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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.”

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!