Hospice Nursing Is…

“We all have lessons to learn during this time called life; this is especially apparent when working with the dying” (Elisabeth Kübler Ross)

Today is International Nurses Day. It is a day to reflect not just upon nursing but also about hospice and palliative care. There are over 220 hospices in the UK and 50 years ago in 1967, Cicely Saunders opened St Christopher’s Hospice in London. Cicely Saunders trained first as a nurse, then as a social worker and finally as a doctor. 

Sarah and Marie qualified in the 1980’s and between them have 63 years of nursing experience. Over the years nursing has continually evolved and has been defined by the Royal College of Nursing as “the use of clinical judgement in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability, until death”. Meanwhile, the Nursing and Midwifery Code contains the professional standards that registered nurses and midwives must uphold: to prioritise people, practice effectively, preserve safety and promote professionalism and trust.

Furthermore, many reports in recent years have emphasised the importance of a compassionate, competent, well-trained and supported health and care workforce in delivering high-quality end of life care that meets everybody’s needs and preferences. For example, Ambitions for Palliative and End of Life Care – a national framework for local action has as one of its six ambitions for its vision “All staff are prepared to care”. There was deliberate ambiguity in that vision: “prepared” meaning both “ready and willing” and “trained and supported” (Henry 2016 in Workforce report). 

So how do hospice nurses make sure they are prepared to care? How do we always prioritise people, practice effectively, preserve safety and promote professionalism and trust?

Hospice nursing is…

“A privilege, helping normal life to carry on when worlds are turned upside down” (Judith Park, Deputy Chief Executive, St Luke’s Hospice, Sheffield) 

“Careful attention to what is most important for the patient, followed by kind, expert and confident action to enable that where possible” (Heather Richardson, Joint Chief Executive, St Christopher’s Hospice)

“Giving personal, loving, tender and vigilant care” (Dr Gill Horne, Director of Patient Care, Rowcroft Hospice, Torquay, Devon)

“Supporting patients and family members to look at what’s important to them” (The Living Well Centre team at Rowans Hospice).

“A blend of evidence-based interventions, offered with compassion and care by skilled professionals” (Carole Walford, Incoming Chief Clinical Officer, Hospice UK)

“Hospice nursing is seeing the person and those important to them as unique, and work together to support them to live and die well.  It’s also important to  provide support into bereavement as how people die affects how those left behind remember them” (Claire Henry, Chief Executive, NCPC)

“Hospice nursing is seeing the person – their dreams, loves and losses” (Tracy Livingstone: Innovation & Governance Nightingale House, Wrexham)

“Exploring patients and carers’ wishes and preferences and start to have difficult end of life conversations” (The Living Well Centre team at Rowans Hospice).

“Myself and two colleagues were able to take a group of patients to a beautiful garden to see the first glimpse of spring. We sat in the sunshine, having a bit of gentle banter and lots of laughter. No talk specifically of illness but an appreciation of each other and the joy of spring. Nursing the soul if that makes any sense” (Vanessa Gibson, Queens Nurse, Community Nursing Services Manager, St. Richard’s Hospice, Worcester).

As hospice care and nursing responds to the ever changing health and social care landscape, perhaps our Nurses Day reflection is on how we should always be prepared to care by never stopping learning from our patients, their families, ourselves and others; always seeking to nurse and to be a nurse with kindness, compassion, expertise and knowledge. 

“There are so many lessons to learn in life; it is impossible to master them all in one life time. But the more lessons we learn the more business we finish, and more fully we live, really live life”. (Elisabeth Kübler Ross)

Perhaps the last word is from the Day Care Team at Rowans Hospice

• being there for the whole journey
• seeing your patient smile for the first time
• caring about the little things that matter to them
• when your patient is able to laugh in amongst frightening times
• being able to completely change your day from what you had planned because this is what your patients need from you.
• accepting that there are many things you cannot change, but small changes can make a big difference.
• being humbled by how people cope in very difficult circumstances

Nursing is…being prepared to care, prioritising people, practising effectively, preserving safety and promoting professionalism and trust.