On the 40^th anniversary of St Luke’s Hospice Plymouth, we began our series focusing on the past of our charity that has touched the lives of so many local families over the past four decades. Today, we share the reflections of Dr Mary Nugent, who started as a young doctor at the hospice in our early years and soon became a central figure in the small yet dynamic team whose dedication, skills and compassion helped shape the specialist service for which St Luke’s is still renowned today.

Having been recruited by St Luke’s first Medical Director, Dr Sheila Cassidy, who spotted her potential and went on to become her mentor, Dr Mary – as she became known to everyone – joined the hospice in 1985. This was at Syrena House in Plymstock, the forerunner of the specialist inpatient unit at Turnchapel that was bought and converted, thanks to huge support from local people who believed in St Luke’s mission to relieve the pain and distress of terminally ill people nearing the end of their lives.

Dr Mary quickly found her vocation looking after patients holistically, recognising that in listening and focussing on what matters to them, alleviating their pain and putting them at ease, people with conditions such as cancer, multiple sclerosis and motor neurone disease can live well to the end of their lives and die with dignity.

Together, Sheila and Mary – plus the small team of nurses alongside them – developed this as their way of working, ensuring patients felt understood and uplifted and their families supported and reassured.

Dr Mary said: “When I joined St Luke’s, I could see how innovative the team was, giving bespoke care to terminally ill people as inpatients instead of them having to stay in hospital or being looked after at home. As a young doctor though, I could barely even spell palliative care so I was in at the deep end, and that’s how my journey with the hospice began.

“Space was incredibly tight at Syrena House, but we used every inch for the care and comfort our patients. We all crammed in together and just made it work. The bathroom even became the doctor’s office and we had a makeshift desk across the bath! There were just seven patient beds initially, with three more added later because patient referrals kept on coming.

“I found my niche at the hospice because we had the luxury of time to love and look after our patients. What we were doing was desperately needed by people in Plymouth and surrounding areas, and it was exciting to be part of developing something that was so pioneering.

“The camaraderie was tremendous, too. We were friends working together, all to help people who were in the last stages of life. I was quickly building on my basic medical knowledge, learning about the anatomy of being very sick and the effects and benefits of new drugs, then taking to the road to teach young doctors around the country about what we were doing and why it was so important.

“You have to remember that palliative care wasn’t recognised as a medical specialism until early 1994 – since which time is has grown and grown – so we were all just seen as ‘hospice doctors’. Recognition of the highly skilled work we were doing in hospice care only grew thanks to Dr Sheila Cassidy – and others like her – who had the insight and tenacity to make changes that were needed so that talking about death and dying became a bit less taboo and patients received more personalised care, maintaining their dignity.”

With a pressing need for larger premises, we embarked on a high-profile fundraising campaign for what became our purpose-built inpatient unit at Turnchapel, which opened in 1988. The 20-bed facility with beautiful views was built on land given to us by Plymouth City Council.

Dr Mary said: “When the move to Turnchapel came, it was a joy. Double the number of beds, plenty of bathrooms and wonderful new gadgets. We created the very best hospice environment we could, enabling people with terminal illness to be themselves and be looked after as themselves.

“There was great excitement when Prince Charles performed the official opening, in 1988, with crowds lining the driveway all waving their flags. He was well informed about the hospice movement and generous in his attitude, spending time talking to patients, volunteers and staff

Dr Mary, who became Medical Director of St Luke’s in 1993, has fond memories of the many patients she met as well as the family atmosphere Turnchapel provides for them, thanks to the kindness of staff and volunteers.

She said: “I remember patients’ weddings, which though they had to be arranged quickly by our team, were so beautiful and poignant. I also recall a lady who recognised me from the hospital and greeted me like a long-lost friend. She was determined to have at least three weeks of being looked after by me, and she did. I can still see her smiling face.”

During her time with the hospice Dr Mary witnessed – and was part of – a big expansion in the provision of palliative care, which included closer working between St Luke’s and the Primary Care Trusts to pioneer an integrated palliative care service. Whereas previously, Derriford Hospital had been separate to the hospice, in 2005 the new St Luke’s Hospital Service was established, with Dr Mary appointed its lead. In her dual roles of Palliative Care Consultant at Derriford and Medical Director at St Luke’s she was the link between the two organisations.

Dr Mary said: “I was made very welcome by the consultants. No barriers were put up and the integrated service at the hospital got into gear. This meant a joined-up service for patients, with hospice staff providing education and leadership for many hospital doctors and nurses.

“St Luke’s is a leader in palliative care, and the triple service it provides at home, in hospital and at the specialist unit has been replicated by many other hospices because they, too, have recognised how much patients benefit when they experience a seamless service. The needs of patients must always be at the centre of that service, and St Luke’s has never forgotten this.”