'As a live-in nurse you have to be able to enjoy your own company'
Julie Howard retired early to work as a live-in nurse, which gives her the freedom and the funding for a gap decade of travel
You might think that working as a live-in nurse would be restrictive, but it has allowed Julie Howard to travel the world on a “gap decade”.
Ms Howard works around two weeks each month and uses the remaining time to travel the world and see friends. She took early retirement in 2011 and became a live-in nurse to fund her new lifestyle.
She qualified in 1982 after training at St Barts in London. Initially she worked on surgical wards then specialised, undertaking a cancer nursing course in Sheffield. She followed this with a district nurse course in preparation for more home cancer care then became a practice educator, continuing to work in the community.
“I never expected to take early retirement. I was hoping to stick it out in the NHS, but the NHS I joined no longer exists,” Ms Howard says. “It was difficult to leave; there was a huge sense of loss. It felt like a huge thing to do.”
Ms Howard now works for Consultus Care, a private live-in nursing company. “They were thorough with their selection. The interview lasted about two-and-a-half hours, which was mostly us sharing our expectations,” she says.
The skills required for live-in nurses are no different from those for other types of community nursing. Being able to adapt to each client’s environment is key.
“You have to accept that there are non-nursing duties that need to be done,” says Ms Howard. “I often have to do cooking and cleaning, but I’ve never felt I was being taken advantage of.”
A solid grounding in nursing skills is needed, as is the ability to quickly refresh skills such as managing ventilators and parenteral feeds.
The working schedule for a live-in nurse is different, too. Nurses work from 8am to 8pm every day for two weeks, though sometimes they stay on longer to care for patients who are approaching the end of their lives.
“You obviously have to be flexible because sometimes the patient needs additional care,” Ms Howard says. “We put the patient first. There are times when it would be wrong to change a patient’s nurse, so we stay on for a few days.”
The biggest adjustment is being on your own. “When you’re working in a hospital and something goes wrong, you can shout. You can’t do that as a live-in nurse,” says Ms Howard, although she is quick to stress that there is a good support network.
“You have to be able to enjoy your own company,” she adds.
Live-in nurses have to access all of the equipment they might need through the community nursing team.
“It makes no difference whether you’re in hospital or out in the community. There is really no excuse not to have the things a patient needs,” she says.
Occasionally, live-in nurses are treated unfairly by community nurses. “Once a staff nurse shouted at me for giving an injection. I had to let her have her moment and finish before I asked: ‘Don’t you know who I am?’ People sometimes think you’re a care worker. Usually community nurses are brilliant, but you do run into prejudices.”
Ms Howard says it is sometimes odd being away from family and friends for two weeks, but the long hours have less of an impact on her home life than might be expected.
“When I’m away I’m away, but when I’m back I have more free time so I actually see my friends more than I used to,” she said.
Ms Howard has lots of experience working with patients at the end of their lives and says she takes solace in the fact that, as a live-in nurse, she can make sure she is giving them the best care, enabling them to achieve a natural death at home with their family as they wished.
There is a shortage of live-in nurses. Ms Howard found out about the role in the Royal College of Nursing bulletin and says that, although she was nervous at first, she is well supported by the team at Consultus and now thoroughly recommends it.