Tag Archive for: hospital

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BLOG: How chaplain Pat ‘happens by’ at Derriford Hospital

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.

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BLOG: Reflections from CEO Steve

With my retirement as St Luke’s Chief Executive coming up on 4 May, I want to take this opportunity to say what an immense privilege it has been to serve at the helm of our hospice for the past six years.

It would be far too difficult to home in on just one or two memories that I will take with me from my time as CEO, and my years as Deputy and HR Director before that, so instead I’ll share the overriding feeling I am left with as I approach retirement.

It really has been way more than a job – it has been the most incredible journey, working alongside our amazing staff and volunteers, and I speak from my heart when I say I am very proud of what we have achieved together, always putting the best interests of our patients and their families at the centre of what we do.

I want to say a huge thank-you to everyone I’ve had the pleasure of knowing and working with at St Luke’s. The dedication all our staff and volunteers show to our community day in, day out is second to none, and I say this recognising that maintaining such a high calibre of service is often very challenging in the face of growing demands on our hospice team. I am so grateful to have ended my career at a place where everyone cares so much and is working towards the same, shared goal.  

The decision to step away has not been an easy one, but I am retiring at the time that feels right for me, professionally and personally, and with the assurance of knowing that St Luke’s incoming CEO, Christina Quinn, is absolutely the best pair of hands to receive the reins from me.

She will be supported by the same great group of senior management colleagues I have been fortunate enough to work alongside.

For those of you who don’t already know, until last November Christina was Chair of our charity’s Board of Trustees. She comes with not only her trademark dynamism and many years’ experience at senior level within the NHS, but also the knowledge, wisdom and insight gained from six years of leading our governing body, during which time we have weathered the pandemic and gone through transformation.

I want to thank current Chair of Trustees Charles Hackett (and former Chair Christina), and every other member of our board for their support over the years. Being a trustee is a massive responsibility and they work tirelessly to steer our charity safely towards our vision. We could not do what we do without them.

As I prepare for my retirement (I’m still getting used to that word!) and then ‘decompressing’ from the huge responsibility of running a hospice, I want to let you know that I am not thinking of this as ‘goodbye’. While I won’t be interfering in the running of St Luke’s, I’ll be following St Luke’s with interest and great affection – and you’re bound to see me pop up, getting muddy at Tour de Moor and no doubt volunteering at Midnight Walk.

In signing off this last message as St Luke’s CEO, I want to say thank you again to everyone for their support in making sure St Luke’s continues to be the safe haven our community needs for anyone diagnosed with, or affected by, life-limiting illness.

Thank you.

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BLOG: The nurses in purple scrubs

The nurses in purple scrubs

As the pressures of winter illnesses put more strain on already overstretched hospital services, St Luke’s copywriter Jackie Butler meets the dedicated St Luke’s team providing expert end of life support for patients and staff at Derriford.

Day in and day out, NHS clinical staff at University Hospital Plymouth are working tirelessly to save lives and make sick people better. Sadly, doctors must sometimes break the news that nothing more can be done to prolong someone’s life and that a person has only weeks, or even days, left to live.

That’s when the St Luke’s at Derriford team steps in to wrap a blanket of compassion and expertise around a patient, aiming to make sure their remaining time can be lived as fully as possible, with dignity and minimal pain.

Unless you’ve encountered them first hand, most people don’t realise that St Luke’s has a permanent and regular presence at the hospital, with highly trained doctors, nurses and admin staff on duty seven days a week, working alongside NHS staff, and having a major impact on the care of around 100 patients a month.

Based on Level 8, alongside Brent Ward, the St Luke’s doctors and nurses visit adult patients anywhere in the hospital who have a progressive, life-limiting illness and a terminal diagnosis, and there are as many as four or five new referrals daily. Their priority is to offer quick and efficient advice on how best to manage someone’s symptoms and provide the most appropriate care, as well as to help determine the best place – often preferably not in hospital – for a patient to spend their final months, weeks or days.

The team are also there to offer emotional and social support to patients’ families and carers, as well as to share their knowledge and compassion with Derriford’s own nurses and doctors who can find it upsetting and challenging when, despite their best efforts, death becomes inevitable.

As gatekeepers for the hospice as a whole, the St Luke’s hospital team liaises closely with the organisation’s at home and Turnchapel services to find the right solution for each individual. If it’s possible for someone to leave hospital, the team help Derriford’s own complex discharge service arrange their transfer, often recommending them for St Luke’s end of life care in the community or, for those with the most complicated needs, seek admission to the specialist unit if it’s appropriate.

