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In May, at the height of the pandemic, Dr Doug Hooper, Consultant in Palliative Medicine in the St Luke’s team at Derriford, shared how it felt to be ‘in the eye of the storm’ at the hospital, with this specialist team extending their work to support the hospital in caring for COVID-19 patients. Nearly two months on, with such admissions steadily decreasing, two of his colleagues – nurse Linzie Collins and Dr Roger Smith – explain how the experience has been for them, and how the team is adapting as it moves into this new phase.

Linzie, who joined the team in February 2019 after nursing patients at Turnchapel, said: “I think what’s been most remarkable is the way everyone – both in our team and across the wider hospital – has pulled together, supporting each other and quickly adapting to the huge amount of change that’s had to happen quickly due to the gravity of the pandemic.

“It’s been tough at times with new changes daily, sometimes even hourly, but what’s always been at the forefront of our minds is making sure we’ve all been as well equipped as possible to give our very best care to patients who are in their last weeks, days and hours of life.

“Not only did the hospital undergo a complete transformation, with many wards moved or designated as COVID-specific – and Oncology being temporarily relocated to the nearby Nuffield hospital to free up capacity – there was also the redeployment of many staff, including nurses from other specialities who were assigned to our team to help us cope with the anticipated surge in patients needing end of life care. Now that we’re seeing less people with the virus, they’ve been able to return to their usual roles.

“My work has included covering the COVID wards as well as looking after non-COVID patients, which has given me some low-level anxiety because I’m always aware of the risks involved, but it’s been so helpful that this responsibility is shared with my colleagues.

“What’s struck me is how positive and supportive everyone has been, despite the undeniable fatigue that set in coping with the crisis. We’ve all pulled together, and I especially want to thank St Luke’s Clinical Admin, who’ve continued to be a lifeline for us, handling calls and making sure things run smoothly, despite having to do all their work off-site at home.”

Linzie’s colleague Dr Roger Smith is working with St Luke’s as part of his training in palliative care.

He said: “Fortunately, Plymouth has not seen the very high number of COVID-19 cases some other cities have had, but we’ve seen a steady stream of people admitted to the hospital because of the virus, and this has been over a prolonged period. We’ve done really well as a team to manage it, thanks to excellent teamwork and the strong leadership we have, but I won’t deny it’s been challenging at times.

“Not only have we been working with the uncertainty the crisis has brought, it was difficult using the necessary PPE with FFP (filtering face-piece), which looks a bit like a gas mask and can feel hot and uncomfortable.

“Of course, there is the emotional side, too. We’ve been supporting relatives whose loved one is dying without them by their side. However, we’ve been grateful for technology such as phones and iPad screens that’s meant that at least some could maintain some sense of connection. Nonetheless, it’s been heart-breaking to see.

Looking ahead, Roger is uncertain as to what future weeks might bring, given the number of tourists and second-home owners expected in the region soon with lockdown restrictions easing.

He said: “While it is good to see a steady decline in cases, I think our popularity as a holiday destination could make us more vulnerable than some other areas, so we need to remain vigilant. We also need to be well prepared in case of a second wave of cases in the winter months, when traditionally NHS resources are already more stretched.”

Both Roger and Linzie are also concerned that currently at Nuffield they are already seeing an increased number of cancer patients who need palliative care.

Linzie said: “It seems some people are presenting later than they normally would, perhaps because they haven’t been able to access the treatment they need due to the pandemic or because of wanting to avoid what they regard as them placing ‘additional pressure’ on the NHS. We want to reiterate the NHS’s message that it’s vitally important you don’t put off seeking medical help if you’re concerned about your health, and that you don’t miss your appointments.

“The past few months have been emotionally and physically tough, but we will manage whatever lies ahead by making sure we look after ourselves and each other, including taking some much-needed annual leave to bolster our resilience.

“We’ll continue to be here for those who need us, and do whatever we can to make such a difficult time that little bit easier for them and their loved ones.”

Small in number yet dynamic and consistently compassionate in the face of unprecedented pressure, the St Luke’s team at University Hospitals Plymouth NHS Trust (UHP) is making a vital contribution to the hospital’s response to the COVID-19 pandemic.

Dr Doug Hooper, Consultant in Palliative Medicine, is part of our team there, which also includes team leader Martin Thomas, nurses James Mills, Linzie Collins, Julie Ayres, Julia Pugh, Becky Harris, Julie Thesinger and Dr Hannah Gregson and Dr Roger Smith, and their Clinical Admin colleagues Jenny Francis and Jenny Brooks. Here, Doug shares how he and his colleagues have rallied, helping to fortify the frontline during this time of crisis.

“Ordinarily, we’re involved in looking after up to 40 patients at any one time, working alongside the hospital doctors and nurses across the wards so that people with terminal illness receive the highest calibre care as they near the end of their lives. We’re also here for their families, providing much-needed emotional support.

