Trish McKee, Deputy Sister in the Inpatient Unit, gives us a glimpse of the daily demands on the hospice’s caring and compassionate ward:
I start work at 8am and, although we have a number of routines, every day is different here. Each patient is an individual and we aim to look after them both physically and holistically. And that goes for the families too. The patients are at the centre of everything we do but it is about everyone around them and we recognise what impact it has on them.
My first job is to take the handover from the night shift and co-ordinate what needs to be done on the day shift. We have an 18-bed unit with five nurses and three healthcare assistants (HCAs) on duty in the morning with four nurses and two HCAs in the afternoon.
We have a multidisciplinary team meeting with the doctors and the on-duty consultant to assess who is being discharged and what patients are being referred to the unit. It is a complex and changing landscape so communication is key to how we operate.
I like to think I’m a good coordinator and I make sure that everyone understands their roles for the day as soon as the shift starts.
Patients are referred to the unit for a number of reasons such as pain and symptom management, end of life care and we also do palliative rehab so they can get to a place where they could go home. We also do respite care as we understand the caring burden on family members and the need to support them too.
The first 90 minutes are all about making sure we know what we are doing and that the patients are cared for appropriately so I spend time allocating staff to patients, priorities treatments and talking to everyone.
If there is a need for more clinical care, the management is very good at making it available. I also have a good relationship with the two to three doctors and consultants who are on duty and we will discuss treatment options throughout the day.
I take my first break at around 9:30am and it’s time to grab a cup of coffee and check my phone and emails for 15 minutes and then it’s back to the unit.
Communication is key to my role but so is listening. You have to let the patient talk. It may seem like we have a million-and-one questions for them when they arrive so it is important to listen to their feelings or pick up on the cues – a lot of patients are concerned about being a bother so we like to make time so we know if anything is worrying them.
You have to make that time because it is as valuable as any medication. You cannot put a price on that time; it is very precious.
I like to take my 30-minute lunch break at 12 noon. I used to sit in the staff room but found myself doing work at the same time so I have been very good taking myself away from it and sitting in the canteen, off the phone, having a proper break.
I oversee the first of three drug rounds at 1pm and then if there are any teaching or in-house training sessions they are at 2pm. But all the time we are reacting and changing plans depending on the needs of the patients and their families.
My day includes ensuring staff get their breaks along with doing regular tasks such as stock check on the drugs, ordering new medication and liaising with the pharmacist on what drugs are needed. I also ensure we have the right number of staff to cope with changing needs on the ward. I also look after new staff members and student nurses who may be on the ward.
I coordinate the ward as I am responsible for its safe and smooth running for both patients and staff – I am the first point of call for any changes or developments. We have a wonderful workforce and we are well supported by the IPU manager Jo Hempstead and the hospice director, Steve Barnes.
The days are busy but very rewarding. We all get a lift from knowing we are helping a patient and their family during what can be difficult times. Some shifts can be quite intense and can be draining physically and mentally but our commitment goes to the end of the shift and often beyond.
There is another break in the afternoon and we can fit in a cup of tea or coffee when there is a moment. We look out for each other. It is important that colleagues know they can share experiences and say how they feel because we all go through those same things.
When there has been a difficult, demanding period at work, there is counselling available should you need it and it is very reassuring to know it is there.
There are lots of formalities and procedures that I need to organise during the day such as liaising with district nurses, care in the community teams and the hospice reception but everything is geared towards making the unit run smoothly and enabling us to have that vital time to care for and support our patients and their families.
I have been here for nine years and couldn’t really think of working anywhere else. Everyone here is heading in the same direction and we support each other.
After work, I do mindfulness and yoga from a phone app and find it is a good way of relaxing. We also get complementary therapies here such as massage, reflexology and acupuncture which are very relaxing and welcome.
At home, I like things that are nothing related to the medical world. I like box sets and have just watched Catherine The Great which is fantastic – Helen Mirren is amazing. I can blitz through a box set in an evening and always come back to work the next day feeling refreshed.