‘It was a game-changer’: how Wolfson funding propelled Helen’s hospice career

Having enjoyed her five-plus years as a Community Nurse Specialist (CNS) at Strathcarron Hospice, Helen Teed found herself thinking about a new challenge: how she could take the next step in her career and strengthen her passion for palliative care.

A conversation with one of the hospice’s consultants uncovered the skills that Helen would need to be able to help her to provide even better care. Those skills would eventually come from taking a four year, part-time master’s course – which Helen would have to fit in around her work at the hospice.

But postgraduate education can be prohibitively expensive for many. Thankfully, once she’d found the right training, Helen says that it was the hospice’s Community Lead Nurse who suggested that she apply for a Wolfson Professional Development Grant through Hospice UK, to help fund her place. 

These grants are aimed at supporting people working in hospices and palliative care to take further education to gain new skills and qualifications.

Helen explains that finding this funding was ‘a game changer:’

“The grant made it possible to do the course… because otherwise it would have come out of my own pocket. That would have been really difficult for me.

“Thankfully, the Wolfson Professional Development Grant paid for 50% of my master’s, and the hospice matched the other 50%. The timing worked really well, and applying for the grant had a really quick turnaround.” 

The application process itself was easy and straightforward, thanks to the Hospice UK grants application system:

“It’s a little like writing a job application: you've got to think about what the funder is looking for, what they’re actually wanting to hear – and how what I'm trying to do fits with that.

“With the evaluation afterwards you also need to show the impact of the funding – and you get the chance to dovetail it into a personal reflection for yourself which is a really nice way of reflecting back on how far you’ve come. For me, that was a double-win.”
 

So what were the day to day experiences that spurred Helen into her decision to take further training? She explains:

“When I had that initial chat with the consultant about my career plans, we talked about the types of skills that would be useful for me to have in my community nursing role. And one of the things we discussed was whether actually being able to examine patients would be quite helpful.

“When you’re a CNS, not being able to do those examinations can cause quite a delay. We might be seeing somebody at home, and suspect that they've got a bowel obstruction. But then we’d have to go back to the office, and arrange for the GP to visit. That can often really delay the time it takes the person to be admitted to hospital or treated, and obviously getting a GP to do a home visit can sometimes be a challenge as well.

“What was really telling was actually how having those advanced examination skills were hugely helpful. I have just completed a small audit of how often I use my advanced examination skills,  and what impact this had for the individual, their family and the health care team. 

"The findings indicated that being able to examine patients either stops them needing a GP visit but enables them to remain at home with the appropriate treatment or when needed can sometimes facilitate a more timely hospital admission.  Having these advanced assessment skills can help your decision making process, so you can assess whether you can manage this at home safely, and whether you can exclude more serious issues.  

“It's really about the speed in which you can respond to the patients in an appropriate and more holistic way, rather than having to disjoint the service and rely on other people to do part of the job that you're already in the house doing.”
 

Whilst having the education enabled Helen to make those assessments whilst already in situ, it also gave her something priceless – the confidence and belief in her own decisions:

“Being able to examine the patient helped reinforce an idea I’d had in my mind. It gave me much greater confidence that I was pursuing the right diagnosis and therefore the right course of treatment.

"So just being able to have that broader knowledge of medicine as a whole has helped me to make sure that we're not missing anything. It gives me a much higher degree of confidence that we're managing things appropriately.”
 

This wider knowledge of medicine and the confidence to examine and make diagnoses came to the fore when Helen was looking after a 65-year-old gentleman with lung cancer. Whilst he was presenting with increased breathlessness and new haemoptysis – something that Helen says could have been attributed to a progression of his disease. 

But Helen’s training helped her spot something else that could have otherwise been missed:

“By being able to examine his chest, along with knowledge of the risk factors for Venous thromboembolism, we were able to exclude a chest infection but there was a raised suspicion of a PE as a differential diagnosis. His Well’s score was 8, putting him at high risk of having a PE. He wanted further investigations and active treatment, so I discussed his case with the GP who then arranged for direct admission to hospital for further investigations.”
 

