Tag Archive for: St Luke’s Hospice Plymouth

Hospice Las Vegas
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BLOG: Hospices across borders

St Luke’s Digital Communications Officer Gabby Nott currently works for us remotely from Las Vegas, USA. She has been exploring what hospice care looks like on the other side of the Atlantic Ocean.

Sin city, the place of roulette wheels, palm trees and endless sunshine.

Venture away from the bright lights of the strip and just like any other big city, hundreds of people are living with a life-limiting or terminal illness. Death does not limit itself and wherever you find yourself in the world, sadly you will also find death.

As Dame Cicely Saunders championed the modern hospice movement in London back in the 1960s, before taking it overseas to America with the first hospice in the USA established in 1974 in collaboration with Florence Wald, it seems fitting to be following the trail of hospice care from Plymouth to Las Vegas.

This comes as this last week it hit the headlines that former American President Jimmy Carter, who at 98 is the longest living president in American history, is receiving hospice care at his home in Georgia.

Almost half a century may have passed since the pioneering movement settled in the States, but today the strength of hospice care is scattered across Las Vegas, with around 79 hospices providing end of life care on a daily basis.

I was surprised to hear how many hospices there are within the city. It hit home how privileged St Luke’s is within its community of Plymouth, the South Hams and South East Cornwall, being a focal point for so many.

Hospice Las Vegas

I paid a visit to two of the leading hospices in the Las Vegas area to discover more about their work and palliative care this side of the Atlantic Ocean. Having lived in Vegas for the last couple of years I have witnessed the private healthcare system in full force, where each individual is responsible for having their own health insurance, which can be hugely dependent on income. This means that the hospices here rely on the insurance pay-outs to pay for the care, with many working for profit and having to pay tax on these funds and provide a financial return to shareholders. This is in contrast to St Luke’s, which is only partially funded by the NHS and therefore relies on the generosity of our supporters. I was intrigued to see how this model of hospice care differs from our own.

Hospice Las Vegas

Nathan Adelson Hospice is the only non-profit hospice in Southern Nevada and is the longest established, starting their home care back in 1978 before opening the area’s first inpatient hospice in 1983. I met with Director of Admissions and Transportation, Ashley Earle, who gave me a tour of their main hospice building, located just a few streets away from the world-famous Las Vegas boulevard.

Tucked away in a rare pocket of greenery, the hospice felt like an oasis of calm on first appearance, a stark contrast to the intensity of the nearby casinos. I was instantly transported back to our specialist unit at Turnchapel as I walked through the doors, with an in-memory display adorning the walls, similar to our beloved memory tree, with each leaf representing someone special we have cared for.

The building itself is laid out in different quads, each with private rooms leading out onto a patio, providing patients with easy access to fresh air and the famous blue skies of Vegas. In the middle sits a serene garden, with running water providing a peaceful backdrop for patients and families to sit and reflect in.

Ashley tells me that they’re currently providing care for 338 patients, across the two inpatient units and in the local hospitals, but with the majority seen in the comfort of their own homes. Like St Luke’s she describes their various nursing teams, including their inpatient and homecare nurses as well as their admissions team, who work in the hospital responding to referrals and doing evaluations before passing on the care to the homecare team once a patient is transferred home.

Hospice Las Vegas

Ashley is not a Vegas native, having moved to the area from Plymouth, Massachusetts (a fitting coincidence) but like many of the patients they see, it was the bright sunshine that drew her west.

“I moved to Vegas three years ago to come and get some sunshine,” she explains. “I started working for a hospice back in Massachusetts when my mother was receiving hospice care and saw the amazing work that was being done and thought I want to be part of that. I worked for an inpatient unit and thought this is it, this is my calling. I wanted to move here, get some sunshine and work for Nathan Adelson. There were no ifs or buts about it. We’re the only non-profit hospice and that makes a huge difference. The hospice is so established in the community. Vegas is a really interesting market for hospice care, there’s a lot of competition, it’s very transient, so we have a special place here.”

It is not just Ashley that was drawn to the bright lights of Vegas, many of their patients specifically travel to the city to live out their last days in a place that is special to them.

“It’s really unique here in Las Vegas, it’s a very important place for a lot of people. We have patients coming over from Hawaii. We had a patient here who was a very big poker player and he wanted to come to Vegas one more time and win a lot of money so that his family were taken care of and that was something the hospice was able to help with. We’re in a fortunate position that we can provide hospice care for a lot of people who are travelling here. It makes a huge difference for people who want to make that one last trip. It’s a special place for so many. We prioritise our community but we won’t turn anybody away. If they need us, we’re there.”

