On the frontline: “We treat the person, not the disease”

May 11, 2021
ellenor

ellenor’s inpatient ward has seven beds, supporting people from the age of 14 upwards who are living with a broad spectrum of complex, life-limiting conditions. That could mean cancer, chronic respiratory illness, motor neurone disease, or anything else requiring palliative treatment.

“Because we’re classed as a specialist palliative care unit, we can focus specifically on a holistic approach. We cover all the patient’s needs, whether that’s personal care, wellbeing, physical or mental, spiritual, or pastoral – it’s all in our remit” Chris says.

This is one of the key advantages a hospice setting provides over that of an acute hospital, she explains, as it allow nurses to “treat the person and the family, as opposed to the disease”.

Chris describes her role as being 40% clinical and 60% managerial; taking care of patients, while also coordinating the network of services that caters to all aspects of the patients’ welfare, including GPs, social services, physiotherapists, the wellbeing team and occupational therapy.

The start of the pandemic

Chris had been in her role for just six weeks when the coronavirus pandemic began, bringing with it seismic changes to how the ward would operate. The number of beds more than doubled to 15, as it opened its doors to ‘step down’ patients, supporting the local acute hospital and other health and social care providers. Throughout the crisis, the ward has been providing a safe place for patients to recover before being reunited with loved ones.

Alongside the logistical concerns that come with higher patient numbers, it was adjusting to a new kind of patient that Chris says was most challenging for her nurses. “It was a huge difference for the staff, because they were looking after patients that weren’t palliative, and people with illnesses that weren’t commonplace to what the nurses were used to. They had to adapt to the fact that these people had a different set of health needs”.

Challenges for loved ones

Balancing the wishes and involvement of the family alongside health and governmental guidelines has been a key – if demanding – focus. For instance, while the wearing of PPE has been largely welcomed by families, it’s still been difficult to get used to for all involved.

“The hardest thing we’ve witnessed is a relative with PPE – which includes the wearing of gloves – that wants to hold their loved one’s hand. We try and convey the risks, but why would you stop someone taking off a glove to hold their husband’s hand?”

ellenor was also forced to stop the frequency of visits by family members, something Chris feels “goes against the hospice ethos”.

“It’s hard for the patients, and for us as well – because we’re the ones saying no. If we put ourselves in the patient’s shoes, how would we feel? That has been one of the toughest aspects of COVID-19”. Sadly, it’s also led some patients to turn down admission to the inpatient ward, knowing that the guidelines will limit their family contact there.

Silver linings

To an extent, the impact of lockdown restrictions was lessened by the ward’s embracing of video conferencing tools such as Zoom, which helps keep family members in the loop.  There have been some silver linings too - Chris and her team had the pleasure of sending home two centenarian patients – one aged 100, and the other 102 – both of whom had made full recoveries on the ward.

Chris says this it’s this positive outlook, and not the “doom and gloom” often associated with palliative care, that’s representative of ellenor’s inpatient ward.

“Despite what our work is, we still find the time to laugh with our patients. There are still lots of smiles. But above all, we’re still here. We’re still helping. We still care”.

More information

Our Frontline is a partnership between Shout, Samaritans, Mind, Hospice UK and The Royal Foundation of the Duke and Duchess of Cambridge. It offers round-the-clock one-to-one support, by call or text from trained volunteers, plus resources, tips and ideas to look after your mental health.

Hospice UK’s Just ‘B’ Counselling & Trauma helpline.  The service is a free confidential national helpline available 7 days a week from 8am to 8pm on 0300 030 4434, providing bereavement, trauma and emotional support for all NHS, care sector staff and emergency service workers.

  • Call the ‘Just B’ Counselling & Trauma helpline on 0300 030 4434
  • Visit the Our Frontline site

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