Helen Brewerton moved back to Trinity Hospice after leaving to join King’s College Hospital four years ago. She explains why she couldn’t keep away
When Helen Brewerton arrived at a Roehampton council estate to visit a woman in her 80s who was terminally ill, she didn’t expect to find a glamorous woman with beautifully kept hair, painting her fingernails. But while working as a nurse at Trinity Hospice in Clapham, London, Ms Brewerton found that a lot of her assumptions about death and dying were challenged.
“She had cancer and yet she always made sure she was glamorous,” Ms Brewerton recalls. “I was so upset when her husband called me to say she had died suddenly. She’d made such an impact on me. I’d wanted to spend more time with her and take care of her.”
Being able to make home visits is something Ms Brewerton most values about her job, having started her career as a junior gynaecology nurse and quickly becoming tired of the “conveyor belt nursing” she saw there. She joined Trinity in 1998, first as a nurse looking after inpatients, and then doing home visits as a community nurse.
“Sometimes the patient wants to tell you about their life and when you walk into a person’s home their life is there in front of you,” she explains. “But in a hospital there’s not so much of them there… The good thing about community [nursing] is you’re in their home, they’re in charge and they can tell you their story.”
The desire to deliver personal end-of-life care is also the exact thing that drew her back to Trinity in January, after she left there in 2009 to join the palliative care team at King’s College Hospital, London.
At King’s, where she was often assigned patients who were already extremely sick, Ms Brewerton found acute palliative care was like a “completely different profession”and she struggled to spend much quality time with her patients.
“I sometimes thought, what can I do here? I didn’t always meet the patient’s family and it felt very much like firefighting. I had to completely change the way I looked at my approach to care. I had to almost undo what I’d learnt.”
While there, she learnt a huge amount, broadened her skills and studied for a Master’s degree in palliative care alongside her work. Realising that her heart was back in the community, she took the decision to apply for the position of team leader at Trinity, the place where she says she “grew up” in her career.
In her new role as a community nursing team leader Ms Brewerton works with local services to determine need in the Wandsworth area, working closely with local GPs and St George’s Hospital. Her role includes a lot of “external liaison”, which means often joining up services for her patients, who can feel overwhelmed.
In addition to this, she continues to carry out the home visits that are so important to her and has 15 patients on her caseload. She makes around three home visits a day and spends anywhere between an hour and an hour and a half supporting her patients - although this can be longer if she is meeting them for the first time.
“Sometimes I think we must be slightly unhinged to do this job,” she says. “But it grounds you as an individual. I think to myself: ‘I’m not going to moan about the weather, I’m not going to moan about sitting in traffic.’ My patients are facing dying from the moment I meet them and working with them shapes you as a person.”
People often tell her that her job must be depressing, but Ms Brewerton disagrees. For her, the single most inspiring thing about her work is the “absolute resilience” of her patients and the fact that many of them approach the end of their life with both composure and tremendous inner strength.
“The people I work with are often extremely strong - not physically, but psychologically strong,” she says. “And if I could help in any way to demystify end-of-life care, then I would be happy.”