As a non-profit, the insurance only covers the cost of the care, so they rely on the generosity of their local community to help provide their patients with a full range of support services as well as covering the cost of about 20% of the patients, who they see that have no insurance.

Like St Luke’s flagship events, Men’s Day Out, Midnight Walk and Tour de Moor, Ashley describes how they also work with the community to host different events to raise funds for the hospice. “We have a fashion show every year which is our biggest fundraiser and we also have a Doctors in Concert that’s another big fundraiser, along with a regular wine tasting event. Just things that the community looks forward to year after year. We also do a butterfly release in early spring where you can donate and purchase a butterfly in memory of a loved one. It’s really beautiful.”

Ashley tells me about one programme that was introduced using the money raised by donations that involves robotic pets – ‘Paws at home’ – I was intrigued to hear more. “We have a ‘Paws for Paul’ pet therapy service set up by the foundation through donations,” she says. “As well as therapy for patients, it helps us support pets while our patients are on service and helps with rehoming if needed when a patient passes away. Paws at Home is an extension to this programme, with robotic cats and dogs which are normal size and can breath, purr or bark and their heads can move. It’s so comforting for those patients with Alzheimer’s or dementia who just need a little bit of companionship.”

As many are aware, death and grief come hand in hand and wherever a hospice is, bereavement soon follows. At St Luke’s our social care and support team provide bereavement support to both adults and children who are experiencing a loss. Ashley describes how they also commit their time to supporting children who are coming to terms with losing a loved one.

“We do a lot of work for bereavement. We have a camp that is one of my favourite things that I was able to participate in last summer. We go up to the mountains for the weekend with 30 kids, their loved one might not have necessarily passed away in our service, it is open to the community. They have a weekend in the mountains where they have a lot of fun, but also do grief work. It was one of the most powerful things I have been involved in and was something I felt really proud of. It was really special and put things into perspective for me.”

During my visit, I was able to steal a minute with one of the staff nurses on duty that morning, Annabelle Buynay and find out what drew her to working in hospice care.

“I find working in hospice care really rewarding,” she explains. “I’ve been in different care settings, but have found I prefer to work in a hospice as I feel like you do more patient care and working with families a lot more. You have more time to spend with patients.

“When I was in nursing school, I didn’t want to do hospice care as I thought it would be too depressing so I steered away from it. Then I got introduced to it when I was working in skilled nursing, working in long term care and I got to work with hospices and I thought this is what I want to be doing, rather than just passing meds. I feel like you’re paying more attention to their needs, treating their symptoms and providing education to the patients and their families. I thought this is what nursing should be.”

I left Ashley and Annabelle feeling a spread of warmth that is relatable to anyone who has been in the company of any of our St Luke’s care teams, witnessing a passion for providing patients with the highest quality of care and dignity when they need it most.

Having met the non-profit hospice, I wanted to pay a visit to a for-profit hospice, to witness the difference between the two.

CompassionCare Hospice is one such Vegas hospice. Lying in the quiet suburb of Summerlin – popular with families and sprinkled with restaurants and shopping areas – it is a far cry from the reputation that has come to be associated with Vegas. Ranked in the top three of hospices in the city, they pride themselves on being there for the patient, providing them with a peaceful end of life experience in a familiar and secure environment.

I met with Director of Education and Community Relations, Julie McIntosh and Executive Director Jennifer Wantoch. CompassionCare’s main services are provided by clinical teams in patients homes or assisted living facilities, with links to several of the main hospitals in the city as well, to be on hand when a patient reaches end of life. While they don’t have an actual hospice in-patient unit, they instead are contracted with about 30 different facilities across the city.

Julie explains that 90% of all their patients are funded by Medicare, the federal health insurance program specifically for people 65 and older. But they won’t turn away someone who can’t afford to pay the insurance. “We’ve been here 18 years and we take more gratuitous patients on average than the other hospices,” she says.

Jennifer describes the care they deliver: “A Medicare condition of participation is that every hospice has to offer four levels of care – routine home care, continuous care where we will put a nurse at a patient’s bedside if the systems can’t be managed, general inpatient care and respite care. We look after about 200-250 patients at any one time and usually patients are seen one to two times a week.”

It highlighted to me how lucky we are to be able to provide care free to our patients, but that is down to the incredible supporters we have, who go above and beyond raising more than £7.8 million a year to keep our services running.

