Hazel came to Dorothy House as a Nurse Specialist in 2002 having worked as a Nurse Specialist at St Christopher’s Hospice in London. She explained to us how her role enables patients with life-limiting conditions to receive the very best hospice care.
‘Patients are referred to us by GPs, District Nurses and hospital professionals via our Contact Centre where decisions are made as to which professional at Dorothy House they should see. Often, we are the first professionals from the hospice to see a patient, although since Dorothy House has started taking early referrals people often have met someone or come to one of the Coffee Clubs before meeting us.
My role as a Nurse Specialist is to address the – often complex – physical symptoms and emotional needs of patients with life-limiting conditions. Our role used to centre on patients with cancer and Motor Neurone Disease but the hospice now accepts patients with many life-limiting conditions, for instance chronic lung conditions, end-stage heart and renal failure. Nurse Specialists focus on those people with difficult symptoms whose needs cannot be met elsewhere.
With a typical new referral, I go and meet the person at their home for a first assessment – which usually takes around one and a half hours. My first question is always: ‘Do you know why I’m here?’ Often, I’ll find they don’t really understand what we’re about, not necessarily because it hasn’t been explained to them but they just haven’t taken it in. People often have preconceived ideas of what hospice means and that makes them very anxious about accepting a referral.
The aim of my visit is to get their story, find out what got them to where they are now, what physical symptoms they have, how they are feeling, what their understanding for the future is and what their plans, fears and anxieties are. It is a privilege to be party to all this information when it’s the first time you’ve met someone. I always draw a family tree and that’s about who’s around for them – both in their family and also other social support that, from the start, gives us an idea of how well supported they are. We also find out about how they are financially and can access benefits for them, or refer them to a Macmillan CAB adviser if their financial needs are more complex.
At the end of an assessment, I’ll explain the other services we have that they may benefit from. These include physiotherapy, occupational therapy, complementary therapies, Coffee Club, day patient services and the Family Support Team.
It’s not just about getting information on which to base clinical decisions, it’s about making a connection, and being ‘alongside’ someone. I’m passionate about that – you get a huge amount from a relationship when you’re known and trusted. Talking and listening to people is a skill and you can’t learn it from books. Families are as important as the patients, and they are a big part of what enable people to stay in their own home, if that is what they wish.’