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BLOG: How chaplain Pat ‘happens by’ at Derriford Hospital

Jackie Butler meets a special person whose calm and comforting presence is hugely valued by St Luke’s Hospice Plymouth hospital team and those they care for.

The first thing that stands out about Pat Brenton as she walks through Derriford Hospital is her gentle, unhurried pace. All around her doctors, nurses and support staff stride purposefully to their destinations, while she strolls mindfully, always alert to anyone along the way who might welcome a kindly face and a confidential chat.

Some days she’ll leave her desk in the chaplain’s office to visit a ward and only get as far as the first bench along the corridor before being drawn to the side of a young lad worried sick about his grandma who is dying upstairs, or a woman in the throes of shock after losing her husband.

Impromptu encounters and casual arrivals underpin her approach as the hospital’s palliative and oncology chaplain, a role in which she works closely with St Luke’s Hospice Plymouth hospital team.  She likes to “happen by”, making it easier for people to welcome or reject her presence in the moment, although she does also pre-arrange some appointments.

“The less I say, the better. It’s about letting people have the space, especially St Luke’s patients,” says Pat. “They don’t necessarily always want to share their thoughts with friends or family. We just turn up and they can talk if they want or not if they don’t. I am not going to cry or be judgmental. We have that little bit of distance, which helps. Then, once they have consented to our visit, we can go back again.”

Pat, her four chaplaincy colleagues and a pool of trained and experienced volunteers are there for everyone in the University Hospitals Plymouth NHS Trust – patients, visitors and staff. Between them they visit up to seven out of 10 patients and families who are being supported by St Luke’s nurses and doctors. They try to make sure appropriate pastoral and spiritual care is there for those that want it, backing up the hospice’s compassionate expertise and advice, and the care of Derriford’s own clinical teams.

On Tuesdays, Pat joins the St Luke’s virtual morning meeting where she’ll listen in to Clinical Nurse Specialist Julie Ayers, Nurse Consultant Martin Thomas and the rest of the clinical team as they discuss existing and newly referred patients on their long lists. Bypassing clinical, care or discharge details, as the nurses and doctors talk, Pat picks up on each patient’s potential emotional or spiritual vulnerabilities, mostly sensing which individuals she should visit. It’s a seamless collaboration, fed as much by instinct and subtle looks as words.

“I like to think that I can get there before anyone asks me,” she says. Amid discussions around each patient’s condition, their prognosis, their discharge home, or transfer to St Luke’s at Turnchapel, and their loved ones who might be struggling, Pat will occasionally chip in to say she or a colleague have already been to see a particular person and will return, or that she’ll simply “happen by” to introduce herself and listen.

“I try to follow up as many as I can during the week with help from my colleagues. We have a good rapport with St Luke’s and an excellent trust between us and I really value their generosity to share this with us.”

Each person’s circumstances are unique, from complex scenarios where people’s lives have been tipped upside down by a catalogue of illness and painful bereavement, to those who are resigned to their terminal prognosis and seeking to live out their final days as fully as possible.

When there’s an urgent referral, the St Luke’s team can call on Pat or her colleagues 24 hours a day – one of them is always on duty. “They can refer someone to us any way they want – email us, ring us up or bump into us in the corridor,” she says.

Pat, who was a nurse many years ago, was ordained as a Church of England minister 18 months ago.

“I did a course in listening with the hospital and wanted to volunteer, but they didn’t have a vacancy straight away. They said I could come and help in the office in the meantime, so I did. When I became a pastoral care volunteer, I knew this was what I wanted to do. I spent more and more time on the wards. They couldn’t get rid of me! Gradually I realised my calling was to be here as a chaplain.

“I think I saw 240 relatives in the first year before I was ordained, working with former palliative and oncology chaplain Andy Barton before taking on the role myself,” adds Pat, who also now co-teaches the department’s training course for volunteers.

Although the roots of her vocation lie in her longstanding Christian faith, she stresses that her daily work has nothing to do with religion in the conventional sense and everything to do with humanity, compassion, and discretion. Pat wears a white collar while she’s on duty but doesn’t think it gets in the way.

“We approach in a very gentle way, so people feel comfortable and are able to be themselves. They can just be real because they know we are genuine and focusing on them, not ourselves. I try especially hard when I see someone is fearful, particularly at the end of life.”

With that thought in mind, it was fascinating to silently shadow Pat as she set off on her rounds visiting three patients in different wards who’d been mentioned at the St Luke’s meeting, insisting that, like her and the rest of the team, I take no phone, camera or notebook.

While a widow with a shock terminal cancer diagnosis waited for her transport to St Luke’s at Turnchapel – where her mother died a few years ago – she was relieved to quietly share with Pat the anxiety of knowing that it would be her final journey.

In a side room with a butterfly motif on the door to honour a patient at the end of life, Pat knocked gently to introduce herself to a man and his wife as they sat either side of the bed where his elderly mother was slipping peacefully away. They clearly found comfort in the chaplain’s presence and the chance to confirm the old lady’s faith and love of hymns.

Pat’s final call was a return visit to a man with a life-limiting illness and a bad fracture who the day before appeared to give up hope. But today he was chatty and animated, buoyed up by the St Luke’s team’s belief that he could return home to live out his last months or weeks with the right help. After firmly declaring his non-belief in God, he told Pat he felt the need for something spiritual to hold on to.

