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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.”

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.