Beyond the initial care, a key part of their work, like our own is breaking down the taboo around death and educating patients, communities, loved ones and carers. Julie explains: “Every time you have that opportunity to go into that patient or care giver’s home, you can help provide guidance and technical help to make their lives easier and answer any questions they have.” They also work closely with other local organisations to help spread awareness and understanding of what hospice care is.

Like Devon, Vegas is often regarded as a retirement oasis which means the need for hospice care is steadily increasing, and we know first-hand it can be a challenge to keep up that demand.

“We have a huge senior population here in Las Vegas,” Julie explains. “People come out here to retire and we have several military bases, so we have a large veteran population. Therefore we have a higher than average senior population, with Alzheimer’s and dementia being in the number two spot for terminal illnesses below cancer.”

However, because of the high number of hospices in the city, it becomes a challenge to find their footing within the community.

“There are 79 active hospice licenses in Las Vegas alone. New hospices open every day and hospices close very frequently too,” Julie says. “The challenge is providing that level of high patient care but also differentiating yourself and being able to be competitive. We’ve worked super hard on our reputation, but not everyone always follows the rules. Medicare has rules that everyone must abide with and there are definitely people who go above and beyond what is ethical and that’s hard to battle against. I think something has to be done. It’s like the wild west here in Las Vegas.”

In order to stay ahead of their competition, the hospice has had to make sure they are providing services that others are not. While in the UK we are used to the reassurance that an ambulance will deliver us to hospital for free, here in the US, it again will cost the patient. CompassionCare Hospice decided to provide free transportation from hospital to a patient’s home, something that to many will ease the burden at a time when they have enough to worry about.

Listening to Julie and Jennifer describe the hospice and its workings made me realise that no matter where in the world you are, there will always be challenges you are faced with. While our circumstances may be different, St Luke’s, Nathan Adelson and CompassionCare all have one key thing in common, that our patients receive the care and dignity they deserve at the end of their lives. St Luke’s is incredibly fortunate to have the unyielding support of the local community, without which we would not still be here today and as Ashley put it quite simply, wherever in the world you are, thanks to the evolving world of hospice care, “If they need us, we’re there.”

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BLOG: St Luke’s Hospice Plymouth appoints new CEO

St Luke's Hospice Plymouth CEOSt Luke’s Hospice Plymouth appoints new CEO

St Luke’s Hospice Plymouth is delighted to announce the appointment of new CEO Christina Quinn. She will take up her post this spring following the retirement of highly respected chief executive Steve Statham.

Currently Director of NHS South West Leadership Academy, Christina emerged as the standout choice in the charity’s quest to find the very best candidate to step into this incredibly important role.

Her diverse career portfolio, clinical background and leadership expertise mean she brings a unique set of health care and NHS knowledge and experience to St Luke’s, where she has previously served in a voluntary capacity as a trustee and chair of the board.

“Unsurprisingly, we had a very strong pool of 26 applicants for this prestigious and appealing job, including several CEOs with experience of running hospitals, NHS organisations and medical charities, as well as people from the business and management sectors,” said Charles Hackett, chair of St Luke’s Board of Trustees.

“Ultimately, Christina’s selection was all about her personality, attitude, capabilities, motivation and the extensive experience that gives her the capacity to lead. In her present job she is responsible for shaping leadership development interventions at a national and regional level, and she certainly delivered on many levels recently during the Covid pandemic. She has a high level of empathy and a curiosity to learn and discover and has given a huge amount of energy and passion to the organisations she has previously worked for.”

Originally from London, Christina trained as a nurse at St Bartholomew’s Hospital, before moving to the South West where she has pursued her keen interest in the impact of leadership in terms of patient care outcomes.

“I am certain that Christina’s experience in leading and developing change will give us all an opportunity to refresh our future vision as we continue to deliver the excellent end of life care St Luke’s is renowned for, while always keeping clear sight of our mission to make sure no one dies alone, in pain or distress,” said Charles.

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BLOG: National Apprenticeship Week 2023: Meet Selina

 

This week (6-12 February) is National Apprenticeship Week. It is an opportunity to celebrate the achievements of apprentices and the positive impact they make to communities, businesses, and the wider economy.

As an employer of choice, St Luke’s invests in developing people. We offer apprenticeships across the organisation to give individuals the opportunity to step into a career progressing role and develop their passion.

We wanted to share some stories from our current apprentices and celebrate them and their roles within St Luke’s.

