Posts

Working across the wards of University Hospitals Plymouth (UHP) NHS Trust 365 days a year, there’s a team small in number yet dynamic and consistently compassionate in the face of pressure, who swiftly stepped up to help strengthen the hospital’s emergency response when the pandemic hit hard earlier this year.

Now, with the number of COVID-19 patients on the rise locally as well as nationally, our hospital team is again giving its support to NHS colleagues, fortifying the frontline so that patients who are dying from complications of the virus receive the compassionate end of life care they need. As part of one big team at the hospital, our hospice staff are not only lending their expertise on the COVID red wards though – just as before, they’re pulling out all the stops to continue their usual work as well, ensuring that right across the hospital patients whose time is running short are as comfortable and at ease as possible.

Explaining how St Luke’s stepped up to help the hospital respond in the early months of the pandemic – and how it feels to be back supporting NHS colleagues dealing with the challenge of another influx of COVID-19 patients – St Luke’s nurse Julie Ayers said:

“Ordinarily, our team is involved in looking after up to 40 hospital patients at any one time, ensuring they receive the highest calibre care and giving emotional support to their families, too. While we are a small team, we are also flexible so when the gravity of the COVID-19 situation brought huge extra pressure to bear on the hospital, we were able to adapt quickly as part of its response to dealing with the emergency.

“It was about more than just providing specialist care and advice for patients with complex symptoms caused by the virus. We were also there supporting hospital staff who suddenly needed to have difficult but necessary conversations with patients’ families. This was especially hard for colleagues who’d never done it before, in some cases because they’d only very recently qualified as doctors and nurses. We drew on our experience to build their confidence and help them do this with kindness and sensitivity while not shying away from clarity because it’s so important to be open and honest with families in these situations.

“In addition, when inpatient and outpatient cancer treatment temporarily transferred to nearby Nuffield Hospital, we were there to provide specialist training for staff at the facility, many of whom were completely unused to looking after people with terminal illness because that’s not what their usual work involves. We continued to provide support for them until cancer care returned to UHP NHS Trust in August.”

“When I look back at that time now, which felt so relentless, I also recall how daunting it was, especially in those first few weeks because it was such an unprecedented time and none of us knew what to expect. I felt really anxious at first, especially with so many news reports about healthcare workers dying from COVID-19, but I think those fears are only natural.

“What’s really helped  – and what’s really stood out to me – is the level of support we’ve given each other. It’s been phenomenal, not just in our tightknit St Luke’s team but more widely across the whole hospital. We are really there for each other because we all recognise the importance of what do and at the same time empathise because we’re all juggling our work with the personal challenges everyone is experiencing due to the pandemic.

“We had to adapt the way we worked really quickly because things were changing not just daily but sometimes by the hour. We just got on with it though because that’s what we do. I’ve worked in palliative and end of life care for most of the past 20 years and have been back with the St Luke’s team for the past three – it’s simply where I feel I belong.”

Julie, who is married with two teenage daughters living at home, appreciates the unswerving support her family has given her as she’s continued to deliver vital care for patients week after week.

This time around, she feels she and the team are much better placed to meet the challenges of working on the frontline of hospital care, looking after patients who include those struggling with symptoms of COVID-19.

She said: “I think because of what we’ve already weathered, we know a lot more about what to expect as COVID cases continue to rise, though of course we can never get complacent.

“I still feel some trepidation – my biggest fear would be to have the virus, be symptomless and pass it on to one of my family – but with all the strict infection control measures in place, the hospital does feel a safe place to work.”

“I really want to emphasise the safety aspect because the rising number of deaths in the community points to people with terminal illness putting off hospital treatment because they’re afraid. I want to say to them, please keep your appointments. Or if you’re worried something might be wrong, don’t put off contacting your GP. It’s so important that people don’t delay what could turn out to be life-saving treatment.”

“Despite all the challenges and the emotional toll my work can take, I still love what I do. Although my role can be very sad at times, it is nevertheless really rewarding as I know I make such a difference to people’s lives.”

St Luke’s Hospice Plymouth provides specialist palliative care to people with life threatening illnesses and support to their families and carers, in partnership with others. The care is not just medical and nursing but incorporates emotional, social and spiritual support as well.

We are always interested to hear from people with the knowledge, skills and motivation to help ensure that as St Luke’s evolves, we continue to make wise decisions that mean we can meet the challenges ahead, including reaching underrepresented groups who sometimes struggle to be heard.

Trustee, Charles Hackett, said: “Being a trustee at St Luke’s supports my personal development but more importantly allows me to use my skills to help, in some way, the community in which I live.”

Being a trustee with St Luke’s can be rewarding for many reasons, including a sense of making a difference with a well-respected charity that touches the lives of local families to gaining new experiences and forging new relationships. (For an insight into our recent work, take a look at our latest impact report.)

Fiona Field, who sits on the Organisational Risk and Audit Committee and chairs the Health & Safety Committee, said: “I give about one day per month on average, this is divided between being a member of the board, chairing the health and safety committee, visiting teams across St Luke’s and taking part in some of the fundraising activities. I have regularly attended the Open Gardens in the summertime, sold programmes on Plymouth Hoe at the Firework Championships and walked the Elmer Trail.

“I find the work interesting and rewarding and I am always proud to talk to others about the brilliant work that everyone at St Luke’s does for such a worthy cause. I am keen that the services St Luke’s offers continue to be of the highest quality possible for our patients and their families locally.”

For more information on getting involved, please contact us by e-mailing info@stlukes-hospice.org.uk

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!