I was honoured recently to join St Luke’s at Derriford Nurse Consultant Martin Thomas and Clinical Nurse Specialist Julie Ayers for what can’t really be described as a typical shift because every single day is different, with its own unique challenges and crucial decisions to be made.

“We have no idea who is coming through the door each day. We try to see urgent cases within 24 hours and if they have very bad pain or other symptoms, we try to see them the same day,” said Julie, who is clearly passionate about her own work as well as educating others.

“We are in a unique and privileged position here advising throughout the hospital. It is all about maintaining good relationships and being part of one big team. We also do a lot of education and believe strongly in encouraging people to use the taboo ‘D’ words – death and dying. It’s about getting the right messages across.

“The earlier we get involved with patients who are palliative, the more they can plan for death and how they are going to spend their remaining time. It’s a privileged role, sorting people’s pain out and stopping them from feeling rubbish.

“We have cover here seven days a week, from 8.30am through to 4.30pm for urgent cases and we always tell hospital staff they can ring through to the specialist unit at Turnchapel for advice out of hours.”

Each day is different but there are regular routines, and the morning begins with a briefing meeting. The busy team has the equivalent of 6.5 full-time nurses, led by Martin, and two full-time and one part-time doctor, headed by Consultant Doctor Doug Hooper, plus a vital clinical administrator who keeps the whole machine rolling. There are always two or three student doctors too, gaining important experience as part of their training.

They meet on camera in a virtual online room – a practical move introduced during the peak of Covid because the team are squirrelled away in three tiny rooms that aren’t big enough for a socially distanced face to face get together.

There’s just one thing on the agenda and that’s the welfare of the day’s list of patients, more than 25 on the day I was there, including several new referrals from various parts of the hospital.

Each individual’s circumstances are discussed in detail – who they are, how unwell they are, whether their condition is stable or deteriorating, whether they have been seen by a member of the team and when, what medications are being used to manage their symptoms and whether that could be improved, what their family situation is and when or whether they might be able to be discharged.

Decisions are made collectively about which patients need to be seen urgently that day and which member of the team will visit them on the wards, always prioritising continuity of care and quickly building a relationship of trust with patients and their loved ones.

Individual cases can be enormously complex. One person had been fighting cancer for years but was now reaching the end. Chemotherapy had initially helped to control their cancer, then the disease had now spread and was no longer treatable, and a chest infection was also adding to their discomfort. They had been brought into hospital because they couldn’t cope at home and now needed to look at what was the best course of action.

It’s a thorough and painstaking meeting that goes on for more than an hour and at the end everyone has their allotted tasks, although in such an unpredictable environment they are always prepared for the unexpected.

For today Julie’s role is triaging referred patients as requests come in from around the hospital. Meanwhile, Martin takes responsibility to visit several patients on the list during the late morning and early afternoon, with important meetings and briefings to fit in too.

He has been familiar with the medical world since he was a child. Martin grew up listening to his nurse mother talk about her work and he was drawn into nursing himself in the late 1980s at a time when strong and positive male role models were being established on TV, notably Charlie Fairhead (Derek Thompson) and Ash (Patrick Robinson) in medical drama Casualty.

“I spent 15 years working on the haematology ward at Derriford, becoming a charge nurse and then a matron, but I was frustrated because I ended up sitting at a desk with little patient contact,” he said. “On a course I sat with the then clinical director at St Luke’s and she asked me if I had thought about being a palliative care nurse. I applied for a job working in the community and fortunately they took a punt on me.”

Martin cared for patients as part of the community urgent care team for 17 years. After being asked to step in to help the St Luke’s hospital team for a couple of months, he got the job to head the department in 2019.

“Our job is about deciding who needs us most and then where do we go from here. If it involves complex symptom management or psychosocial planning, then people will be referred to us to take on management of their care.  If they are still under a surgeon or medic, we will work alongside to give support and good advice,” he explained.

“The average stay on our caseload is six days. Patients are either discharged into the community, or sadly die in hospital. While they are in St Luke’s sights the team will do everything they can to support them and their family members, and try to find the best course of action on discharge.

“All being part of one big St Luke’s team really works and we have a daily dialogue with the community and inpatient teams. Knowing the ins and outs of the organisation as a whole means you know who to refer to and who to speak to.”

During the first Covid lockdown, the nursing team started wearing surgical scrubs for practicality, naturally choosing purple in line with St Luke’s customary colour scheme, and that has carried on ever since, visually underlining their identity as experts in a very special field.