Selina Rogers is one of our Trainee Nursing Associates, working with our St Luke’s Urgent Care team, delivering end of life care in the community, supporting our patients to die within their own homes.

Having worked her way up through different health care settings to become a Senior Health Care Assistant, she decided to develop her career further and when the position within our urgent care service came along, she jumped at the opportunity to do the apprenticeship with St Luke’s and progress within a team she feels passionate about.

“My background since leaving school many years ago has always been within health care,” she says. “I have always wanted to be a registered nurse but had my son at a young age, so I put my effort into raising my son and put my career on hold.

“The apprenticeship has given me the chance to progress without becoming in debt. In gaining a Foundation Degree at Plymouth University, I have had the chance to experience lots of different working environments within the health care service I would not get the chance to do otherwise, such as a GP practice, a private hospital and community nursing to name a few, so they helped hugely in gaining knowledge in my progression to become a Registered Nursing Associate.

“I take great pride in working for St Luke’s and the amazing work the hospice does as a whole for our local community, giving our patients the best possible care and end of life experience for the patient and their family is so important and so special.

“It’s an absolute privilege to be able to do that for a person.”

As part of our Urgent Care team, Selina and her colleagues work alongside our teams in the community, at Derriford hospital and our specialist unit at Turnchapel to ensure a seamless provision of specialist care to people when they have days or weeks left to live.

“The end of life team is extremely special, so many people want to die in their own home, surrounded by their loved ones in their own environment. It is such an amazing thing to be able to do, the team of HCAs and RNs along with the community nurse specialists all work together in ensuring our patients have the best possible experience, bringing some love and laughter along with compassion and empathy. It’s just the best job. I have such great job satisfaction and never wake up not wanting to attend work, who gets to say that, not many! I feel very lucky to have found this opportunity within St Luke’s.”

Selina credits the apprenticeship with giving her a career stepping-stone and helping her to achieve her dream of becoming a registered nurse.

“For people thinking about doing the apprenticeship, do it. It is not easy, it is hard work and I have had times where I thought I cannot do this but your university cohort, employer and colleagues, along with family and friends give you that support.

“It gives such fantastic opportunities and a stepping-stone to becoming a registered nurse which I myself hope to do in the near future and hope to remain with the amazing St Luke’s team when I do so.”

To find out more about our apprenticeships click here or contact our People Services team.

Read Rachel’s and Lewis’ stories.

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BLOG: National Apprenticeship Week 2023: Meet Lewis

This week (6-12 February) is National Apprenticeship Week. It is an opportunity to celebrate the achievements of apprentices and the positive impact they make to communities, businesses, and the wider economy.

As an employer of choice, St Luke’s invests in developing people. We offer apprenticeships across the organisation to give individuals the opportunity to step into a career progressing role and develop their passion.

We wanted to share some stories from our current apprentices and celebrate them and their roles within St Luke’s.

Lewis Kendall, 26, is our Accounts apprentice and joined the organisation in May 2019. An avid golfer for Thurlestone Golf Club, Lewis originally studied Accounting and Finance at University in Swansea, leaving for personal reasons in his second year. However, he soon came across the opportunity to study Accountancy through an Exeter College Apprenticeship with St Luke’s and applied straight away. At the end of last year, he successfully passed his apprenticeship course and last month he also passed the final exam of his Association of Accounting Technicians Diploma.

Lewis reflects back on his first interview with St Luke’s, “I jumped at the opportunity when I saw the apprenticeship as I really enjoyed my time and course at University. My interview with St Luke’s went really well, they gave me a great overall picture of the charity as well as a brief tour of the departments and a chance to meet the team I’d be working with. It was at that moment I knew I wanted to be a part of this great charity and the wonderful service it provides.”

Lewis works within our finance department, the team that are vital when it comes to processing the generous donations we receive.

“When I started I was doing more financial admin tasks, like processing online donations on the fundraising database,” he explains. “As my apprenticeship has gone on my role in the team has evolved to better suit this development. An example of this would be one of my roles now is consolidating data and producing performance reports that are used in the monthly management accounts that are sent to department heads.

“Working for St Luke’s definitely gives me a sense of satisfaction that I don’t think you get if you don’t work for a charity. I feel like the work I do helps to monitor, evaluate and improve the financial position of St Luke’s, therefore contributing to the continuation of the Charity. In terms of the bigger picture I guess the work the Finance Team and I do helps maximise the care we can afford to give to our patients and the support to their families.”

Lewis describes how the apprenticeship has given him the opportunity to learn ‘on the job’, embedding what he learns during his course into his daily practice.

