Thoughts from Hospice at Home, International Nurses Day 2021

It is International Nurses Day today. It has been a challenging time for nurses all over the world during the Pandemic. We asked Nick Saunders, our Hospice at Home Manager for his input on how the period of time throughout COVID-19 has been for the Rowans Hospice at Home Nurses.

It is a long-standing complaint amongst nurses that we are stereotyped: ‘Doctor’s assistants’, ‘too posh to wash’, ’not bright enough to be a doctor’- to name only a few. Perhaps this misunderstanding has been reinforced by the media and television dramas, and maybe as a profession, we have become too preoccupied with how others perceive us. Nevertheless, during the global pandemic, the media has actually been instrumental in overturning some of these impressions. Scenes of Intensive Treatment Unit nurses working tirelessly with desperately sick patients, among a bewildering array of tubes, cables and flickering screens, have provoked a tidal wave of public sympathy and admiration. I can certainly never remember a time when there has been such a focus on our NHS, and I hope that this development will one day mean that nurses are finally perceived as the modern healthcare professionals they truly are.

It should be remembered however, that exciting television scenes in Emergency Rooms and Intensive Treatment Units do not reflect the full breadth of the nursing discipline. I am a very proud member of the Rowans Hospice at Home team, but the situations in which we practice are far removed from those of an ITU. Hospice at Home work with people who are definitively at the end of their lives. There is no hi-tech monitoring equipment, because there will be no recovery or reprieve. Instead of the earnest flurry of the hospital ward, our patient may be cared for in a small bedroom with the quiet tick of a clock or a portable CD playing favourite songs. The patient could be tended, for the most part, by loving family members and friends.

The priorities of care for the dying patient are very different to those whose return to good health is more assured. Those with extensive disease may be oppressed by distressing physical symptoms, which need careful monitoring and treatment. Others may be troubled by intrusive thoughts that make it impossible to relax. Much younger patients may be grieving for the children they are going to leave behind and will never see grow to adulthood. Any of these examples can lead to unimaginable anguish for the patients and their families, and it is the job of our nurses to be alongside these individuals as they move toward their closure – whatever that means for them. To quote Dame Cicely Saunders, who is noted for her work in the birth of the Hospice movement: “you matter because you are you, and you matter to the end of your life”.

Preserving dignity and choice is vital to dying patients, and for some that is achieved by remaining in, or returning to, the comfort of their own home – rather than being cared for in an institutional setting. During an extraordinary public health emergency, Hospice at Home nurses were instrumental in achieving this important goal for many patients, and ensuring that those approaching the end of their lives were not separated from their loved ones.

I recall one terminally ill lady in her nineties who was particularly determined to stay at home, despite being bedbound and having no relatives at all who lived nearby. She got by with help from a neighbour and a care team who visited regularly. In the meantime, she had BBC Radio 4 for company, to which she was devoted. Our team would also go late evenings to check that she was safe – an event that always seemed to surprise her, no matter how many times we called. Eventually, as she began to falter, we decided that we would sit with her overnight, so that she would not be alone in her final moments. It seemed entirely appropriate, as this grand, courageous lady passed away just after midnight, that the National Anthem played her out on the radio.

Throughout the COVID-19 Pandemic Hospice at Home, together with our partners in the District Nursing teams, have quietly but effectively continued to deliver complex care to the most vulnerable and distressed in our communities. We do not conform to any stereotype, and we will continue to get on with our work as we address the longer-term impact of this unprecedented episode. This will go under the radar as far as the media is concerned, and probably always will. But it will not go unnoticed by our patients, their families and all the wonderful people who support Rowans Hospice Charity.

We would like to take this opportunity to thank all the nurses here at Rowans Hospice Charity for the amazing work that they do.

 

*Image taken in line with Government Guidelines at that time.