There’s a palpable sense of relief when Martin walks onto a ward. The Derriford nurses and doctors, anxious to do the best they can for their patient, turn to him eagerly.

Technology now allows much swifter sharing of information about a patient, so Martin can easily access medication records, bed management details, blood test and scan results, oncology and clinic reports. And as a nurse prescriber, he can prescribe appropriate drug treatments without referring to a doctor.

On the door of a side room door there’s the symbol of cupped hands holding a butterfly, a sign to everyone that the patient is nearing the end of life and care needs to be gentle and thoughtful. Inside, a man in his 70s is nearing death, surrounded by loved ones, but he is agitated and clearly uncomfortable.

Liaising with UHP nurses and his family members, Martin quickly organises a syringe driver that will administer palliative care medication just under the skin to relieve his symptoms and let him feel relaxed.

“It’s important that we get this right first time, particularly so the family can feel we are doing everything we can. It is not right to see someone so distressed and not do something about it,” he said. “It’s very much about the family at this stage and making sure they know you are listening, and you understand. We also always assume the patient can hear, even if they aren’t responding, so we will continue talking to them and reassuring them at all times.”

When a doctor or nurse thinks someone is approaching death and that comfort, rather than curative measures are appropriate, they will activate an End of Life icon on their electronic notes that will activate a referral to St Luke’s.

Our next stop is a busy cardiac ward, where the sister and junior doctor are seeking Martin’s opinion about a woman with heart failure who had been deteriorating rapidly over the previous 24 hours. She looks like she’s sleeping peacefully and, Martin confirms, is in the active phase of dying and does not appear to be suffering.

After seeing each patient, Martin makes notes in their paper hospital records and he’ll also add his observations, prescriptions and recommendations to the electronic system so that everyone involved in a patient’s care can be kept up to date at all times.

After a very brief lunch break, he’s hurrying to another ward to visit a frail and terminally ill woman, also suffering with dementia, who is about the be released to a specialist nursing home in North Cornwall. He’s making sure all the correct medications are in place and, because she lives off the St Luke’s at home patch, will make a referral to the Cornwall palliative care team and the woman’s GP.

Throughout the day, Martin’s reassuring presence and commitment to relieve suffering are as awe-inspiring as his philosophical and pragmatic attitude to death and dying is refreshing.

“Death is like going to sleep and we know that because people who are dying tend to have periods of slipping into unconsciousness, when they don’t remember blocks of time. Good days and bad days are part of dying. It is not something to be feared. It is disappointing, knowing the things you are going to miss, but the moment of death is not tortured; it is a release,” he said.

Nevertheless, the heavy caseload and the sadness of patients’ deaths does take its toll. Martin and Julie keep a close watch on the wellbeing of all St Luke’s team members, aiming to vary duties so the pressures don’t become individually overwhelming.

They’ve recently introduced a weekly ritual of personal reflection. Every Friday team members are invited to take a few moments out of their busy day to gather in the hospital chapel and light a candle for patients who have died. It’s a time when they acknowledge the lives lost and the efforts they have made to support those people in their final days.

Far from being a religious gesture, it’s about offering a brief, but important, opportunity for meditation in a quiet and spiritual space.

Julie said: “We sourced some little purple tealights that are heart-shaped. We light them and we write something in remembrance. We each have our own thoughts. When you are so busy you don’t usually have that moment to come away from the ward and find some tranquillity.”

home care
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BLOG: When compassion comes calling

home care

When compassion comes calling

Communications Copywriter Jackie Butler jumps in the deep end on the road with St Luke’s at home

If you want to learn about the fantastic care delivered day in and day out by St Luke’s, one of the best places to start has to be out on the frontline with our at home nursing teams.

Like many people, I’d been under the impression that St Luke’s was all about the wonderful in-patient unit at Turnchapel. I knew that my friend’s husband had been visited at his own house – where he wanted to take his final days – but it was still a surprise to discover that more than half the care delivered by St Luke’s happens out in the community.

Eager to find out more and part of my induction to St Luke’s, I recently had the privilege of accompanying members of our dedicated at home team on daily rounds in and around Plymouth to witness first-hand what a huge difference this treasured service makes to patients who are facing death, and their families.

For someone like me who isn’t used to being around very poorly people at the end of their lives, this was like jumping in at the deep end and I admit I was a bit nervous. But the reassuring presence of Clinical Nurse Specialist Sally, and Urgent Care team nurse Natasha and health care assistant Claire, put me at ease straight away.

