On the frontline: “When someone breaks down, I hold out my arms in a virtual hug”

Categories: Care and Featured.

Jane Osborne is a Community Clinical Nurse Specialist at St Clare Hospice in West Essex. Here she shares how she’s adapted her compassionate care to the need for additional protection during the Covid-19 pandemic.

In the Community Palliative Care Team we see people from the beginning of their palliative journey so we first encounter them when they are still quite well, and we support and care for them through to the end of their journey. At the moment we are walking into their homes with the full PPE on, and it can be frightening for them because they can see what is coming, what they could be facing if their condition deteriorates quickly.

When someone is first told that they have a life-limiting illness it can be a very scary time and people need re-assurance and support to come to terms with it. When they are faced with us, in our PPE, I can’t help feeling that it makes the whole situation more scary for them. I can see that they are frightened and it presents another barrier to the person-centred care we deliver.

We’re all about touch and showing how we care and there is a barrier now. It’s so hard because the patients and their families can’t see our face, so they can’t see that I’m smiling at them, so I try to show it in my eyes. So much communication is done through the face and you just don’t realise it until you’re all covered up, but I try to make up for it by just being honest. I go in and say, ‘Hi, I’m Jane, and this is hard for me dressing like this, not being able to hold your hand and for you to see me smile at you’ and I sit so that they know I am listening to them. I think that helps them to understand that I’m still there for them; that I’m a person who is connecting with them, even behind the mask.

 I was visiting a patient the other day and a family member just broke down, usually I would have given them a hug, and I couldn’t. That was hard. But I told them that, and I gave them a virtual hug – I just held out my arms, 2 metres away – and smiled with my eyes. I got a virtual hug back too! We’re finding new ways of showing that we care.

Our care has never been more important. Even though we are behind a mask, we are someone who has come in to their lives, at a time when most of us are seeing so few people, and we can help – even if it’s just a little. We’re seeing this with our telephone calls as well, more people are calling and they want to talk for longer. We are often getting calls from very anxious people who just need to talk to someone.

Life has changed for us as nurses as well. We are used to coming back to the office and reflecting on our experiences with other nurses, to gain support. We aren’t doing that at the moment. On the days when I am in the office, covering the advice line, we only ever have a couple of other people in our spacious office due to social distancing. And the rest of the time we are working from home and visiting patients in their homes when needed.

As a nurse, I take on the anxieties and pain of my patients, and where we are now walking into situations where our patients are more fearful it makes it more difficult for us to process once we leave them. You take a little bit of their pain with you. I find it hard too. I still have my daily meetings with my managers and supervision, which help me to reflect and process these feelings, but I miss being able to talk over these things with my colleagues.

We’ve all been missing each other and it’s not until something like this isn’t there that you realise how much you value just being able to see and talk to your colleagues. Understandably we have had to change the way we support each other – we now have daily meetings on TEAMS and we also have team Whatsapp groups, so that we can give each other support and encouragement. It’s been amazing to see us coming together as a team to support each other with offers of shopping for instance when someone has been self-isolating. We’ve grown close in a different way and I don’t think this will change once the pandemic is over.

I’m so proud of everyone at St Clare for the way they have accepted the situation and just got on with it. Yes, it’s been hard, but we are rising to the challenge – each and everyone one of us is pulling together to keep delivering compassionate care, with a smile. I’ve been blown away by my colleagues in the Hospice at Home team and on the Inpatient Unit; I’m so proud of them for carrying on so brilliantly. But it’s not just the nurses and doctors either, it’s everyone at St Clare – the administrators, the housekeepers, the chefs, the facilities team – everyone is still coming to work with a smile on their face and it’s been so amazing to see.  I’m so very proud to work at St Clare Hospice.

To read Jane’s full blog, visit St Clare Hospice: Blog

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