Early efforts on the part of Cicely Saunders and her team focused on providing quality of life for people who were dying even if they could not be cured. There are repeated stories of a positive ending for those who received care from the hospice, often at odds with their experience of care in hospital or elsewhere.
Family members who reflect on the care their relative received highlight the many opportunities afforded them to continue to enjoy small but important aspects of life, like sitting in the garden, opportunities for meaningful activity including art groups and a strong sense of safety.
I’m the eldest of 5 and in 1977 my second youngest sister fell ill… our GP had no idea at all how to cope with it… my sister was only 17 and Dame Cicely bent the rules because she wasn’t really an adult, but she very kindly said that St Christopher’s would take care of my sister… The nurses at St Christopher’s didn’t just look after my sister, they looked after my whole family
Ruth Saunders Volunteer and supporter
The value of honest conversations about the future for those approaching the end of life is a repeated theme, particularly when accompanied by an invitation to set new goals or participate in care in the knowledge that time is short.
A number of professionals came to work at the hospice with a specific ambition to learn the skill and value of open, transparent conversations about impending death.
An insight from this work was a realisation of the link between such an approach and the subsequent quality of life enjoyed by those that are dying and their families.
Seeing the patient as a person and responding to their needs and preferences in an individualised way is one of the most frequently cited foundation stones of the work of St Christopher’s over the years. It sounds easy but professionals talk about the challenges it can present, particularly when people’s choices are at odds with what the professionals think is best.
Staff describe how person-centred care was a founding principle or value enacted in multiple different ways beyond care – for example the way that education and training was delivered and the approach adopted to debriefing exercises and clinical supervision designed to support and sustain clinicians in their practice.
Senior contemporary leaders talk about their fears for the quality of care in the future, specifically that its holistic approach is at risk of being eroded due to limited resources and growing demand.
As people consider the future of palliative care, there is a clear call for an organisation that remains light on its feet and responsive, whilst retaining this essence.
One of Cicely Saunders enduring aspirations in her development of St Christopher’s was for a centre in which the three activities of research, practice and education were live, connected aspects of daily organisational life.
This has been achieved to greater or lesser extents in the course of the lifetime of the hospice, and examples exist in the history of
St Christopher’s of research and educative activities that have been critical in the advancement of the speciality of palliative care.
Stories, on occasion, tell of the tension experienced within St Christopher’s when resources were allocated towards research
or education, seemingly at the cost of direct care.
This, according to some participants, led to the development of the Cicely Saunders Institute where research could be prioritised. Conversely, mention is made of smart efforts in the life of the organisation to integrate research and practice in a highly accessible way – for example the creation of the Journal of Palliative Nursing.
Cicely Saunders based the hospice on three things, it was the inpatient unit, research and education, those were the three legs of her stool.
Deborah Holman Former Senior Nurse, St Christopher’s Hospice
If you’re working here you just have a whole different perspective on nursing, care of the dying, care of the family – I think that was the thing I loved, to see how the family were included and their understanding of what was happening
Anne Conway Former Staff Nurse, St Christopher’s Hospice
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This is the seventh in our serialisation of “Back to the Future – Reflections on an Oral History of St Christopher’s Hospice”
Part I – Introduction
Part II – Being Prepared to be Radical
Part III – Responding to the Experience of Suffering
Part IV – Supporting Innovation
Part V – Hospice as a Way of Life
Part VI – Building and Nurturing Relationships
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