I could imagine the relief you might feel as a patient, a concerned relative or a fellow carer, when these veritable superwomen ring the doorbell. It’s immediately clear that their entire focus is on making things as comfortable as they can in every sense, minimising intrusion, maximising support, easing pain, maintaining people’s dignity – often in difficult circumstances – and helping plan for the best death possible.

Their respectful and unhurried presence suggests they have all the time in the world for each individual and that nothing is too much trouble. Intuitive, gentle and knowledgeable, it was fascinating to see each of them instinctively register the tiniest changes in a patient’s expression or demeanour and then go the extra mile to respond with a practical solution.

I was surprised by the huge patch the at home team covers – some 750 square miles stretching right across the city and across into rural West Devon and remote parts of Dartmoor, as well as down into the South Hams and the coast. And some patients are visited by St Luke’s up to three times a day.

st lukes at home

ROUND ONE Sally – Clinical Nurse Specialist

Sally, who retrained as a nurse after a long career in the police force, usually travels solo but certainly made a delightful companion as I tagged along on her rounds for the day. Her intense passion for her job certainly shone brightly.

As a St Luke’s Clinical Nurse Specialist, she has particular skills in managing patients’ complex symptoms and pain, advising on medication options and other aids to make things easier. Her day involves weighing up care and treatment options and encouraging the most beneficial in each case. Like the rest of the at home team, she takes a sharp and holistic view of each patient and their quality of life, and her calls are scheduled to reflect each situation.

Sally’s upbeat manner disguises how acutely tuned in she is to every scenario she’s faced with, including the health and wellbeing of the individuals caring for a patient, whether that is family members, nursing home staff, district nurses, St Luke’s own at home team or a combination of those.

Uppermost in her mind is recognising people’s needs and acknowledging what they are going through. “It’s important to tell people you really understand,” said Sally.

Answers to the casually chatty but clever questions she asks provide the information she needs to make the right judgments about a patient’s condition and the best path to follow. Faced with a man in pain but reluctant to try a stronger painkilling solution, I noted her gentle powers of persuasion in action as she coaxed not only his agreement to “just give it a try”, but a rare little smile as well.

Minutes after checking in on a lady in a local nursing home, she was back in her car and straight on the phone to the woman’s daughter to reassure her that mum was comfortable and without pain, but very close to the end of life.

I also witnessed as she went above and beyond to make sure a patient who was no longer able to take his medication orally had a syringe pump driver and specific drugs prescribed by the GP, all up and running the very same day to avoid him suffering unnecessarily in his final days at home, surrounded by his loved ones.

“You get a real high from getting it right for the family,” she said.

Making notes during and after each visit, Sally had a mountain of paperwork to complete before calling it a day, filing detailed reports on the patients she’d seen so St Luke’s at home team, and other concerned medical professionals, had a detailed view of her observations and care advice.

While she and her fellow Clinical Nurse Specialists are like the expert flying squad of the service, the consistent daily personal care of patients is the domain of the Urgent Care Team, who work in pairs and can clock up hundreds of miles on a 12.5-hour shift, travelling from patient to patient.

ROUND TWO – Claire and Natasha

Nurse Natasha describes the palliative care she and her Urgent Care Team colleagues deliver as they approach death as “a big, warm hug” and that spirit was ever-present as I watched her and health care assistant Claire in action together in people’s homes.

“We are a very passionate team. We want people to have the very best quality care. At St Luke’s if you need to sort someone in crisis then you can spend the time. Someone else is always ready to help,” said Natasha.

Claire added: “We are not trying to make anybody better, just pain-free and comfortable. We specialise in dying and death.”

The day I joined them began with a handover meeting at Turnchapel discussing the patients they would see that morning, their state of health, their needs, issues with medication, and any other agencies involved, like social care or district nurses.

Sitting in the back of one of St Luke’s bright branded vehicles, I experienced a sense of pride as Claire negotiated the traffic to drive us to the first call of the day.  It’s fair to say that health care assistants are the lifeblood of the service and the main faces of St Luke’s care out in the community. As a nurse Natasha is more often taking an overview of patients, assessing new referrals and giving advice on care, but she clearly loves the hands-on aspects of the job, and it was awe-inspiring to watch her and Claire working seamlessly together.

Our first call was to a very weak elderly woman in the final stages of cancer, dozing in the living room of her house where she lived with her husband. Asking permission at every stage, and giving constant reassurance, Claire and Natasha very carefully raised her hospital bed to a manageable height and position. They slowly stripped back her blankets, one by one, making sure she didn’t feel cold, and gave her the gentlest of washes to freshen her up, while watching for signs of pain, discomfort and noting any deterioration since the day before.

