Production editor Sarah Hill steps outside Nursing Times’ headquarters to spend a day at a hospice
“You can’t just tackle pain with painkillers.” That was one of the most memorable statements I was told when I recently spent a day with the nurses at St Christopher’s Hospice.
What was apparent from my time spent shadowing the preceptor nurse Rebecca Newman to talking to the hospice’s home care team is that addressing patients’ emotional needs is the key to providing high-quality care.
St Christopher’s Hospice has been running its preceptor programme for newly qualified nurses from King’s College London for about three years. It believes it is the first hospice preceptorship scheme in the country.
‘Addressing patients’ emotional needs is the key to providing high-quality care’
Jane Manns from the advancing practice team explained that a lot of hospices don’t employ new registrants because it is often felt they don’t have enough life experience.
However, Penny Hansford director of nursing at St Christopher’s felt because a lot of end-of-life care is happening in hospitals, the best place to train new nurses in end-of-life skills is in a hospice – nurses can then take those skills into hospital environments.
“If they come to the hospice for a year and then go back out into the acute setting, they’ve gained all that experience in caring for dying patients. And caring for them very well. It’s a win-win situation,” Ms Manns explained.
The skills needed to care for the dying – such as sound assessment, listening and communication skills, as well as care delivered to the whole family – are the fundamentals of nursing that are needed in any environment. From speaking to Ms Newman, it appears that hospices are an ideal place to pick up these skills:
“Holistic nursing is actually quite difficult in hospitals. At the hospice there is a culture where everyone is doing that so it is a good grounding.”
There is no doubt hospices do not face the same staffing issues that occur in hospital settings.
Recent research by the National Nursing Research Unit has found that eight out of 10 hospital nurses have had to leave care undone because of staff shortages, and the activities most frequently missed were comforting, talking with or educating patients, and developing or updating care plans.
It is because hospices are better staffed than hospitals that nurses are able to care for the whole person, including family members. As Ms Newman said: “What I like about hospice nursing compared with hospitals is there is a lot of emotional work. You get to know your patients and you work closely with the families; in hospital you rarely got to know the relatives’ names.”
Surely it is this emotional work that makes such a difference to care, no matter in what setting a patient is being nursed?
If the barrier to getting to know patients and their relatives is a lack of staff then addressing this issue would make a profound difference to general nursing.
With the recent announcement that the Liverpool Care Pathway is to be withdrawn and debates surrounding best practice when caring for those who are dying, the model of hospice care must be looked at to get this essential aspect of nursing right for all patients.
Sarah Hill is production editor at Nursing Times