"I ask my patients about what they want - before and after their final moments"
Clare Horgan is a Marie Curie Nurse who values the autonomy of her patients. She spoke to us about starting tough conversations, the misconceptions people have about caring for people living with terminal illness, and remembering what it’s like on the other side of the uniform.
I’ve been a Marie Curie Nurse for eight years, and I couldn’t imagine doing anything else. Before becoming a nurse, I was in restaurant management working abroad for 14 years, until – like a lot of people – I lost somebody to cancer. I had such a positive experience with the nurses who cared for my loved one; they determined my path for me.
Myths and misconceptions
One of the most common things people say to me when they find out I work in palliative care is “I don’t know how you do your job, it must be so depressing!” I’ve had the most amazing conversations with people off the back of that though, and once you start a conversation about it, people understand.
We’ll talk about how rewarding it is to help make sure people are where they want to be at the end. I explain that as a nurse, you’re in a position to help guide the patient to the point where they’re ready to accept that they’re dying, and ask “Is there anything in particular that you would like me to do for you once the moment comes?” It’s the person’s final piece of autonomy.
False teeth and final moments
When you’re caring for someone in their own home, it’s even more important to talk about what they’d like us to do in the short term once they’ve passed. I cared for an elderly lady once who liked to keep herself well groomed and for her, the thought of being taken out of her house on her final journey without her teeth in was horrifying!
I promised her that when she died I would put her teeth back in, and I did. I remember her saying “I’d never go outside my house without my teeth in, so why would that be different when I died?” Things like that are important, and they’re part of having that autonomy and the ability to make that final decision.
“On the other side of the uniform”
As a Marie Curie Nurse, you’re entrusted with a lot of responsibility and people are placing a huge amount of trust in you. I think it’s important to remember what it feels like to be on the other side of the uniform, and you need to take that into you’re working practise every day.
This is especially so when you meet a patient whose family have been caring for their loved one for months or years. You need to remember that in some cases if you’re there, they’ve had to admit that they can no longer cope. No one knows the patient better than the family or person who cares for them, and as nurses we respect that.
You can help support the vital work that nurses like Clare carry out to help people and families affected by terminal illness, and a gift of just £20 will pay for an hour of dedicated nursing care.