They dealt with her catheter bag, moisturised her feet, brushed her hair and teeth. They changed her bedding and nightclothes and propped up her up with pillows so she could see out the window to the garden. When they left the house she was clean, snug and dozing again and they – or another St Luke’s UC team – would be back to do it all again in the early evening.  I sensed it wasn’t going to be long.

 

st lukes at home

Natasha and Claire repeated that level of kindness and care on each of their visits, depending on the individual and their circumstances. En route to the next patient, Claire explained a bit more about what is happening quietly under the surface when they are in someone’s home.

“You read the whole situation holistically. We soak it all up. Quite often it’s the relatives who are struggling the most. Even the dog’s behaviour can give you clues about the situation when you walk in the door,” she said. “We look for all the signs that someone is actively dying. We learn our skills and we are out there doing it. The person you are working with, you just give them a little look and they know what you are thinking.”

When death does arrive, St Luke’s role doesn’t stop, and it was humbling to hear how Claire and her fellow HCAs have a particularly poignant and challenging role to play.

“Ideally everyone would die in their sleep with someone holding their hand. But you can give them the dignity after, and it’s such a privilege to provide that care after death, for the family and the patient themselves,” she said. “We’re there for the practicalities and to talk about what happened.

“Care after death is really important and I like to do it as much as looking after someone when they are alive. To have them looking beautiful or handsome and put on their best clothes, give them a shave, some make up or perfume. It’s the last memory people are going to have of their loved one before they have to let them go, so it’s really important. You like to know that you have done your best.”

After three patients, a quick lunch, report writing and what they call a “huddle” with colleagues, Natasha and Claire were heading back out late afternoon with another set of visits on their list, maybe the same patients, maybe different ones. Every day is different for them.

I retired to my desk to reflect on my experiences with Sally, Claire and Natasha, blown away by the extraordinary compassion and skilled care I’d seen in action on the frontline and so grateful for the opportunity.  There’s still so much more for me to learn about St Luke’s, but I now have a much better insight into why we’re all here, working together to keep these incredible services running.

st lukes at home

carer passport
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BLOG: Introducing the new Carer Passport

carer passport

Introducing the new Carer Passport

A new Family and Friend Carer Passport is being launched in Plymouth on 28 November 2022 to recognise and value the support carers provide.

The Family and Friend Carer Passport is designed to help

  • Carers to identify themselves as a carer
  • All staff to recognise carers and the vital role they play

The passport has been launched by health and social care partners across the city including St Luke’s, Livewell Southwest, University Hospital’s Plymouth NHS Trust, Plymouth City Council and Improving Lives Plymouth. It highlights the expertise carers bring and the needs they have in terms of their own health and welfare.

A carer is anyone who cares, unpaid, for a family or friend who needs help and support due to illness, disability, a mental health condition or an addiction.

‘Mentally, emotionally, 24/7 your thoughts are with them and their needs and what you might be having to do, or will need to do or what you didn’t do…if the carers card works well, it will break down quite a lot of barriers. I do believe it will acknowledge the role and hopefully increase the two-way information sharing and the openness of professionals to actually speak with the carers about the things that worry them…put simply, it will make life slightly less fraught…if the carer breaks down, who’s going to do the caring?’

Carer of an adult son who has a serious mental illness, Plymouth

The new Carer Passport comprises an A5 booklet with information about caring and a credit card sized Carer Identification card. This will provide:

Carer passport

  • A recognisable way for carers to identify their caring role to health, social care and other organisations
  • Discounts at participating businesses
  • Access to information and support to help with caring
  • An opportunity to connect with other carers
  • An emergency alert card
  • Some discounts in healthcare settings, depending on circumstances

The Carer Passport also aims to give the Carer the confidence to talk with health and social care staff about the person they care for and are actively encouraged to show the Carers Card to professionals to let them know they are a carer. However, it should not be seen as ‘proof’ and all appropriate checks with the cared for person should be undertaken to ensure their confidentiality is not breached.

Dr Ed Parry-Jones, GP, Clinical Advisor for One Devon and member of Plymouth Carer’s Strategic Partnership, said: “We know that unpaid carers of family or friends routinely neglect their own health and care needs and prioritise the needs of the person they care for. By working together across organisations we are committing to help carers access the support they need to keep themselves in good physical and mental wellbeing. This will enable them to maintain their caring role and, when appropriate, help them to relinquish some aspects of their caring role’.

The Council’s commissioned service for adult carers in Plymouth is called Caring for Carers, run by Improving Lives Plymouth, and provides a range of advice, guidance, help and support for unpaid carers.

