Your support helps provide care to patients and families in their own homes. We followed nurse Lisa for a day to find out more.
North Devon Hospice is all about helping people live their best life, even if they have a terminal diagnosis, and the majority of care actually takes place in the comfort of people’s own homes. This includes visits from the hospice’s Clinical Nurse Specialist (or CNS) team. To find out more about this largely unseen role, we followed a typical day in the life of hospice CNS Lisa Davies…
Lisa’s day starts early, catching up on patient info and messages from the evening before. “I can check on the system to see if there’s been any changes with the patients in my care,” says Lisa. “Once I’m caught up it’s time for our 9am ‘capacity’ meeting, where our hospice community team discuss new referrals as well as any deaths in the last 24 hours. Once that’s done it’s time to start the bread and butter of our role, which is visiting patients at home.”
Community CNS’s like Lisa are almost always the first person from North Devon Hospice that patients will see. They get involved with people who have an illness which means they are likely to be in their last year of their life, although everyone’s prognosis is of course unique. Lisa and her team have an expertise in controlling symptoms from such illnesses, which means their support helps people to live well despite their diagnosis.
“My first visit is to Sandra, to see how she is after radiotherapy. She’s on high dose steroids too so I want to see how things are going with her pain control.” says Lisa, who finds Sandra in pretty good spirits. However, there are things which concern Lisa and she will follow up to make sure Sandra’s changing needs are being met.
Lisa can action this immediately at her next appointment of the day, at Barnstaple’s Litchon Medical Centre. Each hospice nurse like Lisa is twinned with a local GP surgery throughout North Devon. It means they catch up frequently and work with that practice’s doctors and nurses to ensure patients are getting exactly what they need.
Lisa is here for the regular Gold Standards Framework meeting. She explains: “The Gold Standards Framework is a nationwide system to help care for patients who are towards the end of life. It uses green, amber or red lights to show how poorly or well patients are, so that everyone involved knows what level of care and support is needed. At Litchdon Medical Centre I catch up with all the GPs and the district nurses so we’re all on the same page about our patients.”
One of Lisa’s afternoon visits is to a lady who is new to the hospice and being visited for the first time. “It’s a privilege to be invited into patient’s homes, and it’s the only way to get a real sense of what they’re dealing with and how they’re coping. We never really know what to expect, and this visit is particularly challenging as the family are facing a huge number of medical, emotional and practical battles. I make sure the patient’s medication is suitable, to keep her comfortable at home, but I also refer the family on to a service who can help them claim the appropriate benefits as they’re having financial struggles. That’s a much overlooked part of being diagnosed with an illness like cancer.”
Difficult visits like this prompt the question as to how Lisa deals with the rigours of the job, caring for people who are going through unimaginably tough times. “Absolutely it affects me,” she says. “You can’t totally put it out of you mind, but I’ve got a really supportive team that I work with, and we’re always talking things through. I also have a family at home that keep me really grounded.”
The life of a hospice community nurse is not an easy one, but it’s one which Lisa has always striven towards. “This line of work is always where I saw myself being. It’s been nine years at the hospice now and I love it. We never really know what’s going to happen in a day. We can have our visits planned but things can happen and we just have to respond accordingly. It is emotionally very challenging, but I also know we’re making a difference and helping people at a really difficult time. I really do think I’ve got the best job in the world.”
The people of North Devon are certainly grateful that Lisa feels that way.