“It’s given me the opportunity to ask questions and apply knowledge learnt from my study leave in the workplace. It’s also been helpful that in asking these questions, my manager and head of department have been able to see how my progression has been going and present me with new responsibilities that coincide with what I’ve been learning. It’s a relationship that’s worked very well and kept my role in the Accounts team really interesting.”

For many school leavers and graduates, the idea of working for a hospice can sound fairly depressing, but working for St Luke’s has given Lewis an insight into the care and services we provide for so many local families.

“I know St Luke’s is extremely admired and respected in the service it provides, but before I started working here I (honestly) will admit I hadn’t had been aware of St Luke’s and the incredible work it does to support end of life patients. In the time I’ve been here I couldn’t commend St Luke’s more in the way it helps its patients and helps support their families and I feel proud that I’ve played a (small) part in it.

“Working at St Luke’s has provided an interesting perspective on my profession. I was the only student in my class that worked outside of a practice so applying the knowledge was sometimes harder than it might have been for others working in another industry or an accountancy firm.

“Since starting, I’ve helped volunteer at our Men’s Day Out and Midnight Walk events. It’s also made me aware of all the ways people raise donations, their enthusiasm in fundraising for us and the stories behind it.

“You feel incredibly proud working for a charity so fondly thought of by so many people.”

If you’re considering a career change or looking to take the next step in developing your role, get in touch with our People Services team to learn more about our apprenticeships and placements. We are currently looking for an IT Apprentice to work alongside our IT team, click here to find out more and apply.

“With the experience I’ve had with St Luke’s I would absolutely recommend an apprenticeship to others, especially if you’re uncertain about going into further education or pursuing a career after GCSE’s and A Levels,” Lewis adds. “It’s the best mix of practical workplace experience and learning I could have hoped for.

“I’ve always felt supported by both my employer and training provider and encouraged to achieve the best results I can in any exams while my knowledge and opinion have been tested in the work place, preparing me for extra responsibilities or the next stage of my career.”

Look out for more of our apprentice’s stories this week…

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BLOG: National Apprenticeship Week 2023: Meet Rachel

National Apprenticeship Week 2023: Meet Rachel

This week (6-12 February) is National Apprenticeship Week. It is an opportunity to celebrate the achievements of apprentices and the positive impact they make to communities, businesses, and the wider economy.

As an employer of choice, St Luke’s invests in developing people. We offer apprenticeships across the organisation to give individuals the opportunity to step into a career progressing role and develop their passion.

We wanted to share some stories from our current apprentices and celebrate them and their roles within St Luke’s.

Rachel Marriott, 43, has been one of our Health Care Assistants (HCA) working at our specialist unit at Turnchapel for the last few years. A mother of three, she has always had a passion for helping people at the end of their lives. She first became a HCA 17 years ago, before joining St Luke’s in 2019. She is currently finishing her two-year apprenticeship as a Trainee Nursing Associate (TNA) through Plymouth University.

In amongst her daily family life, Rachel spends one day a week at university for lectures and clinical skills, 12 hours a week at our specialist unit as a HCA and then 18 hours working in her trainee nursing role at both Turnchapel and on placements.

“I am supernumerary when working as a Trainee Nursing Associate,” she explains. “I have shadowed the nursing team to learn the roles of the nurses which consists of patient care, admissions and discharges, medications, continuing care, future care planning, working in teams, wound care and learning how to liaise with the multi-disciplinary team within St Luke’s. There are no two days the same, so every shift I work is a learning experience.”

 

With a background working in care homes, Rachel is no stranger to working in palliative care, even completing our Six Steps+ programme in end of life care in 2008, which she describes as igniting her passion for helping those living with a terminal illness. Working alongside our nurses on a daily basis gave Rachel a glimpse of what their roles are like and she knew it was something she wanted to be involved in.

“I have always enjoyed learning and used to watch the nurses eagerly when working alongside them as a HCA and felt that I wanted to further my knowledge and this apprenticeship seemed to fit perfectly for this. It would give me greater responsibility and keep my mind busy. My children are all grown up and it seemed the perfect time for me to better myself.”

Like with any further education course, Rachel has had to put in a great number of hours and hard work and has been truly dedicated to her learning, alongside her family life and role as HCA and at times has felt the pressure and encountered challenges, especially when moving between roles.