There is also help and support for the 800 plus young carers in Plymouth which is delivered by Time 4 U, a partnership between children’s charity Barnardo’s, Hamoaze House and the City Council’s Youth Services Team.

To request a carer passport residents will first need to register with Caring for Carers in any of the following ways:

Carers that are already registered with Caring for Carers will automatically receive a passport in the post.

Caitlin
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BLOG: Celebrating Caitlin: A life lived in technicolour

Caitlin

Celebrating Caitlin: A life lived in technicolour

Celebrating the life of their loved one in a way that reflects that person’s special qualities often helps the bereaved find comfort at such a deeply sad time.

For the Kelly family from Devon, paying tribute to much-loved Caitlin, just 23 years old when she died, involved a final adventure that perfectly captured her independent spirit and zest for life.

This Hospice Care Week (10 – 14 October) in partnership with Hospice UK, we’re sharing Caitlin’s story to remember the inspirational young woman she was, to highlight the vital help that hospices and hospice care can provide to people of all ages, and to reveal the very personal part a ground-breaking transatlantic voyage played in her family’s fond and fitting farewell.

At the end of her life, in May 2021, Caitlin – who was born with cerebral palsy and had epilepsy as well was a visual impairment and learning difficulties – was looked after by St Luke’s, initially at University Hospitals Plymouth NHS Trust, then at our specialist unit at Turnchapel.

Caitlin

Caitlin’s father, Sean Kelly, said: “It wasn’t unusual for Caitlin to have seizures, but when she suffered a brain haemorrhage at home, we knew we were facing something different and very serious.

“The hospital teams – initially at Royal Devon and Exeter and then at Derriford in Plymouth – did everything they could for her, but despite a series of operations the reality began to dawn that her life was coming to an end.  When it was suggested it might be time to have a conversation with someone from St Luke’s, Dr Doug Hooper – a member of the charity’s team at the hospital – was there to talk things through with us.

Caitlin Doug Hooper

“It was an incredibly difficult situation to accept because as a parent it’s always your instinct to fight on, but when he told us about Turnchapel, it felt like the best place for Caitlin to spend the final part of her life.”

So much more than simply a place to deliver expert medical provision, her family, including her mother, Jacqueline, brother, Cameron, and sister, Erin, describe the specialist unit as “an oasis of calm” in the most tumultuous of times.

Sean said: “After such a frenetic time, we welcomed the peace we found at the hospice, without the constant distractions of the hospital environment and the very necessary but stressful cacophony of beepers and warning sounds in the Intensive Care Unit. We decorated Caitlin’s room with her artwork, brought in her own pillows and familiar items from home and spent time reading to and just talking to her.”

It wasn’t just the tranquillity of our specialist unit at Turnchapel that made it such a haven for the Kelly family. They found solace in being able to lie down next to Caitlin on our special “cuddle bed”, which at the touch of a button expands from a single into a safe, comfortable double.

Sean said: “It was only afterwards that we learned the cuddle bed was donated in memory of a young lady, Chloe Hunn, who was close to Caitlin’s age when she was looked after at the hospice. Finding out it had been Chloe’s dying wish to have just such a bed so she and her boyfriend could cuddle – and that the family, together with friends and her local Cornish community, had clubbed together to posthumously donate it – made such an impact on us.

“The care and kindness of St Luke’s meant we had the time, space and even a certain serenity – in the midst of this most emotional of experiences – to say our goodbye to Caitlin, something for which we will always be grateful. We were grateful, too, for the support on hand, whether it was the St Luke’s nurses offering a cup of tea, a walk out in the garden or even a chat with the bereavement support staff who made themselves available, both during our time there and after her passing.”

In the week Caitlin was at St Luke’s, by chance Sean and his family, learned about a remarkable challenge, steeped in history, that brought to mind their daughter’s indomitable spirit. As part of celebrations to mark the 400th anniversary of the Pilgrims’ journey on board the Mayflower, from Plymouth, Devon, to Plymouth, Massachusetts, a 21st century cutting-edge, fully autonomous ship, completely run by an IBM computer, was undertaking sea trials in preparation to set to sail – without a crew – following the same route across the Atlantic, collecting important scientific data along the way.

Caitlin IMB / ProMare Inc

Photo credit: IMB / ProMare Inc

Inspired by Caitlin’s can-do attitude to life, the family – who have relatives in the USA, including Caitlin’s sister – got in touch with Mayflower Autonomous Ship’s co-developer, ProMare Inc, with a very special request.

