As we head towards the close of this extraordinary year, which has seen our clinical staff work so tirelessly to keep giving their compassionate care, members of our team based at University Hospitals Plymouth NHS Trust share their reflections on these past turbulent months, during which time the hospital’s ‘one big team’ ethos has been tested as never before.
Earlier this year, when the hospital was in the eye of the storm, Specialist Nurses Linzie Collins and Becky Harris were among the St Luke’s staff who joined forces with hospital doctors and nurses on the frontline, looking after seriously ill patients on the COVID red wards. As they stepped up to do this, working flat out, their colleagues at the hospital were also pulling out all the stops to ensure that the terminally ill patients nearing the end of their lives still received the specialist care they required.
Listening to Linzie and Becky talk about their experience then – and how things have been since – with admissions rising again more recently, it is clear that it is not just their expert hands-on care that has made such an important difference, ensuring patients are more comfortable and at ease. It is also the way they have communicated with patients’ families, combining sensitivity and kindness with the clarity that is so necessary to gaining relatives’ understanding of their loved one’s prognosis.
It is this same style of compassionate communication that they have used to help their hospital colleagues feel more confident in having these difficult conversations with patients’ families, including not only newly qualified nurses who suddenly found themselves on the frontline of COVID care, but more experienced staff, too.
Linzi said: “Before joining the team at Derriford I nursed patients at Turnchapel, where having these honest conversations with families happens on a very regular basis. It is never easy but you realise that in being open with them and, in a sensitive way, being clear about what they should expect is actually the kindest thing you can do because it helps prepare them – as much as possible – for what is going to happen. It gives them the opportunity to tell their loved one all that they feel they want to say before that person dies, which helps bring them comfort and more peace of mind.”
Preparing their hospital counterparts to have these open discussions wasn’t the only way Linzie and Becky helped them with communication, though. Recognising that UHP NHS Trust nurses often have difficulty finding the time to make calls to patients’ families, Linzie developed a ‘communication folder’ containing a simple form to record dates, times and brief notes of conversations that took place.. Thanks to the simplicity of the form, it can easily be updated no matter what the time of the day or night the call takes place, even if it’s at 3am.
Linzie said: “Nurses are so busy that they just don’t have time to be hunting around for information. I felt this was something simple I could do to help make things a little easier, with all key details about conversations with family and friends recorded in one central place.
“It was rewarding being able to help in this way to relieve some of the pressure on the hospital team, who have been so brave and are so exhausted, and they welcomed our suggestions and help with this.
“Something that it really brought home to Becky and me is that in working for St Luke’s we have the benefit of time to spend getting to know our patients – it’s all part of our holistic approach. Time is such a precious commodity at the hospital and there are always so many demands on the nurses – they have to prioritise giving clinical care above all else.”
Of course, we can’t mention communication without highlighting how Linzie, Becky and their colleagues had to think ‘outside the box’ to help dying patients – and the loved ones who couldn’t be with them in person because of the pandemic – feel as connected as possible, despite the physical distance between them. Technology had a big part to play here.
Becky said: “I’ll never forget witnessing a Zoom call we facilitated between a patient and his daughter. As you’d expect, she was devastated that she couldn’t be at his side to hold his hand, but she was at least able to tell him over and again how much she loved him. It was heart-breaking to see, but I’m so reassured that she was able to have that conversation with her dad. In time, knowing he heard her say how precious he was to her will – I hope – help heal her memories.”
“Normal grief patterns have been lost in COVID-19 because of how fast things have happened, the restrictions on families visiting their loved one and even funerals having to be done differently, so being able to help – even in small ways – feels very rewarding for us.”
The final word goes to Dr Doug Hooper, Consultant in Palliative Medicine in our team at Derriford. He said: “Although the virus means people have had to stay apart in a way we have never witnessed before, at the hospital we have seen how in another sense it has brought everyone closer together. It is not just our St Luke’s team who have gone over and above but colleagues right across the hospital. While this year has felt exhausting and relentless, we have all learned from each other and are stronger for it.”