As the home of the modern hospice movement, St Christopher’s has been a beacon for new research and insight into palliative care practice. In a new role, supported by the National Institute for Health and Care Research (NIHR), our nurse Sarah Combes will be pioneering research at both St Christopher’s and across the hospice network.
Sarah is the first ever hospice or palliative care practitioner to be awarded an NIHR Senior Research Leader Nursing and Midwifery programme place, but it’s not something that daunts her.
In fact, she’s used to being the first to reach milestones as she was the first in her family to go to university. Now, she is a specialist palliative care nurse and holds a PhD, MSc, BSc and is writing St Christopher’s new research policy.
“Working as a nurse, I can make a huge a difference to the person in front of me and their loved ones. But when I qualified, I quickly realised I could make a bigger difference as a clinical academic nurse,” she says. ”With research we can really make an impact on thousands of people at once.”
Opportunity and variety are partly what attracted Sarah to nursing. Previously, she worked as Head of Education and Training at an awarding body. While she loved the role, it could at times be pressurised, and sometimes felt that decisions were a matter of life or death.
“I thought I may as well deal with life and death in actuality,” she says.
“When I was training I was drawn to palliative and end of life care. It immediately made sense to me,” she says.
“It’s holistic, it’s about the person and all those people and issues that are important to them and it’s also about what is concerning them in their lives, not just the part of body where the pain is.”
She joined St Christopher’s after qualifying and worked on the hospices in-patient unit before leaving to complete her MSc. She then completed her PhD and returned to the organisation’s Community Team.
Her PhD focused on developing a behaviour change intervention to support health and social care professionals to better instigate and support advance care planning with older people living with advancing frailty.
“It’s about what matters most to that person. Working with the people themselves and seeing that through to the end,” she says.
As part of the research, she spoke with many older people about advance care planning. One gentleman has stuck with her.
“He told me that it was only by me calling to arrange the interview, and asking him to complete the consent form, and by visiting him in his own home and taking part in the interview, that he really understood what advance care planning was,” she says.
“And then he just sat there and dictated the whole of his advanced care plan to me,” she adds. “I had to sit there and not get overly emotional watching his wife in the background, crying quietly in the corner while he just spoke enthusiastically on what was the most important thing to him in his life, about his wife and his family.”
Not only did the research help develop the behaviour change intervention, and lead to this gentleman’s clarity over his future, but it improved Sarah’s work as a nurse too.
“My practice developed by doing the research because I was having these conversations in so much depth with people all the time and having to articulate it to clinicians, non-clinicians, patients, family members, and find language that worked in different environments and community settings, and with the voluntary sector,” she says.
“I was constantly trying to broaden it to make sense to everybody.”
It also reinforced a core belief of hers around research – that it has to engage with people and take them along on the journey.
“We need to bring everybody along and support people to make their own decisions. And, even if their decision is ‘I don’t want to engage with this’, that’s their decision as long as it’s informed.”
What she’s really excited about in her new role is lifting up the professionals at St Christopher’s, and across the hospice network, proactively championing their work and inspiring new researchers.
One of our strategic aims at St Christopher’s is to fulfil a national and global leadership role — Sarah’s role is crucial to this.
“We have a lot of research curious individuals but, as organisations, hospices perhaps currently lack a bit of infrastructure so I’m really excited for us at St Christopher’s, and across the network, to rise to the challenge.”
If you’re interested in working with Sarah in her role as Senior Research Leader at St Christopher’s, email her on s.combes@stchristophers.org.uk
Leave a Reply