“I did not anticipate how hard the course was going to be,” she says. “12 modules divided between two years was a lot to do as well as working full time. It was hard to find the right balance. It has been a challenge changing my role when working as a TNA then working as a HCA. I want to constantly learn and work alongside the nurses, when working as a HCA you have to step back and not be as involved which I have found frustrating at times. I am very grateful to be at the end of this course and looking forward to starting my new role as a registered professional. I am lucky that within St Luke’s the TNA role is recognised and understood whereas some of my fellow cohort colleagues have struggled to help others understand their role.”

 

While challenging at times, Rachel’s passion for learning and being able to make a difference to patients when they really need it, has given her an incredible amount of satisfaction, both in a professional and personal capacity.

“I love working in a hospice. Being able to make a patient feel good about themselves, make them smile or give them the extra time and care they need. A good day for me is being able to understand the needs of the patients and working out what can be done to make that patient person centred and individual to their needs. This could be from helping them dress, assisting them to have a soak in the bath, washing their hair or just sitting and chatting to them.

“I want patients to feel comfortable and happy when in my care. I never underestimate how a patient feels, I just try to make them feel that bit more special and contented in any way that I can.

“I do get a lot of job satisfaction in my role. Friends and family ask how I do my job but I always turn around and say that I love my job. The hospice is not a depressing or morbid place to work, there is generally laughter heard and the nursing and HCA team all go above and beyond to leave any problems at the door and give their very best to the patients.

“The team is like a family, I have never seen such a closeness in any of my previous jobs. If you need help you ask and someone will always go the extra mile to help each other out.”

To find out more about our apprenticeships click here or contact our People Services department.

Look out for Lewis’ and Selina’s stories coming soon…

SIX STEPS CARE HOME
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BLOG: Agency’s six steps to end of life care excellence

SIX STEPS CARE HOMEAgency’s six steps to end of life care excellence

The very first nursing and care agency in Plymouth to boast St Luke’s end of life training verification is delighted that its high standards and good practice have been recognised and verified for the 12th year running.

St Luke’s has long been committed to helping the wider caring community to deliver the very best care for people who are approaching death, through its dedicated Six Steps+ education programme.

There’s a growing band of great nursing and care homes in and around Plymouth that have invested in the specialist training initiative. However, the highly respected Prestige Nursing & Care – a Domiciliary Care and temporary staffing provider – with clients across Devon and Cornwall is the only agency that has proudly renewed its Six Steps+ accreditation, year after year.

With three in-house certificated St Luke’s End of Life Champions to spread their specialist knowledge and skills to all their staff, Prestige has demonstrated an ongoing commitment to make a real difference to clients at such an important time in their lives.

Their care teams are experienced at looking after the dying in their own homes, during the day and overnight, working alongside St Luke’s specialist teams when expert input is needed. The agency, rated “Outstanding” by the CQC, also supplies staff for nursing and care homes, and occasionally provides temporary cover for St Luke’s specialist unit at Turnchapel.

Manager Emma Bonney, who spearheaded the agency’s ongoing connection with St Luke’s, says their Six Steps+ training by St Luke’s End of Life Educators, has been a game changer, giving her staff the confidence, not only to give a better standard care, but to champion their clients.

“We were having more and more clients at the end of life in the community and my main motivation was to improve our services and support those people more effectively,” she said. “Liz Lawley and the St Luke’s education team have empowered us to challenge things when it’s in the best interest of the patient – we have the knowledge to do that now.

“It’s great that we know what to do to look after people at the end of life appropriately. Families don’t know what to expect because they can’t tell what is normal, but our health care assistants can calmly explain things and take away some of their worry.”

A recent example was a woman who was trying to look after her elderly, terminally ill mother at home but found it overwhelming when she deteriorated steeply and was in a lot of pain and distress.

“The daughter just couldn’t cope and thought she would have to put her mother in residential care. Because of our specialist knowledge, we were able to go in and help to keep the lady calm and comfortable so that she could stay at home.

“Stories like that are why we do the Six Steps+ training, to provide really high quality care that allows people to stay at home at the end of their lives,” said Emma.

The programme’s standards also emphasise the importance of Advance Care Plans and documenting people’s wishes in terms of their future care.

“Advance care planning is a big benefit. We looked after a lady who had early onset Alzheimer’s and she could see where the disease was going to take her. We helped her to make a plan while she still had capacity. She wanted to be care for in her own home and was very concerned about being patronised. This was documented as part of her Advanced Care Plan and she remained at home until she died, in her preferred place of care”.

Another of Prestige’s top priorities is providing continuity of care for people in their own homes.

