly with each case.
The eight nurses saw nearly 900 patients, spent 9,106 hours in face-to-face meetings with patients and 6,231 hours on the phone to them last year.
For Gwen, a typical day starts when she checks her messages to see if there have been any overnight calls or messages from patients.
She then has a meeting with the staff from the in-patient unit to talk about any issues, before heading off to visit patients.
As well as the essential face-to-face sessions, Gwen also liaises with GPs or district nurses to make sure patients’ symptoms are under control.
Gwen said: “Regular contact with families is important and I encourage them to contact me if they have worries or concerns regarding their loved one, because they play an extremely vital role.
“They are there all the time.
“They are crucial so it is important to hold them up, support them and answer their questions – and tell them they are doing a good job.”
Gwen also acts as a bridge between the patient and the hospice, and can offer information about the services it can provide, such as occupational therapy, the day hospice and the chaplain.
She said: “There is always an unpredictable element in between the normal routine of seeing patients.
“I might need to arrange pain-killing drugs and sickness drugs, so I speak to GPs to improve the level of symptom control.
“It is also a teaching role, we do this all the time and as such we can be a resource for other medics.
“I would say we are the key worker in terms of advising patients where to go, so there is a great deal of responsibility involved.”
Instead of being a reactive role as some might expect, community nurses are there to anticipate the course of a patient’s illness and draw up a plan to assist them.
She said: “I make individuals aware of the choices available to them, where they would like to be cared for and where they would like to die.”
Advance care planning aims to take some of the pressure off of families so they can focus on spending quality time together.
Gwen lives in Weston with her two teenage children, and says she likes to take a long run to reflect after a long day.
She said: “The best part of my job is building a relationship. The first visit can be quite daunting, but once they have met me they can relax a little.
“Of course, the job can be upsetting because I am a human being.
“But being a hospice nurse is special because of the time we can give to patients and families.
“We can offer spiritual and emotional support, not just physical. When a patient opens up to me, sharing can help shift the fear because they are not alone in it.”