And the impact of the Wolfson Professional Development Grant doesn’t stop at patient examinations and diagnoses. In fact, says Helen, the knowledge that she developed on the course means that she can help teach her junior colleagues on joint visits, and when they are new to the hospice, or palliative care. It’s this education and leadership that means the grant funding is helping not just Helen, but scores of other colleagues at the hospice, and in turn, their patients:

“One of the things I found when we got to year three of the master’s is that I’d been doing a lot of the other pillars of Advanced Practice before even knowing that it was what was expected of you. 

“We had several new members of the team, and I'd spotted that they didn't come from a palliative care background. So whilst their community skills were exceptional, there were certain things they needed to learn about symptom management.

“Because I’d had my training, I went to my manager and asked whether I could do some teaching. Speaking to them, I was able to get a sense of where they thought the gaps in their knowledge were, and how they wanted to address that. 

“I then ran a teaching programme for them. I developed all the teaching resources and case studies which we worked through to upskill them over a six month period. It was really nice for me, professionally, and it was really nice to seeing them grow, develop and gain confidence in those skills.

“By doing that teaching, it taught me how to find the approach that works for everyone. Sometimes I felt like an approach wasn’t working – and that forced me to switch it up and try and find a concept that did engage people. So just having that ability to be responsive, to read the room and put the information out in a different way, it helped consolidate my own knowledge about it as well.”
 

Without the grant funding, Helen describes how her career started to feel like it was plateauing:

“I think without the grant, life would have just been much the same. I think I was beginning to get itchy feet…I kind of needed a new challenge and it's really given me that. It's actually brought me this whole new dynamic, in terms of coming to work every day, and I feel like I've my knowledge has just completely mushroomed. 

Having finished the third year of her course, she’s now stepped up into a more senior role at Strathcarron – which has brought with it a bright new phase of career opportunities and fresh challenges.
 

Helen describes how the hospice had recognised that there was a need for an advanced practice nursing role at the hospice.

What they didn’t know was what that would look like, or how it would fit both with the needs of their patients and the services that they offered. It’s something that Helen is in the process of establishing in her first year as their new Advanced Clinical Nurse Specialist:

“I'm on a bit of a fact finding mission, splitting my time between the ward and the community. I'm just really looking at opportunities for what might work.

“That involves going into the bed meetings each day and asking questions: if we didn't have a bed, what else could we be offering this person? Or, this person doesn't want to actually come in, so what else could we be doing if the CNS offering is not enough – what’s the middle ground? Can we help get people back home to where they want to be by providing a more intensive support short-term?

“A part of it is also education. Today I'm spending the day researching what other hospices have done and I’m finding that they’re saying you need to do what works for you, rather than taking a model off the shelf and fitting it in. 

“And really my training has allowed me to think about whether we could or should be doing this differently. Then there's also a role in there for me to be in more of a formal advisory capacity for the rest of the CNS team."

Whereas Helen’s role pre-master’s took more of a part in active service delivery, Helen describes how in her new position, as well as still being hand’s on, she’s able to step back and look at processes and systems from a strategic standpoint – all the while utilising her grant-funded knowledge:

“Before my master’s, I would have a caseload of patients and go and visit them in their home, or ring them. But now at the start of this  new role, I can really step back, look at the strategy, at how we can implement new services, create capacity and do things differently, and how we can utilise the skills that I've got.”
 

It can be all too easy, in any career, to get comfortable and forget about the importance of keeping oneself engaged through learning. Wolfson Professional Development Grants are an opportunity to invest in yourself, and for the hospice and end of life care sector, also a chance to help with workforce challenges. Helen explains: 

“We’re facing a massive crisis of ageing in the workforce with retiring nurses and actually there's a lot of succession planning that needs to be done. We need to invest in people to be able to keep them and develop them into the nurses who have that expertise. Then, not only can they operate at that level but they can also support new members of staff too.

“Grants like these are really helping that recruitment and upskilling. They help staff retention as well because I think if you’ve got somebody who is motivated and has been doing the same job for a number of years, they need something to keep that motivation going. And I think if you know you can't provide that within then there is the risk that people will leave and maybe even leave palliative care, full stop.”
 

When it comes to education, Helen says that she’s never regretted doing any learning or development. In fact, says Helen, not only does it give you more knowledge, but it also enthuses you for the job that you're already doing. 

Her advice to anyone working in a hospice is to just go for it – it’ll give you a new lease of life, and open up new avenues of thought.

Thank you to Helen for sharing her experience as a Wolfson Professional Development Grant recipient.

Find out more about Wolfson funding, below.