“Given the tremendous gravity of the COVID-19 situation and the huge additional pressure it’s putting on the NHS, we’ve naturally pulled out all the stops to adapt what we do really quickly so that the hospital is as well prepared as possible to manage the influx of people admitted with complications from the virus.

“Now several weeks in, UHP is relatively quiet due to much of the non-urgent inpatient and outpatient care being postponed, but the situation can change by the hour. There are ‘red wards’ dedicated to people struggling with COVID-19 symptoms and sadly, some of them have died. That’s why our team is embedded on these wards, supporting the doctors, nurses and healthcare assistants so that they have a better understanding of each individual patient’s needs.

“Crucially, we’re providing emotional support for the hospital staff who need us, some of whom are relatively inexperienced nurses. Understandably, the enormity of the situation can take a toll on them so we are there to listen and help however we can.

“With both patients and their relatives in mind we’ve helped the hospital’s Patient Advice and Liaison Service access iPads for each ward so that families can keep in touch. While it’s heart-breaking that people can’t usually visit their loved one due to current restrictions, it’s really moving to see how Zoom and social media have helped bring people together so powerfully at such a challenging time. These human connections are vital to the relief of suffering.

“We’ve also worked closely with the hospital communications team and Annie Charles from the Mustard Tree Cancer Macmillan Support Centre so that family can be offered more in-depth support and be able to send uplifting personalised messages to their loved ones.

“When it is clear that a patient is not going to survive COVID-19, doctors and nurses need to have brave, honest and realistic but kind conversations with families. This is far from easy even when you have worked in end of life care for years, but the pandemic means some staff are facing this for the first time, having to break the hardest of news to those who can’t be there to hold their loved one’s hand.

“We’ve used our experience to produce advice packs for staff to help them feel better prepared to have these conversations with truth and clarity but gentleness and kindness, too.

“Part of relieving pressure on the NHS is the private sector lending its support, so our team has been busy providing specialist training to those working at the Nuffield Health Plymouth Hospital as the organisation is lending its facility and workforce to UHP by temporarily providing both inpatient and outpatient cancer treatment. It’s heartening to see them getting behind the NHS like this in the interest of public health.

“In the toughest of circumstances so many positive changes have been made, and I hope many of them will continue to benefit healthcare in the future. Our team will remain agile as this situation unfolds, working shoulder to shoulder with our NHS colleagues to meet the challenge. And I know we’ll continue to support each other – the camaraderie between us is second to none.”

Learn more about St Luke’s at Derriford.

Located on the eighth floor of Derriford Hospital in Plymouth, with offices just outside Brent Ward, is our busy Hospital Team providing bespoke care for patients at end of life and supporting the families around them. They are there seven days a week, across every ward, with the core team made up of two doctors, six nurses and administration support, while the extended team includes a chaplain, physiotherapist, occupational therapist and welfare rights officer.

Recently, the team has been joined by a new colleague, Specialist Nurse Becki Harris, so we spoke to her about her role, what it means to be part of the team, and what motivates her to want to make a difference at Derriford.

Becki, who is from Bristol, moved to Plymouth two years ago, attracted by our beautiful coastal location and the quality of life here. She worked as a Chemotherapy Nurse with Healthcare at Home, looking after private patients with cancer, which is when she first witnessed St Luke’s in action as our team is involved in the care of these patients at times of crisis. It was seeing the way they work and the positive difference this makes that fuelled her desire to work for our charity.

Becki said: “As part of my nursing degree I studied aspects of palliative care, and my dissertation looked at the different experiences of patients at end of life – those in hospital with no palliative care teams and the extent to which their dignity was maintained compared to those being cared for at home by a team with end of life expertise.

“Then, working as a hospital nurse, I saw for myself that when patients received bespoke end of life care it had such a positive impact, not just on them but on the loved ones around them, too. This is so important because a negative or traumatic experience can really stay with families long after, hampering them in all sorts of ways and making it more difficult for them to come to terms with their loss. Meanwhile, those who see their loved one receiving compassionate specialist care from a team that has the time to explain things and put them at ease find it incredibly reassuring have more peace of mind. This helps them, both at the time and going forward because their lasting memories are so much more positive.

“I was delighted to secure the job within the team at Derriford, and everyone has been so welcoming, from the doctors to the admin staff.

“The name St Luke’s is so loved and respected, and I feel incredibly privileged to be part of the team at the hospital, helping to remove some of the fear and anxiety people feel at such a challenging time.

“I love problem-solving and getting to the heart of what matters to those we look after. Sometimes, just a five-minute conversation with a patient or their relative can make the world of difference to them and it all helps to change their view of what it’s like to be in hospital.”

Becki is so enthusiastic about our charity and what we contribute to our community that she has been making things a family affair, enjoying Elmer’s Big Parade with her boyfriend’s young niece visiting from Leicester and giving her mum – who works in a hospital in Bristol – an pin badge to attach to her lanyard, which has sparked conversations with others.

This young nurse is also willing to quite literally go to great lengths to raise money for St Luke’s – she’s set to take the 15,000ft plunge from a plane when she skydives in aid of us next year!