Dr Elizabeth Bailey, Dr Karen Hogarth and students Maddie Elliot and Joe Gebbie explain how a volunteering project at East Lancashire Hospice is benefiting patients and improving the prospects of medicine students.
Students hoping to study medicine are advised by their schools and colleges and by universities that volunteering in a care organisation will enhance their chances of the offer of a place at medical school. East Lancashire Hospice in Blackburn receives many ad hoc requests for volunteering opportunities from students per year. Although one day clinical placements on the Inpatient Unit supervised by members of the medical team have been offered, we have not been able to offer clinical volunteer opportunities.
Lancashire Teaching Hospitals NHS Trust in Preston has introduced the Preston Widening Access Programme for Medicine at Manchester. It is delivered by medical students to support disadvantaged A level students who are applying to study medicine. The programme includes interactive workshops facilitated by the medical students, and there is a commitment from the A level students to complete 50 hours of volunteering in a care-related setting. One such student, Maddie, asked us if she could volunteer at our hospice. At the same time, Joe approached us for a volunteering opportunity prior to applying for a place at medical school.
Maddie and Joe agreed to be part of a project to explore how we can support future doctors from our locality by providing high quality and relevant clinical volunteering opportunities that will benefit the hospice as well as the students.
What we did
The Hospice Risk Manager reviewed our volunteer policy and explored the risks and benefits of recruiting future doctor volunteers under the age of 18 years. Following her report to the hospice Senior Management Team, approval to recruit two future doctor volunteers for the project was granted.
Each student went through a process that included gaining signed parental consent, enhanced DBS checks, allocation of a mentor – Maddie with our Senior Hospice Physician and Joe with the Medical Director, induction and completion of mandatory training workbooks, as for other clinical volunteers. In addition, Joe and Maddie were to keep a diary of volunteering sessions documenting their reflections on their experiences, meeting with their mentor regularly to share these and to receive feedback. We also asked them to contribute to the project report feeding back on the benefits of volunteering to the student, benefits to the hospice, what they enjoyed and the challenges, along with ideas for future workshops.
We agreed what Maddie and Joe would be doing during their sessions. There was a much greater emphasis on the medical side of hospice care compared with our usual clinical volunteers. This included handover with the medical team and nursing staff, and taking part in ward rounds and patient reviews with the hospice physician on duty and with the permission of the patient. Maddie and Joe also got to know inpatients by helping them to complete their ‘one page profile’, offering beverages and assisting with meals, talking to patients and assisting with activities in the Creative and Support Therapy Department.
Both students and mentors found the experience very rewarding. Patients, their families, staff and other volunteers gave very positive feedback after meeting and interacting with the students. Here are the observations and reflections of Maddie and Joe who each completed 50 hours of volunteering over a four month period.
Benefits for the hospice
“We think the hospice benefits from having future doctor volunteers. The hospice is now more aware of the current programme undertaken by students applying for medicine at university, patients have more interaction and opportunities to talk to people and we felt we were able to support patients and their families. By taking on some tasks we were able to free up staff and more experienced volunteers to do other things.”
“The hospice will have more community involvement through schools and colleges. This volunteering opportunity has definitely raised the profile of palliative medicine at the very start of our medical careers – who knows, you may be growing your own future palliative care doctors!”
Benefits for students
“We discovered so many benefits for ourselves – this was not just a tick box exercise to say we have done some volunteering. The experience gave us a completely different perspective on medicine compared to the acute care which can be observed in hospitals. It gave us many different experiences and insights into the way in which care is delivered which can be drawn on in our personal statements and interviews for medical school.”
“We developed a better understanding of palliative care and how this differs from other forms of care (joint decision making, patient-doctor relationship, patient autonomy, holistic and person-centred care). We were able to practise and improve our communication skills through contact with patients, their families and clinical staff, and received valuable feedback and supervision from our mentors. The volunteering has made a massive impact on our personal statements and on wanting to do medicine too. We think our chances of getting into medical school have increased.”
What we enjoyed most
“Having the chance to witness and be part of the amazing team at East Lancashire Hospice – as many people who come to stay in the hospice are very ill, it was surprising to see how positive their views were on life after maybe only being in the hospice for a few days.”
“Learning different skills by watching how staff interacted with each individual patient and having the opportunity to talk to patients, helping them and hearing about their experiences in the hospice. Working alongside a medical team and witnessing the way the IPU operates with the network of staff, keeping of patient records, maintenance of charts and drug prescribing, and patient confidentiality.”
The challenges we experienced
“Seeing family members being extremely upset when coming to terms with the fact that their loved ones were deteriorating fast was a challenge. Although we found this difficult, we have now learnt that this is something that a doctor comes into contact with very regularly, and we have learnt that as well as treating patients, doctors must also help family members too, who may need support and therapy for the pain that they are feeling mentally. Seeing patients at the end of their life and witnessing the deterioration of patients who we got to know over a period of time was also a challenge.”
“It was a challenge to hear patients speaking of actively wanting death due to their pain and discomfort but we also saw what could be done to alleviate their pain and distress. We saw high emotions in a number of different scenarios and this was a challenge too.”
Conclusions and next steps
The project was a success for the students and the hospice, and developing a formal programme for future doctors will be worthwhile.
With Maddie’s experience of her sessions at Preston and both Maddie and Joe’s observations during their time volunteering with us, we were able to come up with a list of topics to explore in interactive workshops. These include why you want to be a doctor, communication skills, dos and don’ts e.g. how to break bad news, confidentiality, ethics in healthcare, dealing with death, official bodies involved in healthcare (CQC, NICE, GMC etc), and managing stress/emotions in this field of work.
Now we are working on an action plan to establish a formal programme for future doctors. The plan includes communicating with local colleges and schools, considering how many students we can accommodate, deciding on the application process, deciding on the selection process if applications exceed places and agreeing the time frame for completion and date when future doctor volunteers can start.
For more information visit East Lancashire Hospice