Now Ye're Talking - to a Palliative Care Nurse

volchitsa

I'm a Palliative Care Nurse, AMA wrote: »

That in itself can be surprisingly difficult though because you might arrive to a house where a person or their family have ween waiting anxiously on you, have lots of questions/problems and they expect you to have all the answers instantly.

^^ This. It just struck such a chord with me, having been on the other side of it, as "the family" doing the waiting! The amount of pressure you must be under sometimes is almost unimaginable, I really don't know how you do it. You all do such a fantastic job, it makes an indescribable difference to people's lives at a very emotional and possibly quite traumatic time in their lives.

I'm a Palliative Care Nurse, AMA

volchitsa wrote: »

^^ This. It just struck such a chord with me, having been on the other side of it, as "the family" doing the waiting! The amount of pressure you must be under sometimes is almost unimaginable, I really don't know how you do it. You all do such a fantastic job, it makes an indescribable difference to people's lives at a very emotional and possibly quite traumatic time in their lives.

Thanks again

Any more questions?

monflat

Is there any famiies/person who passed away that you remember more so than others?

If so for what reasons?


Is there any future plans to build any more hospice? In regions where there is no hospice care and people have to travel?

Lucyfur

Tell us about early palliative care. When are you assigned a palliative care nurse? Do you have to ''sign up for it'' or is it something that's automatically assigned when your illness reaches a certain stage?

And you've spoken briefly about non cancer patients. Is there another illness that's prominent in your work? Do you work with people with Cystic Fibrosis or Motor Neuron Disease?

Dubl07

I'm a Palliative Care Nurse, AMA wrote: »

Thanks again

Any more questions?

Other people have alluded to MacMillan nurses in the UK. Do you ever get a chance to do stints with them or other such organisations and vice versa? Do you think it might be helpful?

(Yet more thanks for your time!)

I'm a Palliative Care Nurse, AMA

monflat wrote: »

Is there any famiies/person who passed away that you remember more so than others?

If so for what reasons?


Is there any future plans to build any more hospice? In regions where there is no hospice care and people have to travel?

I remember a lot of patients, usually they stick in your mind if they were young or had an unusual illness or symptom or their circumstances were remarkable. I can't really go into specifics obviously.

There's apparently plans afoot to build one in Wicklow, Waterford are also looking into it I believe and I'm not sure about Cavan/Monaghan and Mayo/Roscommon. Some community hospitals have beds ring fenced for "Level 2" palliative care. (There are 3 levels as outlined here http://www.hse.ie/eng/about/Who/clinical/natclinprog/palliativecareprogramme/About_Palliative_Care/ )

I'm a Palliative Care Nurse, AMA

Lucyfur wrote: »

Tell us about early palliative care. When are you assigned a palliative care nurse? Do you have to ''sign up for it'' or is it something that's automatically assigned when your illness reaches a certain stage?

And you've spoken briefly about non cancer patients. Is there another illness that's prominent in your work? Do you work with people with Cystic Fibrosis or Motor Neuron Disease?

In an ideal world, people would be referred to palliative care at diagnosis! As I said, we do discharge people from the service if appropriate, but early would demystify what we do and allow people's suffering while going through treatment to be limited by allowing time to get to know the person, build trust and identify/anticipate symptoms. As it stands however we are often only invited when it is felt that no more can be done from a treatment point of view, but it is improving and many of our malignant patients are still undergoing active treatment.

We usually receive referrals from GPs or treating teams but now and again people self-refer. Not everyone that is referred to us is deemed appropriate however. Someone who has no specialist palliative needs and is not imminently dying won't be taken as we are often though of as a last gap solution, particularly around place of care.

We tend not to get referrals for CF patients too often, they might get seen by paediatric palliative care in their hospital but to date I haven't looked after any adults with it since starting working here.

We do look after a lot of people with MND, I suppose returning to the answer above, one man stands out for me as I developed a good rapport with him and his wife and really enjoyed visiting them, even though he could be a bit tricky. I seem to find myself sometimes drawn to looking after cantankerous men, I don't know why! I think maybe it's kinda satisfying or something if you "crack" the nut and make headway with them.

Getting back on track, we look after a lot of other people with non-malignant diseases, particularly COPD, heart failure and dementia. It can be a lot more difficult for us to prognosticate when looking after these people as their disease trajectory is filled with peaks and troughs with lots of "close calls" and "this is it" moments, followed by miraculous resurrections whereas people with cancer tend to usually follow a more consistently downward decline towards the end, making it somewhat easier to identify when someone is starting to die. In either case, the earlier we are involved and the better we get to know the person, the better the outcomes are for people.

I'm a Palliative Care Nurse, AMA

Dubl07 wrote: »

Other people have alluded to MacMillan nurses in the UK. Do you ever get a chance to do stints with them or other such organisations and vice versa? Do you think it might be helpful?

(Yet more thanks for your time!)

You're welcome

One of my colleagues did some of her placement for her grad dip in the UK, it's something I wish I'd thought of doing! I am giving some thought to going over to St. Christopher's Hospice in London next year to one of the courses they offer and I'll see if I can do some supernumerary work with them to expand my horizons

monflat

Thanks for your informative answers.
Apart from cancer diagnosis is Copd dementia and heart failure the 3 main groups of conditions that utilitise palliative services?
Or which is the most common condition you see now?

Also just curious have you experienced any older nurses /health professionals that treated you differently because your a lot younger than them and of courses have such great expertise and knowledge?

Dav

I'm going to wrap this up here and say a big thank you to you all for taking part and to our nurse for her time and care in answering the questions.