Sean said: “Plymouth has historically been a point of embarkation and adventure.  We explained how much it would mean to us if a few of Caitlin’s personal possessions, including some medals, bookmarks but also a small teddy bear from Turnchapel, could make the transatlantic crossing on Mayflower so they could reach her relatives in the USA, and they very kindly agreed. After a circa three-week voyage, the trimaran arrived at its destination in the summer of 2022.  Caitlin loved adventures and, in a way, the crossing represented a great adventure in honour of that spirit.

Caitlin

“Our beautiful, happy and sometimes sassy daughter never considered herself to be less able than others. She was defined by her determination to overcome her disabilities and to live her life literally in technicolour. She was – and will always be – such an inspiration to us.”

Sally Kate career
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BLOG: Follow your heart to find a life-enhancing career

Sally Kate career

Follow your heart to find a life-enhancing career

If you’re thinking of a midlife career change, there’s a lot to weigh up. But as Sally Hutchings and Kate Hillman – both in their 50s – have shown, it’s never too late to follow your heart!

Having both enjoyed long, fulfilling careers in the police, these inspirational women made the choice re-train rather than retire. Now, they’re part of our dedicated team, where each member is valued as a person and not only for what’s on their CV.

Sally’s story

At 18, it was a strong desire to serve her community that led Sally, now 54, to join Devon and Cornwall Police as a uniformed officer. A successful 30-year career saw her rise through the ranks to Neighbourhood Inspector for Plymouth City Centre and Stonehouse and provide cover for the Chief Inspector for Plymouth.

Sally, who is married with four children and lives in Saltash, said: “I really enjoyed the variety of my police career, but – as I approached 50 – I started to feel it was ‘now or never’ if I was ever going to make the leap into nursing. I’d gained interest in the idea over the years, partly due to the many hospital visits I made with my daughter Jo, who has cystic fibrosis.  

“My lightbulb moment came one night when, looking across into another ward, I saw a nurse sitting at the bedside of an elderly man I sensed was dying. I had such a powerful feeling that working in end of life care was where I was meant to be. I could carry on making a difference in my community, but in different way – helping people at the most vulnerable time of all, when what they most need is the reassurance they are not alone and to be treated with sensitivity, kindness and respect.”

Later, a conversation with Ali Griffiths – now Community Nurse Specialist (CNS) at St Luke’s but at that time manager of the ward where Sally’s daughter Jo was receiving her treatment – spurred Sally on to study full time to be a nurse. Sally said: “Ali looked me right in the eyes and said: “It’s not too late – just do it!”.”

Sally first joined St Luke’s at Turnchapel, where we look after our most vulnerable patients. She then went to work at Derriford’s Emergency Department to gain more nursing experience before joining our Hospital team. Soon, she’ll be moving across to our Community team, where – in a wonderful twist of ‘fate’ – her manager will be CNS Ali, who helped inspire her big career change!

Sally said: “Working in the police, I was used to listening to people and having sensitive conversations, and what’s so great about St Luke’s is that they recognise these transferable skills. It isn’t just my nursing degree but my life experience they see as an asset.”

“The greatest gift we can give those in our care is to remember they are people, not simply patients. It’s the little extras, too, like the wedding I helped organise at short notice for a terminally ill lady at the hospital. Seeing what it meant to her and her family felt incredibly special. When time is running short for someone, it is such a privilege to help them feel more comfortable and in control, and to ensure their families have beautiful memories they can treasure for years to come.”

Kate’s story

For former Detective Inspector Kate, who is in her 50s and joined our Urgent Care team as a Healthcare Assistant (HCA) team in May, being in a healthcare environment is in many ways familiar territory. She said: “In the police, I had safeguarding responsibilities for children so often spent time in hospitals, and when my husband became ill and needed to be cared for at Derriford, being there with him really developed my interest in taking up a career in health.”

It was later though, when her father Mark was being looked after at Turnchapel in the last hours of his life, that Kate’s desire to work in hospice care was sparked. She said: “The team was wonderful with my dad, helping him die peacefully and supporting us as a family. It had a really big impact on me. I knew I wanted to help people in the same way.”

Having reached the stage where she could retire from the police, Kate’s journey to follow her dream began when she embarked on a six-month development programme to qualify as an HCA. Happily, she then spotted the job advert for the part-time position she now has with us. She said: “I won’t deny it felt daunting at first, being ‘the new girl’ with so much to learn, but everyone is so friendly and supportive, and I can really feel my confidence growing.