“When we consider a package of care, we always look to assign a set team to ensure we can cover it fully and safely. We try to minimise the number of people as much as we can so that the client has a consistent team who know them well. This in turn gives the client a more effective service as the staff are able to respond promptly to any changes in their condition and wellbeing.”

Emma and her fellow Prestige End of Life Champions, Jane Lys and Clare Waterfield, are all involved in training the Prestige staff. As part of the Six Steps+ programme, they undertake refresher courses with the St Luke’s Education Team and attend the regular End of Life forums that bring together other local champions to discuss common issues and expand knowledge with guest speakers.

“The programme is ongoing. Every year we re-verify. At that point we have to provide evidence that we are still providing high quality end of life care, showing examples of how we put the Six Steps+ into practice.”

What is the Six Steps+ programme?

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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.”

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BLOG: How to knit a St Luke’s lottery win into a sociable money spinner

How to knit a St Luke’s lottery win into a sociable money spinner

When Lynne Matthews had a lucky £250 win on St Luke’s weekly lottery last summer she thought about giving it straight back. Instead, the passionate knitter invested her winnings in an inspired plan that’s earned four times that amount to support her favourite charity, as well as creating a weekly social get-together for craft fans.

Retired teacher Lynne reckoned that using her windfall to buy balls of good quality wool and recruiting fellow knitters to magic them into items to sell, would be a great way to raise money for St Luke’s, while indulging in her favourite hobby.

“I really love to knit but I don’t have any babies at home to knit for any more,” said grandmother Lynne as she put the finishing touches to a beautiful little cardigan in candyfloss pink.

She put out a call asking if anyone would like to join a weekly knit and natter group at Fort Stamford Health and Fitness – next door to St Luke’s base at Turnchapel – on Wednesday mornings, specifically to raise funds for the charity.

“I’d never done anything like it before, and I was a bit nervous when I started, but it’s gone really well. Lots of people have come along and since July we’ve raised more than £1,200 from that initial £250,” explained Lynne. “I do the St Luke’s Lottery every week and previously I’ve won a few pounds and given the money back. This time I thought it was an opportunity to do something more.”

Now there’s a core of around a dozen knitting and crochet fans of all abilities turning up, usually before or after their swims or exercise classes. Lynne provides the needles, wool and patterns – and even free expert tuition for beginners – and people choose what they feel confident enough to make, although she suggests themes if anyone is stuck for ideas.

“We natter more than we knit, to be fair, but we do carry on knitting or crocheting at home,” said one regular member of the group. “We have a good laugh and we put the world to rights a few times on a Wednesday. I think we all have some sort of link to St Luke’s – there is always someone you know who has been supported by St Luke’s.”

Since July 2022, Lynne – whose grandmother was cared for by St Luke’s back in the 1990s – and the Fort Stamford group have hand-crafted dozens of wonderful items including hats, scarves, gloves, baby and children’s clothes, toys, blankets and bags. Out in the corridor at the club, all the work is on display while the group meets, courtesy of owner Royston Sumner, and it’s been selling like hot cakes.

The project has blossomed organically, with some people who no longer knit popping in to donate wool and needles, while others have asked Lynne to create special items for them, like the very cute toy dogs that are very popular.

At Christmas the most coveted items were little red knitted stockings to hang up for Santa, personalised with people’s initials. The group are currently working on special Valentine’s Day and Easter themes, with little chicks popping out of eggshells sure to be bestsellers.

Lynne’s Knit and Natter group meets at Fort Stamford Health and Fitness, Stamford Lane, Jennycliff, Plymouth on Wednesdays from 9.30am to 11.30am when their work is also for sale. Everyone is welcome to come along – you don’t have to be a club member to knit or to buy!

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BLOG: Pocket hugs are a labour of love for Lyn

Sometimes all you need is a hug and a whole box full of pocket cuddles has arrived on St Luke’s doorstep recently, courtesy of a kind-hearted and talented Plymouth woman who wants to bring a little bit of comfort to people when they need it most.

Small, round and woolly little faces, with googly eyes, tiny arms clutching a heart and a loop to hang them up with, Lyn Frost has crocheted them with love in a variety of colours and wrapped them in organza bags to keep them safe until they find the right homes amongst St Luke’s patients and their families.

“When you are having a tough time, a hug is just what you need.,” said Lyn from Plymouth, who also wanted to say thank you to St Luke’s for the care her father received a few years ago. “I thought they would cheer people up and maybe they could also raise a little bit of money for St Luke’s if anyone wants to make a donation.”

