A typical day for Hospice at Home nurse Lucy
8:30 I catch up on any overnight changes by checking emails and messages from yesterday evening’s on-call nurse and the night response team. A patient’s needs can change rapidly, so it’s important to monitor and adapt our care accordingly.
09:00 At the team’s daily virtual meeting we discuss existing patients and new referrals with our doctors. These meetings help us to plan the day’s schedule.
09:30 I return some phone calls to patients who have phoned in over night.
10:00 I set off for my first visit of the day, to a new patient and his daughter. I arrive early, to put on my PPE. We have a long discussion about the home support Princess Alice Hospice can provide. Communicating whilst wearing a face mask can be a challenge, but it’s clear the patient wants to remain at home. He and his daughter are relieved to know we’ll do our absolute best to support them to do so, and make sure that the coming weeks are as comfortable as possible. Later on today, I will refer this patient to our occupational therapy team. They will assess his needs for equipment, allowing him to remain independent and safe at home. The patient’s daughter is struggling and would like some emotional support from one of our social workers. Lockdown has made a difficult time even harder for families, as friends and relatives can’t pop in. She feels guilty for not being able to visit as much as she would like, so I suggest matching her Dad with a ‘compassionate neighbour’ – a trained volunteer who lives locally who can help with things like shopping. Before I leave, I tell them I’ll phone in a few days. They’re relieved when I give them our 24-hour phone number and reassure them they can call, whatever the hour.
11.30 Next I call on a patient living alone who phoned overnight worried about breathlessness. Upon arrival I re-apply PPE on the doorstep. It’s clear my patient is anxious and in some discomfort, so we discuss adjusting her medication to relieve the symptoms. She agrees to join our weekly virtual breathlessness support group. Wellbeing groups like these used to be in person at the Hospice but we’ve adapted to keep everyone safe.
12.30 Having removed my PPE before leaving the patient’s home, I check my messages before driving home. I respond to an email from a Royal Marsden Nurse Specialist about a patient who is being referred to us from hospital, saying I can visit the patient at home tomorrow afternoon.
13:00 Just time for a quick shower at home – we all do this now to reduce the spread of coronavirus.
13:15 I join a virtual meeting with a local GP and district nurse. It’s useful to share notes and arrange support for each patient as everyone is so busy during this pandemic. I squeeze in a cup of coffee and some soup during the meeting.
14:00 Another virtual meeting – this time with the manager of a local nursing home about a patient who is unwell but doesn’t want to go to hospital. I speak with the patient and in liaison with the nursing home and the patient’s family I agree to contact their GP and arrange a new prescription.
15:00 I complete a referral form for the patient I visited this morning – for both the occupational therapy team and our social worker. I then phone a couple of my patients to see how they’re doing. That reassurance really makes a difference.
17:30 I usually finish work around now but today I’m on call until 9pm, ready to advise and support anyone who contacts us during the evening – being there for them, whatever the time, means so much.
21:00 I hand over to the night response nurses. It’s great to know that they’re there to support patients at home as most people’s anxiety is worse at night time, when it’s quiet and dark. I handover a couple of patients who may need calls or visits overnight. My day is over, but it’s hard to switch off!