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Nurses are being urged to think about the importance of time to older patients

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A poem has been specially written by a nurse in order to draw attention among health professionals to the importance of time to older patients.

The poem, called the Last 1,000 Days (see below), was written by nurse and creative artist Molly Case and commissioned by the chief nursing officer for England Professor Jane Cummings.

“There are few people for whom time matters more than patients, especially older patients”

Jane Cummings

It tells the fictional story of an elderly woman while she is treated in hospital and her subsequent discharge, through her own eyes and words, noting how pleased she is to return home.

Ms Case introduced a video featuring the poem for the first time in public on Tuesday to an audience of senior nurses at the CNO’s annual summit in Birmingham.

It is based on the concept that patients’ time is the “most important currency in healthcare” and that this is especially true for older patients who may have entered the “last 1,000 days” of their life.

360 Health Care

Nurse’s poem highlights value of time to older patients

Brian Dolan

A booklet with the same name was also launched at the event, urging senior nurses to adopt the TODAY care model, which is based upon the same principles around adding values to people’s lives.

The acronym TODAY – standing for time, ownership, diagnostics, action and you – was originally coined by Professor Brian Dolan, nursing academic and chair of the consultancy firm Health Service 360.

Writing the introduction to the booklet, the CNO said “There are few people for whom time matters more than patients, especially older patients who have fewer tomorrows than yesterdays.

“Thinking about this time in the context of the last 1,000 days helps us focus on what is the most important currency in healthcare, time and more specifically patients’ time,” she said.

“The Last 1,000 Days [booklet] sets out how we all have a part to play, how together, we can recognise and tackle the challenges patients face,” said Professor Cummings.

Molly Case

Nurse’s poem highlights value of time to older patients

Molly Case at RCN Congress

She added: “It draws attention to where time is wasted, the questions to ask, what might be done differently and it shares some real successes.”

The CNO highlighted an example of valuing time by encouraging patients to “get up, get dressed and get moving” – an idea called #EndPJparalysis – that she said enhanced both dignity and outcomes.

Speaking at the summit on Tuesday, Professor Cummings said: “I believe poetry can make our hearts sing, even the most cynical amongst us.

“I have, with many others been supporting the last 1,000 days, the idea created by Brian Dolan as a currency that connects in purest form with our values, and it’s an area where we do lead change and add value as we remind ourselves and others of the influence and impact we do have on peoples experiences and lives,” she said.

“So I have commissioned a new work of poetry by Molly Case,” she said. “Molly is a remarkable poet, a spoken word artist, and a nurse, and her words reflect on the last 1,000 days of a person’s life. Those last 1,000 days are sacred.”

She added that she had been partly inspired to commission the poem and accompanying film by the late Dr Kate Granger who launched the #hellomynameis campaign.

“Kate was an inspiration to many, not least our profession in helping us to focus on personalised care, and also an inspiration to focussing on just how important the last 1,000 days of life are,” said the CNO.

“Kate was just 34 when she died last July and we miss her. I’d like to dedicate this poem to the memory of Kate and to you all; the nurses, midwives and care staff of England,” she said. 

Ms Case, who currently works at King’s College Hospital in London as a cardiac nurse, achieved national recognition in 2013, when she performed her poem Nursing the Nation at the Royal College of Nursing’s annual congress.

The Last 1,000 Days by Molly Case

“These days slip away like coins into a slot.

I sit here; the person, the life, the woman that time forgot.

Caught between hospital bays and grey rooms that speak nothing of the life I’ve had.

 

Molly Case

Nurse’s poem highlights value of time to older patients

“These days, these days, always in my memory;

Post Office and tea dance reverie. But recently, hazy as hospital wards become mazes,

and I am amazed at all the ways I am lost when once I was so found.

 

“When we kissed so hard we felt the ground move, these days, spent on the windswept, salt-slapped dunes by the bay.

These days that seemed to go on until the horizon line, where the sea, the sun and the moon aligned

and we were just part of it and we danced in the shallows that had never felt so cold.

Until now, because these blankets are thin and my skin has not felt your warm palms in years.

 

“In here kind faces come and go but the wait spreads out,

slow and unknowable ahead these days are spent staring at walls and lying in bed.

 

“Today they say an investigation is needed:

why your heart is filling with water.

A wheelchair comes, another hospital porter who whistles old Nat King Cole songs

and I sing along, all of the words that once made me strong.

These days, these days that now all blur into one.

 

“But then a nurse comes in and says:

Hello, my name is Kate and together we’re going to get you home soon.

I think of the dunes, the moon, and you forever framed photographs in my front room,

soon to be back again, as Kate goes on to explain:

 

“We’ll get this referral sped up the results of the scan on the way

so that you don’t have to waste any more time sitting here today

these days are yours that we must help look after

let’s see if we can get your medication ordered just a little bit faster.

 

“The staff are remarkable, always here with me yet all so busy I wonder if they forget

I don’t have all the time in the world.

But today something has shifted, no longer the woman that spends time in bed:

my life is a horizon line still unfurling out ahead.

 

“And it leads me home to my garden,

‘When I Fall in Love’ drifts down the path a single sparrow flies past sits on the ledge and watches me knees muddy, cup of tea growing cold:

and I rise up, no longer old nor the woman who waits but grown strong from love songs and long days spent in the sun,

and stronger still from all those days yet to come for they could be the most precious yet.

So thank you for helping me to spend them well it’s something I will never forget.”

  • 2 Comments

Readers' comments (2)

  • I am a nurse with the elderly and I do not like this poem. Unlike Molly's first poem It is well meant but it lacks authenticity- I do not believe it. I do not believe in Molly as an elderly care nurse. I do not believe that any of the people at CNO conference have nursed a group of older people for at least 10 years! Get real. It is a vehicle to sell the CNOs idea and not a message that resonates with me or the people I care for. Please don't patronise older people or the nurses working with them with this "Clintons Cards" illusion. Molly is a more talented poet than this.

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  • This is just as nauseating as her first attempt. Makes me angry when I read it for the very reasons given by anonymous above.

    Commissioned by Jane Cummings? hasn't she got anything better to do? It would be interesting to see the brief.

    I'm not sure Molly should be either a nurse or a poet to be honest.

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