“What I love is that we can spend unhurried time with the people we look after in their own homes, doing whatever is needed to make them comfortable. While ultimately, we can’t change the outcome, there’s a lot we can do to make sure they get back to feeling more like themselves again. I find it incredibly rewarding.

“Though I left the police, all my experience of working with families through such sensitive times came with me to St Luke’s. There’s scope to develop with the hospice, too, so I’m looking forward to spending some time working with the in-patient team soon. That’s the really great thing about stepping outside your comfort zone – the opportunity to keep learning and growing. I’d recommend it to anyone!”

Find out more about working with our dedicated team – directly with patients or more behind the scenes – and check out our latest job vacancies here.

laughter in a hospice
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BLOG: “I did not expect to hear laughter in a hospice.”

laughter in a hospice

“I did not expect to hear laughter in a hospice.”

“I did not expect to hear laughter in a hospice. The atmosphere is uplifting – I knew right away I was volunteering with an organisation that was just right for me.”

When Eleanor first joined us after relocating from South Africa to Plymouth, it was as part of our friendly reception team at Turnchapel. Being at our specialist unit, where we look after our most vulnerable patients and welcome their family and friends, gave her valuable insight into our compassionate care. So, every Monday when she volunteers in her new role at our Shabby Chic charity shop on the Barbican, she feels really inspired, knowing the vital difference our retail income makes for patients and their loved ones.

Eleanor, who lives in Oreston, said: “Being welcomed into the wonderful St Luke’s ‘family’ has helped me feel more at home in a city completely new to me. Best of all is the feeling I get meeting customers and knowing every vintage piece the shop sells supports such a vital service for local families.”

Like kind-hearted Eleanor, could you spare a few hours a week to volunteer at our Shabby Chic charity shop? Located in bustling Southside Street on the Barbican, it’s a treasure trove of quality items full of retro charm.

Learn more about our volunteering opportunities.

Head Teacher
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BLOG: Meet the former Head Teacher blossoming as part of our team

Head Teacher

Meet the former Head Teacher blossoming as part of our team

Until recently, Dave Cantin was a teacher in a large Plymouth primary school, where he focussed on creating the right conditions for students to achieve their potential. His 33-year teaching career also includes Deputy Headships and Headships of two Cornish primary schools. Now, he’s two months into his new role working more outside than indoors, and in a completely different sector where our team all go the extra mile to help ensure people at the end of their life get the most out of each day.

So, what was it that motivated Dave to resign from his teaching job and make the leap to become one of our Maintenance Assistants, caring for our beautiful gardens at Turnchapel and contributing to the smooth-running of all St Luke’s facilities, from our specialist unit to our charity shops?

Dave, who is 55 and lives on the Plymouth side of the Saltash Passage, explains: “While I enjoyed my career in teaching and school management, after 33 years I knew it was time for a change otherwise I might always be left thinking, ”What if?”. I’ve always loved being outdoors and have a real passion for gardening, so when my wife saw the job with St Luke’s advertised she just knew she had to show it to me. I’d reached a time in my life where I was able to re-evaluate and choose a new direction if I so wished.

head Teacher

“I wasn’t put off by the idea of working for a hospice. It’s not depressing or distressing – in fact, the opposite is true. I already knew this because when my mum received hospice care in another part of the country, I witnessed not only great warmth and sensitivity in the way she was looked after but the uplifting atmosphere and camaraderie between the people working there. The same is absolutely true of St Luke’s – you only have to read all the heart-warming stories local families share about the precious memories the team helped them and their loved one create.

“It’s natural to feel a bit apprehensive when starting any new job, never mind one so far removed from what you’re used to, but I can honestly say I’ve felt at ease from day one. Everyone is so friendly, and there’s no ‘them and us’ feeling between the staff and volunteers – it’s one team made up of people with different skills, strengths and experience, where each person is valued for who they are and what they bring.

“At the moment, I’m mostly working in the gardens, which I feel is a privilege because they aren’t just ‘any’ gardens, they’re a haven for Turnchapel patients and a special place bereaved families often return to because they find such comfort there. With the remodelling of the workspaces that’s under way inside the building, I’m also looking forward to getting stuck into some of the decorating that will need doing there.”

“I hope my story shows that it’s never too late to change direction and embrace a new challenge, especially if – like me – there’s a job you have always wanted to try. Being a Maintenance Assistant at St Luke’s has highlighted to me that it takes a multi-skilled team to provide such great hospice care, with dedicated people behind the scenes as well colleagues working directly with our patients.”

Learn more about our current job opportunities.

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BLOG: The Power of Words

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.”

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