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.