Back at the team’s office, next door to the chapel, we joined the other chaplains and volunteers to reflect on the morning and talk about anything that stood out or concerned us. That kind of support and back-up is vital when you’re listening to stories that are often extremely emotional, and Pat also makes sure she and the team open their listening ears to all St Luke’s team members.

“We try to support them confidentially on an individual basis, as well as collectively,” she says. “I will make a conscious effort this week to ‘happen by’ if someone in the St Luke’s team seems upset about something or not themselves.

“They do carry a huge workload. Where do you put all that emotion? They can come and dump it here if they wish. It can sometimes be hard to share with your team when everyone is in the same boat.”

Julie and the St Luke’s team feel privileged to have such a great working relationship with the hospital chaplaincy and access to their valuable support.

“It’s so reassuring for us to know that Pat and the other chaplains are there, not only for our patients and their families, but for our team too. Pat is a really calming presence and an incredibly warm and patient listener, and she seems to know exactly the right time to ‘happen by’, as she calls it,” says Julie.

When a St Luke’s colleague died suddenly at the end of last year, Pat held a quiet period of reflection in the chapel for the team, based on what they wanted – a poem a reading, and a candle lit in memory. The St Luke’s nurses and doctors also take time out on a weekly basis to come together in the hospital chapel for reflection, lighting a purple candle in remembrance of patients who have died.

“The chapel is a lovely place where everyone can come and sit in peace,” adds Pat, whose quiet, thoughtful, and confident demeanour seems to put everyone at their ease wherever she goes.

She and her colleagues are glowing examples of how St Luke’s and Derriford are working hard together as one big team to achieve the very best holistic care for patients who find themselves in hospital as they approach the end of life.

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BLOG: Dying Matters Awareness Week 8 – 14 May 2023

Personal grief when you work in health and care

How we can become more compassionate around terminal illness, dying and grief in the workplace is the focus for this year’s national Dying Matters Awareness Week (8-14 May).

The devastating and often prolonged effect of losing a loved one will have been experienced by more than half of all employees during the past five years but offering the right support – in the place where many of us spend so much of our lives – is something many managers feel unconfident about, according to Hospice UK.

People often assume that those working in health and care are better equipped to cope with loss because they encounter it on a regular basis. In reality, whether you’re in a caring or support role at a hospice like St Luke’s, in a hospital or nursing home, or working as a funeral director, celebrant or spiritual leader, it doesn’t make it any easier to cope when terminal illness or bereavement comes calling in your personal life.

In fact, these extraordinary environments can present many situations that resonate deeply and make it harder for people to carry out aspects of their work, particularly in the early days of the grieving process.

Many of us will be very familiar with practical measures and advice for self-care that can be useful following bereavement, even regularly advising and supporting the loved ones and carers of people who die in our community. But, when we’re enveloped in the fog of our own heartache, it’s not so easy to listen to ourselves and recognise our own needs.

It’s comforting to know that there is always someone you can reach out to you if you are facing personal loss. In these specialist sectors of our communities we are often fortunate to be surrounded by professional, empathetic people who know exactly what to say to grieving friends and colleagues. They won’t shy away from asking how you are, listening to your worries or having difficult or painful conversations.

Sharing your feelings with colleagues is a good starting point but, depending on your organisation, your first port of call for formal support and understanding will usually be your line manager.

When you’ve lost a loved one, the last thing you need is to be under pressure to carry on working as normal. Compassionate workplaces and managers will give you permission to take time out to reflect, talk, and tap into things that can help you slowly accept your situation and begin to heal.

No two people’s grieving is the same. Each of us deals with our loss in an individual way and a good employer will be as supportive and adaptable as possible, taking into account the special circumstances we are faced with in our jobs and the need to keep services running.

Crossovers with cases you deal with professionally may inflame your personal distress. Maybe you have lost an elderly parent with the same degenerative disease as one of your patients or there’s a young person under your care who is the same age as a personal friend who has died. These are the kind of trigger points that can be avoided by accepting that someone else may need to step in to take over particular tasks for a while.

Many health and care organisations will have robust in-house policies for good practice when managing bereavement, including arranging compassionate leave and smoothing the way for your return to work when you’re ready.

Line managers can be prepared to handle personal bereavement within their teams by becoming familiar with their organisation’s bereavement and compassionate leave policies.

If you are a health care professional, you may already have established relationships with your local hospice and, like St Luke’s, they will probably be more than happy to offer you or your teams advice on how to cope with personal grief when death and bereavement are part of your job.

  • Common feelings after bereavement are anger, shock, numbness, sadness, fear, guilt and anxiety. You may also experience physical symptoms like difficulty sleeping and eating.
  • It’s OK to take time to process what has happened and look after yourself. Rest, try to sleep and eat well, get outside in the natural world and reach out for support from family, friends and colleagues.
  • It may be very difficult dealing with other people’s grief and distress while you are grieving yourself and a period of compassionate leave could be beneficial.
  • Try to retreat to a quiet place for reflection to punctuate your working day – perhaps a hospital chapel, a library or outdoors in nature.
  • Don’t be afraid to talk about the person you’ve lost and find comfort in rituals, a funeral and personal remembrances.
  • If you are worried how you are feeling, speak to your GP and consider external counselling. Services, like those provided 24 hours a day by Simplyhealth, can be invaluable – grief can often be at its darkest and most painful in the early hours when no one else is around. You may not think you need this straight away but grief can sometimes feel more difficult after the initial period of shock and realisation.

For more information on death, dying and grief in the workplace visit Hospice UK’s Dying Matters Awareness Week

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