“If you can make a difference to someone you only get a chance to meet, you’re doing something right”
Anna Office is a Marie Curie Nurse based at the fast-paced Northumbria Specialist Emergency Care Hospital in Cramlington. She works with a mix of Marie Curie and NHS staff as part of the Marie Curie @Northumbria Palliative Care Hospital Liaison Team, helping patients by managing their pain or other symptoms, offering psychological support and getting them discharged to where they wish to be.
The Northumbria hospital at Cramlington is specialist hospital dedicated to emergency care. It treats the most seriously ill people, with patients staying on average two to three days. Every bed in the hospital is an emergency bed and we see people who have all kinds of complex palliative care health conditions. Every day is different and I’m always learning something new.
I’m a Band 6 nurse, employed by Marie Curie but working within the NHS trust. There are currently 10 of us in the team, including a consultant, working across three hospitals.
We see a high number of patients with long-term conditions such as cancers, respiratory diseases, multiple sclerosis, motor neurone disease, dementia, stroke and Parkinson’s. Some people come in because their disease has progressed, and their care needs have changed from being curative to palliative. Others have had new diagnoses.
Most of the time we won’t have met the patients before – they’ll be new admissions. Referrals come from lots of different sources; we’ll get phone calls from the wards, or from the community Macmillan nurse, the GP and sometimes, the A&E team.
When a patient is referred to us, we'll do a holistic assessment which covers their physical, psychological and social needs. The majority of our work is in symptom and pain management, psychological support and rapid discharges.
If there’s a late admission into A&E, I’ll go and meet the patient and treat their symptoms while I’m there. Sometimes we can solve their problem and get them back home at that point.
I could see as many as 10 people in one day. I'm passionate about doing my best for my patients. We’re all very patient-centred.
Getting people home quickly
If someone’s being discharged home, we work with the Hospital to Home team to make sure they have the right care and equipment in place. We try to anticipate everything that could happen.
Often we go in the ambulance with a patient and meet the district nurses at the other end to do a handover. We’ll support patients in transporting their medication with them, especially if it’s on a weekend, and give them the out-of-hours number. Marie Curie now has a rapid response nursing team in North Tyneside, so we provide a handover to them too.
We’ve got a good understanding within our team. I could be on my way to work and be contacted with a message saying: “You discharged my husband home last night, and he’s been agitated all night.” And I’ll pass the hospital and go straight to the patient’s house.
There’s the flexibility and freedom to do things like that. The nice thing is that, although there's a structure, it’s very supportive. So if one of my colleagues wants to do a home visit, I’ll step in to cover for them.
Important but difficult conversations
In this role, you’ve got to have good communication skills and the confidence to talk to people you’ve never met, at the worst time of their lives.
I saw a gentleman recently, who came in with a chest infection, had a scan and was diagnosed with lung cancer. He was deteriorating quickly so I spoke to his family and explained the situation. They later thanked me for my support. I think if you can make a difference to someone you’re only going to get a chance to meet and build up a relationship with in half an hour, then you’re doing something right.
It’s also about helping patients and their families to have difficult conversations. You need to be able to have that open discussion and say: “This is where we’re at now. What would be important to your loved one?”
For me, the best bit is feeling that I’ve managed to support a family and met somebody’s wishes. We tailor care to every person, because everyone is important.