Lyn has ME which limits her mobility, so crafting gives her something interesting and useful to do at home. “I can move around inside the house but when I go out and about I’m in a wheelchair,” she said. “My husband has turned the spare bedroom into craft room for me and it’s my little haven.”

She taught herself to crochet using YouTube videos during the Covid lockdown and joined an online group called Random Acts of Crochet Kindness, which gave her the idea, and the pattern, to knit the pocket hugs for the first time.

“I made a slightly bigger version for a friend who had lost her mum and she had it hanging on her memorial, so I decided to make these ones for St Luke’s,” said Lyn, who also make things for the special care baby unit at Derriford, the homeless, and fidget balls to help people with dementia or autism.

The colourful pocket hugs are available at our specialist unit at Turnchapel for patients and their families and as it says on the handwritten tag, are ‘for those times you need a little hug’.

Men's Day Out
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BLOG: Men’s Day Out: It’s good to talk

Men’s Day Out: It’s good to talk

Chat, chew the fat, put the world to rights, whatever you do, it’s good to talk.

Men, it’s good to talk. We’re masters at masking how we really feel, even when we’ve lost someone we care deeply about.

Sharing our feelings can make a big difference, and Men’s Day Out offers a great opportunity to drop the brave face and open up to others in the same boat.

Dave Gundry, 54, from Liskeard, will be striding the streets of Plymouth on Saturday 11 March along with hundreds of other like-minded men.

With two decades of work in men’s mental health, Dave has witnessed the changing face and increasing recognition of mental health in men, fully embracing the ‘it’s good to talk’ nature. He looks upon the event as the opportunity to put his skillset and background to good use, in order to help any men who might be suffering in silence.

“During my time on the walk, if someone speaks to me I may be able to help them understand more about some mental health issues that maybe they don’t understand or if they don’t know where to turn to for advice, while also sharing my experience of grief and St Luke’s.”

Like many of the men who will be making big strides for St Luke’s, Dave will be walking in memory of two special loved ones. His father and close family friend and best friend of his wife, Lianne, who was looked after by St Luke’s at our specialist unit at Turnchapel and at home, after a terminal cancer diagnosis.

“During the time we visited her and when she came home briefly in between stays, she was full of praise for all the staff and was telling us how some staff would call in to see how she was doing. Despite not being her carer for the day they would just pop in to cheer her up and make her laugh, always going the extra mile.”

Men's Day out

Dave was the first of our Men’s Day Out participants to get his JustGiving page up and running. The money he and all our walkers raise through sponsorship means we can keep our teams out in the community, providing the highest calibre of care for our patients and their families, ensuring no one has to die alone and that they can have comfort and dignity until the end.

It was Dave’s group of friends, known as the ‘Friday Team’ that first suggested Men’s Day Out to him, having completed it multiple times themselves. Unfortunately, the timing wasn’t to be, due to the COVID-19 pandemic and Dave’s father growing ill and passing. So it wasn’t until last year that he was finally able to take part.

Along with Dave, many of his teammates – who vary in ages from their 20s to 70s – have experienced the care and support St Luke’s provides first-hand, through family members or friends, making Men’s Day Out the opportune time to walk, talk and share.

“I wanted to do it again this year, to try to raise some more money and awareness and also in the hope that some of the people I met and talked with last year I may bump into again and get an update on how they are doing. I think it’s a wonderful event and to mix raising funds for St Luke’s with raising awareness for men’s mental health works really well.

“Oh and it would be a bit unjust if I didn’t say that of course some good laughs and great company of like-minded people and rugby all thrown in were a bit persuasive too…”

Visit Dave’s fundraising page to find out more about his fundraising journey https://www.justgiving.com/fundraising/david-gundry1

Like Dave, you have the opportunity to discover a special bond with friends old and new as you stride a scenic 12km (7.5 mile) route through the city and waterfront. Winding up at Plymouth Albion, you’ll be ready to tuck into a well-earned pasty, enjoy a welcome beverage and cheer the local boys as they clash with the Rams from Reading.

If you’ve already got your place for Men’s Day Out, sponsored by Jem Scaffolding Ltd, now is the time to set up your JustGiving page just like Dave. Not only do the funds you raise make a massive difference to our end-of-life care, but the camaraderie you’ll find on the road can also work wonders if you’re struggling with loss. Click here to get your page up and running.

Sign up for Men’s Day Out now and make mindful miles matter for St Luke’s.

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